Pathways To Integration Of Health And Social Care
“And the political arena has to step up. To take on board that it very much needs to be integrated. We've got to be much more on a level playing field, and everybody can come.”
Our respondent has more than 30 years NHS experience and leads a unit which aims to provide NHS support for Home Care Services in a large region of England. Her team includes registered nurses, occupational health and physical therapists, and administrator, plus open vacancies for Pharmacist, Assistant Practitioner and Speech Therapist. Although her team provides advice on training to home care services and builds networks to enable sharing good practices the team does not provide training to care workers, although training in clinical practice and communication were priorities she identified and worried were not being addressed. In her experience training for care providers is expensive, patchy, difficult to access and not always of good quality. Ideally she would like staff working in the care sector to have the same opportunities for high-quality, validated training as provided within the NHS for Health Care Assistants, registered nurses (care homes will usually employ one or two registered nurses), and other staff (such as occupational therapists, administrators and managers).
“I think it's certainly [lack of] access to good quality training, clinical skills training, particularly. I'm finding that that's what a lot of the homes come to us with, whether we know where they can get training from or to source that training (for them).”
Within the NHS when staff encounter a problem they can quickly get advice and support, they know who to turn to, a doctor, therapist, pharmacist, dietitian etc is available to help. The care sector really struggle to access reliable and timely expert information when they encounter something unfamiliar, and this can lead to patients deteriorating and then needing hospital in-patient care when it could be avoided, integrating the services would save money in the longer term, through better training, support and consistency of service standards.
“We've got to be much more on a level playing field, and everybody can come. The carers have got to be much more confident in in the work that they are doing [through training] and they do a valuable job, but the public needs to re-evaluate perceptions, and it is very sad they don’t, because they do a wonderful, wonderful job.”
An example of how the playing field could be levelled was exploring how to give care providers access to specialist nurses (Parkinson’s disease or Multiple Sclerosis for example), to provide information sessions for care staff, and then provide an easy route to referral to specialist nurses when needed. Currently such a system is not in place, but if it were it would be a step towards integration of care and health services. A key barrier to integration though remains public (and by extension, political) perceptions of the care sector.
“But there's a lot of stereotypical views out there that [are] just not valid at all, around the actual public perception of social care and, actually, sadly the social carers perception of their own work as well.”
Integration of services will require political will, public backing and changes in attitude in both the health and care sectors, but, if it can be achieved the investment in time and money will pay dividends in improving the quality of care and reducing the need for expensive health interventions.