Working in partnership in health and social care

Working in partnership in health and social care

Oxford Dictionaries (2016) defines partnership as an association of 2 or more individuals as
partners. These partners can be healthcare professionals that are supposed to use humanistic
partnerships in empowering patients through use of person centred care (McCormack, 2004).
Howarth et al (2012) further elaborates that to provide care for patients, professionals require
a collaborative approach that is composed of social workers, nurses, doctors, physiotherapists
and so on. All these professionals make up an inter-professional working group that share a
team identity and are working in an independent and integrated manner (Reeves, 2010).
The NICE Guidelines have stipulated that all healthcare professionals working in
partnership must abide by the 6C’s which are care, compassion, competence, communication,
courage and commitment (NHS: 6Cs, 2012). Care states that all healthcare professionals must
deliver care to individuals that will benefit them and the entire community. Compassion is
responsible for showing that the care that professionals give to individuals is based on
relationships modelled through respect, dignity and empathy between the individual and
them. Competence shows that those responsible for delivering care understand an
individual’s health and social needs. Communication is paramount to creating trusting and
caring relationships by involving the patient in decision making about their care. Courage
allows us to speak up when we identify concerns we may have about an individual.
Commitment is responsible for committing to providing care to these individuals.
Patients need to be empowered by healthcare professionals that are providing them
with the information that will enable them to make informed decisions. When a professional
is working with a patient, they need to give all relevant information to a patient for example,
educating a patient about their disease and what to do when there is an exacerbation of their
chronic disease. Patients have rights to be independent and free to make a decision without
coercion. This includes the patient being able to make these decisions autonomously. The
decision of a patient must be respected as this is their wish and according to Human Rights
Act (1998), everyone has a right to be treated fairly, with dignity and with respect.
In partnership working, power should be shared between the patient and other
healthcare professionals. A decision that involves a patient will need to be made with the
patient being involved and having an opinion on it. This eliminates the situations that may
arise that have resulted in a treatment or care package for a patient being made without the

WORKNG IN PERTNERSHIP IN HEALTH AND SOCIAL CARE 2
patient’s knowhow. Sharing of power allows decisions to be made jointly between a patient
and the multi-disciplinary team.
Task 1.2
Majority of the patients admitted into this elderly medical ward will need to be seen
by a doctor, a nurse, physiotherapist, occupational therapist, dietician, adult social care and a
pharmacist. These healthcare professionals do not always see the same patient together. They
go individually to introduce themselves and interview or ask the patient a set of questions.
From here on, a relationship is created between a healthcare professional like a doctor and the
patient. The patient is unwell and in need of help. The doctor is employed by the hospital to
help admitted patients by treating them.
Strategic partnerships are formalised agreements that are made between the
Department of Health and the voluntary sector. The department of Health currently has 21
Strategic partners that it is working in partnership with. These voluntary organisations receive
funding from the government for a specific service that it provides to the public. For elderly
patients about to be discharged, Age UK is able to provide support to these patient’s in their
own homes. They offer services similar to day centres and lunch clubs, handyperson schemes
at home and provide information and advice. Inter-professional working is about healthcare
professionals understanding the roles of other healthcare professionals in the same multi-
disciplinary team. This understanding ensures that the healthcare professionals in a
partnership have a perspective of roles of other healthcare professionals. The professionals in
this partnership can be social workers or physiotherapists that will have different perspectives
on an elderly patient about to be discharged. Inter-agency working is slightly different to
inter-professional partnership because it involves organisations rather than professionals. For
an elderly patient waiting to be discharged this might involve the ambulance transportation
service, local council or community service all ready to provide a different service to a
patient.

The voluntary sector also works with the healthcare sector in providing a service to
patients. St Michaels Hospice is a charity that provides holistic care and support to all those
affected by a progressive life limiting illness in Hastings and Rother (St Michael’s Hospice,
2016). This hospice provides respite care in their inpatient unit and also provides a service for
patients in their home. The hospice works in partnership with the local hospital and the

WORKNG IN PERTNERSHIP IN HEALTH AND SOCIAL CARE 3
community in accepting referrals at no charge. The charity relies on donations to operate its
service and also gets a grant from the government to pay for its operational costs. The elderly
patient in the medical ward might be admitted in hospital after sustaining falls. There are
services in place that help prevention of falls by minimizing the risk. This involves an
assessment by the Occupational Therapist on the available equipment for the patient and how
the patient can easily access it. The physiotherapist will also be involved in falls prevention
by conducting a stairs assessment on the patient if they have stairs in their house.
The local hospital trust runs a programme that reduces the number of re-admission for
local patients. The programme is called Early Intervention and particularly benefits people
with long term conditions such as dementia. This programme is run in partnership between
the local council and the local NHS trust. The partnership between these two organisations
was put in place to reduce hospital re-admission and also to allow elderly people with
dementia to be nursed at home until they die. This domiciliary service supports people in
their homes through carers who visit the patient at home certain times a day to help with the
care. The cost of providing domiciliary care is much less than the cost of a hospital admission
unless it was absolutely essential that they get admitted for treatment.
A model is a description or concept of a system or set of observable events that
accounts for all its known properties in a reasonable way (Oxford dictionary, 2015).
Coordination model identifies individuals with multiple needs and integrating coordinated
services to ensure achievement of life objectives and improvement of health. Researchers
have it that majority of individuals with chronic illnesses struggle with social problems such
as homelessness, social isolation, mental health and substance abuse. Such individuals
experience difficulties in accessing fragmented and complex health care system. Therefore,
healthcare providers should recognise the need for better coordinated care. Care coordination
has several benefits for individuals with multiple needs. A community where healthcare and
housing providers have partnered together benefit in terms of costs, increased management
with self-care and preventive care and reduced health care cost.
Organisations that are in partnership should ensure they have separate and different
legal entities. A virtual entity which offers an interactive opportunity for the two
organisations is then created. In addition, partnering institutions should mobilise the
resources such as human and financial resources which are significant in proper
collaboration. Consequently, a committee should be made to ensure effective planning,

WORKNG IN PERTNERSHIP IN HEALTH AND SOCIAL CARE 4
control and coordination of activities between the partnering institutions. According to John
and Helen, 2010 this committee should not be biased to any party in partnership.
Task 2.2
There is legislation that ensures that delivery of care is provided for under safe
conditions. The employers in the partnership have to employ people that will be able to
deliver the organisations objectives with the necessary skills and knowledge.
The Health and Social Care Act 2012 was introduced to move the responsibility of
social care from Primary Care Trusts to GPs. This frees up providers of Health care to
concentrate more on innovation and it gives the responsibility of commissioning to clinicians.
Previously the PCTs provided this healthcare to its citizens and was made up mostly of
administrators. At the moment, the legislation required that clinicians run this service by
forming Clinical Commissioning Groups (CCGs). The GPs will be able to plan for care of
patients because they are best placed to know the care these patients require. The GP’s have
control of the majority of the NHS budget. These CCGs are able to detect how much money
will be spending through which type of services will be made available in a specific area. The
NHS tariff system costs different types of treatments and this are how the NHS provider will
be paid according to what treatment they performed. The private health providers also offer a
tariff system and can take NHS patients and provide a service especially when the NHS
provider has a backlog. This legislation ensures that the private and public sectors can work
together in partnership.
The Community Act of 1990 AND Health Act 1999 regulates provision of health and
social care services. They therefore advocate for mutual benefit of organisations in
partnership.
The Care standards Act 2000 replaces the Registered Homes Act 1984 and aims to
provide administration of children’s homes, residential homes, nursing homes and
independent hospitals. This legislation provides tools for inspection of all above mentioned
institutions in making sure that there are adhering to the legislation. They are inspected
against National Minimum standards that mainly focus on the environment that these
institutions have to create for its service users. When it was first introduced, many nursing
and residential homes could not be compliant to the standard and they ended up closing
down. This had an impact on the NHS providers because they were the only ones capable of
looking after these displaced service users whilst a home for them was being looked for. This

WORKNG IN PERTNERSHIP IN HEALTH AND SOCIAL CARE 5
also increased the cost of care for these service users because the home owners had to invest
more money on infrastructure to become compliant with legislation and they passed on the
cost to the service user. As of 01/04/2009, the Care Quality Commission was formed and it
took over the responsibility of inspection in health and social are in England and Wales. The
CQC has extended its role by also inspecting services provided by the NHS and local
authority. It’s also protects the interests of people detained under Mental Health Act (2007).
Mental Health Act, (2007) made provisions for detaining and treatment of people with
mental health problems in England and wales. It also broadened the role of mental health
professionals by extending the roles they can play in treating patients without their consent.
The act affects the liberties of some people regardless of their location. They could be in
mental health hospital or in a medical ward, the act can reach them.
Task 2.3
Collaboration in Health and Social care allows patients to be best served according to
their needs. Not all services will be provided for a patient by one institution. Therefore, it
calls for involvement of two sectors to ensure maximum positive impacts. In the case the
patients with chronic illnesses, when they are being discharged, the Community nursing team
and the GP might needs to be involved to ensure the patient is supported at home. Home
based care ensures that the discharged patient maintains good health. Most patients who are
offered home-based care include the elderly or even those with chronic illnesses.
Many partnerships may have broad aims that have been agreed upon but their detailed
goals might not be the same as those of their collaborative partners. The interpretation of
these goals might also be misunderstood which may result in partnership conflict. This can
include things like criteria for patient each partner has. One partner might only look after over
75 year olds whilst the other might only look after any adult age but with a specific long term
condition like diabetes.

Task 3.1
Organisations that are in partnership in health and social sector ensure increased
patient satisfaction. The satisfaction is often contributed by the increased ability of the
involved parties to offer coordinated and high quality services to the users. In partnership,
service providers are at better position to get training through conferences and seminars

WORKNG IN PERTNERSHIP IN HEALTH AND SOCIAL CARE 6
which increases knowledge and skills in their area of specialisation. Health and social care
partnership enhances provision of a broader range of health issues which ensures the needs of
the patients are dealt with effectively.
Partnerships aim to offer patients empowerment, independence, autonomy, respect,
power sharing and help patients make informed choices. Empowerment aims to allow sharing
of power between the patient on the ward and the services that can have in the community
when discharged from hospital. Healthcare professionals need to promote independence in
patients (Ewles & Simnett, 2011). This includes financial, physical, psychological and
emotional independence. Partnerships need to minimize dependency caused by illness by
providing treatment. Partnership is cited by Cooper (2010) as a key component in the
successful management of long-term illness. Barlow et al (2000) concurs by stating that self-
management produces better outcomes for patients.
In order to improve partnerships, barriers to effective working need to be identified
and removed. This can involve identifying areas where services are being duplicated or where
the services are overlapping. As per our scenario, the discharge process needs to be effective
and ensure that the patient is supported when they are sent home. The patients in the scenario
are elderly and might be living alone at home and in need for a home package of care when
they go back home. The nurses are patients advocates and are better placed at identifying all
these patients needs and being pro-active about it through referrals to appropriate healthcare
professional (Nazarko, 2002). This caused and still causes bed blocking in hospitals, as an
elderly patient cannot be discharged as the Adult Social care team need to source funding for
resettlement.
Task 3.2
Barriers significantly affect the effectiveness of working partnership between two
sectors. It is often presumed that partnership increases effectiveness of the services provided
by both organisations and individuals. However, health and social care sectors partnership are
often associated with many challenges which hinder effectiveness of the partnership. To start
with, misunderstanding between two organisations working in partnership may arise leading
to misconceptions and biasness.
In addition, there may be reluctance and reduced commitment towards achievement of
set gaols by a partner organisation which may lead to underperformance for instance, social

WORKNG IN PERTNERSHIP IN HEALTH AND SOCIAL CARE 7
care centre that provides home for elderly people may not fully achieve its goals due to
reluctance to admit new elderly people as a result of increased cost of living as well as
increasing in number in number of aging population. Moreover, poor coordination and
cooperation between organisations may result due to failure to share information, skills,
resources and knowledge between two sectors which are key issues in achieving laid down
goals and objectives. Finally, conflicts may arise due to roles and responsibilities of members
are not clearly stated. Similarly a conflict may arise in-case a partner organisation develops a
self-interest rather than focusing on mutual benefits.

Task 3.3
Implementation of appropriate strategies by health and social care services should be
put in place with the aim of ensuring proper management of the partnership. In order for
partnerships to improve their workings, strategies need to be put in place to address issues
that have a potential of causing misunderstanding. There should be proper communication of
the roles and responsibilities of each and every member in the partnership to enhance
elimination of role ambiguity. Working must be done in collaboration between partners. This
helps identify concerns each partner might have and these can be addressed by all parties
involved together. The partners need to identify their individual weaknesses and strengths.
When discussing together, the parties concerned will end up complementing each other were
ones weakness is compensated for by the strength of another. Partners need to acknowledge
each other expertise and this allows patients to be mostly referred to the expert thereby
receiving the best service available. Families and carers of patients need to be involved in
providing the right support for a patient. The carers and family know the patient best and
involving them ensures that preferences of a patient are made known to the healthcare
professionals. By making families and relatives as equal partners it ensures consistence of
care is maintained especially when the healthcare professionals change.
The health and social care service providers should ensure achievement of
organisational goals and objectives through increased training o the staff members. This will
require the pooling together of resources from the two organisations. Moreover, there should
be proper stipulation of policies, procedures and protocols for information sharing, skills and
knowledge to ensure maximum achievement of these goals. For instance, no partner should

WORKNG IN PERTNERSHIP IN HEALTH AND SOCIAL CARE 8
hide any crucial information that would otherwise be deemed of importance to the
organisation for the achievement of the goals and objectives.
In conclusion, partnerships of working are a big benefit to patients. They promote
patient’s independence, autonomy, empowerment, respect, power sharing and help patients
make informed choices. The healthcare professionals in a partnership must all communicate
effectively in providing a care that is suitable for a particular patient. Power needs to be
shared between health professionals, patient and the carers/family of patient. This ensures
that the patient receives the optimum care from the partnership. Healthcare professionals
need to ensure that obstacles or barriers to working in partnership are removed or challenged.
This can be achieved through effective communication, acknowledging each other’s
expertise, involving families/carers and by using jargon free communication that can be
understood by all parties.

WORKNG IN PERTNERSHIP IN HEALTH AND SOCIAL CARE 9

References

Barlow J et al (2000) Self-management Literature Review. Coventry, Psychological Research
Centre, Coventry University.

Cooper J (2001) Partnerships for Successful Self-Management. London, Long-term Medical
Conditions Alliance.

Ewles L, Simnett I (1992) Promoting Health: A Practical Guide. Second edition. London,
Scutari Press

Howarth, M, Warne, T, & Haigh, C 2012, ”Let’s stick together’ – A grounded theory
exploration of interprofessional working used to provide person centered chronic back
pain services’, Journal Of Interprofessional Care, 26, 6, pp. 491-496 6p, CINAHL Plus
with Full Text, EBSCOhost, viewed 10 May 2016.

WORKNG IN PERTNERSHIP IN HEALTH AND SOCIAL CARE 10
McCormack, B. (2004). Person-centredness in gerontological nursing: An overview of the
literature. International Journal of Older People Nursing in Association with Journal of
Clinical Nursing, 13(3a), 31–38
Nazarko, L. 2002. The impact of National minimum standards on care homes.

standards-on-care-homes/199558.fullarticle . Nursing Times. Accessed at 30/04/16
NHS: 6Cs. 2012.
Oxford English dictionary. (2015) Vol. 2. 6th ed. Oxford: Oxford University Press.
Reeves, S., Lewin, S., Espin, S., & Zwarentsetin, M. (2010). Interprofessional teamwork for
health and social care. London: Wiley-Blackwell.

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