Integration of Health and Social Care

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Integration of Health and Social Carea few
thoughts from the West Country..

• Tony Gardner
• April 2004

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A few words of caution!

• Integration is not..
• An end in itself
• The solution to all problems
• A reason to distract us from doing the basics
  well.
• A quick fix to wicked problems
• A capitulation of one culture to another
• Assimilation

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but it should help us to..

• make good the failings of the present system,
  improve the quality and consistency of services
  and increase efficiency across the board. The
  N.H.S. and Social Services will work more closely
  together and so provide proper integration of
  treatment and care. These reforms mark a new
  beginning for mental health provision

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and it does present opportunities

• To correct some of the failings of the past
• To meet Service User and Carer demands for better
  services and.
• .for better outcomes!
• To remove unhelpful barriers
• To get rid of old excuses
• To work towards Whole Life services
• To offer greater social inclusion

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.and

• To develop a force for improvement,
  strengthening, cohesion and dynamism in mental
  health
• As a means to drive out
• Cost Shunting
• Patrolling agency boundaries
• Buck Passing
• Theological' posturing
• .and other bad habits!

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..whilst giving a better chance of

• delivering national policy
• getting the best of both worlds
• responding to local pressure for better joint
  working
• delivering local commissioning intentions
• improving services
• delivering NSFs
• putting service users and carers at the heart of
  our work

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better outcomes for Service Users

• By challenging traditional assumptions about
  choices and services
• By recognising that users want whole system
  solutions to problems
• By ensuring simple systems for gaining access to
  a wider range of services.
• By building structures that involve and empower
• By promoting their citizenship,recovery and
  inclusion
• Giving people what they need, one care system not
  two

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and for Carers

• Greater involvement
• Adopting social care values for meeting the needs
  of carers
• Receiving integrated and comprehensive
  information
• Single point of access
• One care system, not two!
• Partnership not paternalism

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.and for staff..

• By valuing the best of health and social care
• (..and driving out the worst!..)
• By developing a single organisational culture,
  vision and approach
• By harnessing health and social care skills
• By giving them greater organisational influence
• By offering a more rewarding working environment
• Offering better career development

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The benefits will be maximized for all
stakeholders if.

• We are transparent, put our cards on the table
• We ensure equity of status within the
  Partnerships
• We keep it as simple as possible
• We listen, hear and act
• We keep focussed upon users and carers
• We build upon what works

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.and by ensuring that we.

• Have effective change programme management
• Find the champions and enlist the doers
• Get the basics done well
• Communicate.and then communicate some more!
• Learn from others

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Booby traps..!

• Cowboys and Indians
• Triumphalism
• Lowest Common denominators
• Talking shops slow progress
• Losing sight of purpose
• Timidity
• Loss of ownership

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. and ambushes

• Watch out for lawyers and Accountants!
• Bungee Managers
• Power and Influence
• Professional anxieties and second thoughts
• Cultural Collisions
• Personal rivalries
• Not getting stuck in!

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.the two sides of the coin!

• Tribalism
• Structures
• Power and influence
• Learning from others
• Slow, slow, quick, quick, slow!

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.the Empire Strikes back!..

• Integration of values
• Social Inclusion(Social care)
• Recovery (Hope and optimism)
• Early intervention (Prevention)
• Choice (Self determination)
• Overview and Scrutiny (Local Democracy)

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..and keep reminding ourselves..

• Improvement more than structure
• Hearts and Minds
• Users will tell us when service outcomes are
  right
• Partnership means action and change
• Its really exciting and can make a real
  difference to people

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.and the future?

• Integration is merely the beginning of a process
  to ensure that we respect the whole lives of the
  people we work with. Whole systems work best
  when planned and delivered with and accountable
  to local communities.Perhaps we can move beyond
  the notion of Foundation Trusts to genuinely
  Co-operative and Mutual ways of working.