Knowing me, knowing you

Abstract

Purpose – The purpose of this paper is to report on the findings of the first stage of a project seeking to improve interprofessional working between general practice and adult social care teams. It develops the current evidence base through findings from focus groups and reflects on the implications of the findings for interprofessional collaboration. Design/methodology/approach – The project involved running seven focus groups with general practice staff and adult social work teams to explore their perceptions and understanding of each other. Findings – The focus groups highlighted that the negative aspects of interprofessional working outweighed the positives. Negatives included perceptions of different value bases, a lack of knowledge about each others’ roles and responsibilities which resulted in resorting to stereotypes, poor interprofessional communication and a sense of an unspoken professional hierarchy with general practitioners (GPs) at the top leading preventing a culture of appropriate challenge. Research limitations/implications – The research has only been conducted with four GP practices and three social work teams that had expressed an interest in improving their interprofessional working. Therefore the findings may not be generalisable. Practical implications – The case study suggests that there is a lack of effective interprofessional working between social care teams and general practice. With the current health and social care agenda focused on integration, this suggests there should be a greater focus on this area. Originality/value – This paper illustrates that despite many years of policy makers promoting better integration, the quality of the interprofessional collaboration between social care teams and general practice remains poor.

Collaborate across silos: Perceived barriers to integration of care for the elderly from the perspectives of service providers

“…However, encountering barriers and challenges in the health care system regarding integrated care has been constantly reported in the literature. Among those, the poor communication barrier is a recurring theme, studies address the issues of delayed referral or low‐quality referrals, differences in terminology between service sectors, considerable medical information or too little information, and lack of information sharing as a result of limited information technology support or electronic records . Clarity of roles was identified as a prerequisite for the success of integrated care.…”

Transforming Integration through General Practice: Learning from a UK Primary Care Improvement Programme

“…English primary care is based around general practice and reflects characteristics reflecting strong primary care – is it largely free at the point of access, supports individuals from ‘cradle to grave’, acts as a co-ordinating point of the wider public health system, and has a capitated budget to support an identified patient population [456]. Despite these strengths, English general practice and therefore the primary care system in which it is situated, does not consistently demonstrated integrated and person-centred care [78910]. This is partly due to structural factors such as conflicting organisational objectives, sectorial policy priorities, and activity based incentive systems.…”

“…This is partly due to structural factors such as conflicting organisational objectives, sectorial policy priorities, and activity based incentive systems. Practice issues related to professional differences, insufficient collaborative skills and lack of system knowledge also contribute [910]. National policy priorities for improvement have therefore included co-ordinating care for those with complex needs, encouraging healthy lifestyles, and pro-actively detecting and responding to key long-term conditions [11].…”

Under the radar: General practitioners' experiences of directly employed care workers for older people

“…Neither has there been much focus on those with direct payments, meaning little is known about the implications of an expanding directly employed care workforce for health services. In particular, General Practitioner (GP) have very variable understanding of adult social care (Mangan, Miller, & Ward, 2015), so may not be aware of such developments, which are below their radar. The consequences of this are that significant sources of support may be overlooked by the GP, along with potential risks to older people.…”