Elephant in the room

Abstract

Purpose The purpose of this paper is to report on the findings of the first stage of a project seeking to evaluate and overcome inter-professional barriers between health and social care staff within a single, co-located, integrated community team. The project seeks to answer the following questions: first, Do inter-professional barriers to integrated working exist between health and social care staff at the interface of care delivery? Second, If inter-professional barriers exist, can joint health and social care assessments help to overcome them? The paper develops the current evidence base through findings from a staff questionnaire and the initial findings of a pilot study of joint health and social care assessments aimed at overcoming inter-professional barriers to integration. Design/methodology/approach The first stage of the project involved running an anonymous, online questionnaire with health and social care staff within a single, co-located community adult health and social care team. The questionnaire aimed to explore staffs’ perceptions of inter-professional collaboration when assessing the health and care needs of service users with a high degree of complexity of need. The second element of the study presents the initial findings of a small pilot of joint health and social care assessments. A second staff survey was used in order to provide a “before and after” comparative analysis and to demonstrate the effect of joint assessments on staffs’ perceptions of inter-professional collaboration at the interface of care delivery. Findings Health and social care staff value joint working as a means of improving quality of care. However, they also felt that inter-professional collaboration did not occur routinely due to organisational limitations. Staff members who participated in the pilot of joint assessments believed that this collaborative approach improved their understanding of other professional roles, was an effective means of enabling others to understand their own roles and helped to better identify the health and care needs of the most complex service users on their caseloads. Initial findings suggest that joint assessments may be a practical means of overcoming inter-professional barriers related to a lack of communication and lack of understanding of job roles. Practical implications The questionnaires highlighted the need for integration strategies that are aimed at facilitating collaborative working between staff of different professions, in order to achieve the aims of integration, such as a reduction in duplication of work and hand-offs between services. Originality/value To date, few studies have explored either staff perceptions of collaborative working or the effectiveness of joint assessments as a means of overcoming inter-professional barriers. This paper adds new data to an important area of integration that legislators and researchers increasingly agree requires more focus. Although the findings are limited due to the small scale of the initial pilot, they provide interesting and original data that will provide insight into future workforce integration strategies.

Bridging the gap between the home and the hospital: a qualitative study of partnership working across housing, health and social care

“…In light of increased research and policy interest in joint working, evidence has emerged on the practicalities, strengths and barriers of interagency partnership. In relation to health and social care, research has highlighted a number of difficulties including conflicting professional perceptions (Hudson, 2002), lack of understanding of the roles and remit of external agencies (Fraser, 2019;, struggles in delineating responsibilities (Reed, Cook, Childs, & McCormack, 2005), competing professional agendas (Drennan et al, 2005;Regen et al, 2008), problematic information sharing (Christiansen & Roberts, 2005;Ling, Brereton, Conklin, Newbould, & Roland, 2012;Sundari, Klein, McCluskey, Woolnough, & Diack, 2018), and lack of guidance for leaders and managers (Dickinson & Glasby, 2010). Similar challenges have been found in connection with housing and health (Cameron, Lloyd, Turner, & Macdonald, 2009;Cameron et al, 2007;Sharples, Gibson, Galvin, 2002) but there is a lack of more recent research exploring the impact of current approaches.…”