Working In Partnership in Health and Social Care

Working In Partnership in Health and Social Care

Introduction

The importance of working in partnership is that it facilitates development of mutual and inclusive relationship with the healthcare providers and the service users. This helps improve the delivery of care and enhances the   healthcare provider experiences. However, the process of working in partnership is often complex as it involves articulate planning and implementation of interventions within the community. Working in partnership is extremely important when delivering care to people with long-term health conditions as it facilitates the process of empowering the patients, which increases the understanding on ways to cope with their health conditions both physically and mentally. This helps to ensure that the patients’ health demands are met effectively (Paterson, Nayda & Paterson, 2012). 

 In this regard, this paper aims to explore the existing philosophies of working in partnership. The paper will also evaluate the effectiveness of partnership and collaboration within the system. More so, the paper will also explore on the existing models on partnership within the healthcare, legislations available and organization practices. This aids in describing the various policies and practices that can be integrated in healthcare industry, to promote partnership and collaboration within the industry. Lastly, the paper also aims to explore the various outcomes of working in partnership. This will include the analysis of the prevailing barriers, facilitators and strategies, which will help gain better understanding of working in partnership in healthcare.

Task 1.1

Working in partnership is a vital aspect in healthcare and social care.  Partnership refers to a shared jointness and power, marked by respect for one another, divisions of roles, accountability and individual input. Different terms are used to define partnership including cooperation, shared learning, teamwork, participation and multi-disciplinary working.  The staffs in healthcare have the responsibility to recognize the importance of promoting autonomy within the service users and the service providers.  They are not only expected to be attentive to their own roles but also learn to relate with each other’s within the within St Andrew’s healthcare facility.  This is important particularly in the view of the unrest and cynicism observed in the NHS. Therefore, it is important for those concerned about their commitment in developing a mutual relationship for the good of the service users (Soni 2014).

For this reason, there is need to explore the philosophy that facilitate the staff to work in partnership at the St Andrew’s hospital. The philosophy is needed for several reasons but the ultimate goal is to providing quality care to the service users. The philosophy ensures that there is equity, quality and efficiency in the delivery of the healthcare and social care services. The philosophy is governed by ethics- a complex activity that is concerned with the moral obligations and dilemmas.  Ethics in healthcare philosophy are governed by the ethical theories. For example, the theory of deontology is concerned with the moral duty as well as the action rightness (Petch, Cook, and Miller 2013). Therefore, this theory suggests that a healthcare staff must always do what is morally right irrespective of the associated consequences.  The other theory is the utilitarianism proposed by Jeremy Bentham, which is based on the principle of utility. Although these theories do not describe exactly on how a staff should behave, it gives the healthcare staff an understanding on how to motivate each other and pull ideas especially when confronted by ethical dilemmas and in accordance to ethical principles of autonomy, non-maleficence, justice and beneficence (Paterson, Nayda & Paterson 2012). 

 The working in partnership at St Andrew’s hospital should be governed by the partnership philosophies such as respect, autonomy, and empowerment, power sharing, and making informed choices.  The philosophy of empowerment involves sharing power with other partners who may not have the power.  This philosophy is centered in healthcare service users and providers to enable them take greater charge of themselves.  It involves the process of recognizing, enhancing and empowering other people’s ability to meet their demands and to resolve their own issues with the available resources, making them feel in control of their lives.  This enriching experience is associated with satisfaction and often leads to smooth partnership relationship (Robert& Cornwell 2011).

 The philosophy of independence is a broad concept as it includes the behavioral, psychological and socioeconomic dependency.  The main cause of dependency is disability, cultural expectations and elderly age.  Independence includes the ability for one to make informed choices about their life’s aspects.  The philosophy of autonomy must be enhanced to ensure effective partnership between the healthcare providers. When delivering services, the healthcare providers must refrain from manipulating   the service user’s environment to fulfill their interests (Greco, Webb, and Beecham 2012).

In the discourse if healthcare ethics, respect philosophy is mainly manifested to protect the patient autonomy. Therefore the healthcare providers should provide information to the service users regarding the treatment which will help them make informed decisions.  This includes recognizing the values and accepting the patient belief.  To promote working in partnership, power sharing involves negotiating so as to involve arrive at an understanding of roles as well as the responsibilities in the various disciplines.  Empowering, respecting and power sharing principles enables the partners in health industry to make informed choices (Petch, Cook, and Miller 2013).

Task 1.2

 There are various kinds of partnership relations in healthcare and social care facilities such as St Andrews Hospital. The aim of these partnerships is to ensure that healthcare services are improved and efficient. This includes establishing measures that will improve intervention and preventive care that actually meets the needs of the healthcare providers.

Examples of the partnership relationships include the strategic relationship that exists between the local authorities and the healthcare service providers whose aim is to deliver seamless services to the community. The interagency partnership relationship includes the interaction of the organization in healthcare industry including the NHS, voluntary and private organizations. These organization’s includes an interaction between the inter-professional within the same firm requires to follow the philosophies of partnership to empower them and give them choices that will improve their outcomes. This calls for collaborative communication between the different organizations working together with St Andrew hospital (Hibbard and Green 2013).

 In working with collaboration, one of the benchmark is that every partner must have common knowledge about the respective roles and acquisition of skills. According to white paper “our health, our care, our say” advocates for local authorities to have a better partnership when working with one another and in order to deliver effective services in healthcare so as they can achieve better outcomes.  The white paper has established a good framework that can be used to guide local authorities to work in collaboration. This calls for clarity of on the role of each partner so that they can work together to meet the agreed targets and goals. Patients with complex demands require integrated services from the various disciplines to perform strategic planning stage (Paterson, Nayda & Paterson, 2012). 

 The report mandates that each health care facility must establish a common assessment framework to assess the partnership.  The framework should bring together the various stakeholders including the primary cate, public healthcare and the local government. This is because establishing measures without any agreements will make the healthcare facility to lose focus and make the partners revert to their old methods, which puts other stakeholders at risk. The system should be based on formal assessment should be based on the patient needs and must be assessed on primary care trusts and local partners including local hospitals to  set  frameworks (Greco, Webb, and Beecham 2012). An example of such frameworks includes SCIE, NICE, and department of health. For example, the New horizons document describes that only robust partnerships across the public and private sector must have effect frameworks that will ensure that the necessary change has been achieved to improve effective delivery services. The evaluation platform of this report is done by assessing the outcomes needed for effective delivery of services, ability to access the healthcare facility and the general community health (Petch, Cook, and Miller 2013).

Task 2.1

The partnership models are a vital component of policy and legislations in health and social care. This implies that it is extremely very vital to analyze the partnership across the across the healthcare disciplines. There are about 5,500 partnerships across UK. To effectively implement the philosophy of partnership in healthcare, the theoretical models are very important. These theoretical models include the hybrid model, coalition model, coordinated model, and unified model (Greco, Webb, and Beecham, 2012).

Local strategic partnerships were established in 2000 whose role is to bring all the representatives from the various voluntary and statutory communities to discuss and address the various challenges and allocation of funds. Their main role is to encourage joint working among healthcare stakeholders so as to prevent silos working.  Local Area Agreements deal between the joint working of the local healthcare providers and the government. LAA main aim is to improve the outcomes to link funding with innovate delivery of services. They reflect on the community vision, challenges and priorities established within the community as required by the government through Regional Government offices. LAA gives a practical plan for partnership that has priorities around the safety and economic issues as well as the environment.  They promote the evaluation of outcomes and targets at local and government levels (Ball et al., 2010).

 The unified model amalgamates management, staffing structures and training within the healthcare services. This model provides an integrated delivery of healthcare services which has a single unified trust, with each trust having a specific strategic approach/goals and financial system. This is a model used in St Andrew’s facility as it has a single employer within a single budget and offering a considerable promise. This is an advantage as it has the potential of removing the potential to blame the incompetency for the others. The model benefits includes the fact that it reduces delayed discharges,  ensures that teams are integrates and ensures progressive resettlement from lengthy stays in the hospitals (Greco, Webb, and Beecham, 2012).

 This improves access of healthcare services, referrals and effective delivery of services. The main disadvantages of this model are that it gives hegemony of the health as it affects the partnership philosophy on sharing of power.  This model seems to subsume the social care values and services as the resource focuses more in the acute sector. This may make the integration not be realized to its full potential. The coordinated model involves synchronizing of the healthcare services (management, training and staffing) such that they work individually as a distinct entity. In this type of model, there are many specialized autonomous organizations but work in harmony (Greco, Webb, and Beecham 2012). This is best illustrated by fig. 1 below

The coalition model in healthcare systems is where there exists an association as well as the alliance of various institutions that operate independently. It is a pact among the health and social care (HSC) who operates in joint action but each of the organization has self-interest.  An example is Ottawa coalition of community Health and Resource Centers (CHRCs).  On the other hand, a hybrid model involves the mixture of the different models to attain its range of services including the unified model, coordination model and coalition model (Greco, Webb, and Beecham 2012).  

Task 2.2

 Care delivery to service providers is mainly influenced by the laws that are put in place which makes an organization to function in one specific way.  The main aim for the government policy is to ensure that the established standards are established in the society.  The UK laws give the employees and employers the fundamental principles that should be used to deal with the people in any given scenario. Each set rules attached to specific legislation should be followed and to those who break the laws, sanctions are normally applied.  Therefore, the healthcare providers are expected to have a basic knowledge of the laws and principles so that they can be applied to their work place (Paterson, Nayda & Paterson 2012). 

 According to the Health and Social Care Act 2012, the clinical commissioning groups (CCGs) are the cornerstone of the healthcare system in the UK. There are about 211 CCGs that are responsible to commission for 226,000. The Health and Wellbeing boards (HWBs) are integral in delivering an integrated approach to the health and social care. They bring the NHS, public health staff and local Healthwatch plan to the public with the aim of addressing the inequalities.  These are among many other changes made by the health and social care act 2012, as it addresses the policies that previously were ignored. The reforms have ensured that there is improved equity, excellence and accountability.  The care standard Act 2000 sets out regulations especially on powers that cover areas such as staff, management, conduct and other premises that deliver health and social care. Section 23 of this Act mandates the state secretary to publish statements that the social care inspection must put into consideration when making their decisions (Soni 2014).

According to the mental health section 31 health act (1999) and section 75 of NHS Act have established evaluation procedures that help assess the ability for pooling funds,  delegation of commissioners processes, and integration of providing services and developing of the coordinated services.  The aim of this evaluation procedure is to ensure that partners work in partnership to deliver services rather than spending many resources regarding the organization’s boundaries. This aids in eliminating the unnecessary gaps as well as duplication of services. The Mental Capacity Act (2005) has established a framework that is used to determine when a decision should be done on the behalf of the other.  This ensures that patient mental capacity is assessed appropriately before the various agencies (primary care, social services, and local authorities) take an action that affects the patient (Greco, Webb, and Beecham 2012).

Task 2.3

When delivering care services to the healthcare providers, there are various department involved. Each of the services involved have different policies that focus using different legislations.  For instance, the usual practices at the hospital include the diagnosis, treatment and preventive care. The relevant bodies involved include the department of health as well as the medical council. There are many policies that govern the practices in the hospital (Greco, Webb, and Beecham 2012).

For general practice in healthcare, the key responsibilities resemble those of a hospital and the relevant bodies involved includes CQC, Nursing and midwifery as governed by the mental capacity Act 2005, Medical Act 1983 and Mental health Act. In mental health, the practices involved include the rehabilitative services, psychotherapies, and psychiatric services. The relevant bodies involved include the Public Health UK and NHS. The key legislation used includes the recent Health and social care act. Looking at these examples, it is clear that each service have differences in practice, relevant bodies and the legislation. Although they have the same goal, the practices and policies may not be compatible (Doyle, Lennox, &Bell 2013).

The impact if the differences may make sharing of information to be difficult in many case scenarios. This could prevent identification areas which need to be improved or need partnership to ensure effective delivery of services.  Even in the partnered group, they may fail to create ownership to ensure that demands for the service users are met effectively. This impedes collaboration and achieving the desired outcomes. Although the multiagency co-operation is believed to improve the healthcare services, the established frameworks and policies differ and the leading hindrances of effective delivery of services. The reduced cooperation interferes with the philosophies of working in partnership, which causes adverse impact to the population. For example, the government initiated cooperation is mainly statutory, which implies that each of the service providers is expected to comply with the established set of standards as well as terms of agreements. These laws ensure that the public offices comply with the set standards and serve the community as established by the frameworks.  In private sectors, such practices and policies are voluntary, which implies that the organizations may fail to comply with the set policies, affecting the collaborative processes negatively (Petch, Cook, and Miller 2013).

Task 3.1

 Partnership of working at different levels (inter-professional, inter-organizational and between service users) can be evaluated in reference to their outcomes. This is because the outcomes as well as their effectiveness can be used to determine the effectiveness of the partnership and the whether there is need to regulate the partnership in order to achieve the purposes. The outcomes of working in partnership at organization level can either be negative or positive outcome. The positive outcomes include autonomy, improved delivery of services and increased empowerments to improve the decision making processes. For instance, the inter-organizational partnership can lead to increased training as well as employment opportunities for the professionals including social workers, doctors and nurses (Paterson, Nayda & Paterson, 2012). 

Partnership improves sharing of responsibilities, which improves sharing of labor. Most of such organizations have high employee retention, satisfaction and increased productivity. In addition, partnership between the organizations enables sharing of risks and assets. The outcome is that the organization can raise funds with ease because borrowing. Partnership at organization level makes it easy to attract a prospective employee. The outcome is that it might benefit the employees by offering complimentary skills and create wider pool of skills, knowledge and contacts (Paterson, Nayda & Paterson, 2012). 

The negative outcomes include miscommunication, confusion and frustrations because decision making processes are shared.  The miscommunications could lead to disagreements, abuse, and dramatic split-ups. The main issue of partnership at organization level is loss of autonomy. The requirement to reach into a consensus with partners before taking an action is undertaken can lead to conflicts, especially when there is conflict of interests. The main outcome of these negative impacts is that it impedes smooth implementation of evidence based changes due to challenges of additional management, reporting and monitoring of the process. Lastly, there are issues of reputation impact especially in scenarios where one partnership makes a mega mistake that ruins the partnership reputation and track record (Miller, Whoriskey, and Cook 2008).

  The outcomes of increased partnership between professionals include delivery of coordinated services and efficient resource use which reduces potential risks and mitigates mistakes because of increased understanding of operational context.  Proper communication in partnership results to increased professional development and reduced medical errors due to clarity on responsibilities and effective communication. The outcome is increased effectiveness and efficiency due to reduced cost of operations and sharing of delivery systems that helps reduce duplication of duties. The other outcomes include enhanced professional skills as well as professional competencies due to increased innovation. This further leads to long stability and increased credibility as well as reputation of the partnership (Paterson, Nayda & Paterson, 2012). 

 The negative outcomes include miscommunication, time-wasting and fund mismanagement. In addition, the business partners are individually and jointly responsible for the actions of one another. The profits are shared with others which imply that each partner must learn to value one another skills and time. This is actually a challenge when one of the partners puts less effort and time due personal issues. Lastly miscommunication between partners could lead to distrust and disagreements (Paterson, Nayda & Paterson, 2012). 

  The outcome for working in partnership between service users includes shared principles, coherent approach, integrated services and improved working practices.  The fact that organization benefits from combination of complementary skills, the wider pool of information will improve patient’s health condition and general wellbeing. The powerful moral support and creative brainstorming with the health providers enables them to understand the unique patient demands. Through partnership, the health and social care enables the healthcare providers to establish a better and deeper understanding of the healthcare industry, as well as obtaining skills and expertise’s that are necessary for effective management of patients.  The negative outcomes for partnership between healthcare providers are limited, but it can include increased costs due to the many organizations involved. It also leads to disjointed delivery of services and reduced shared mission and vision, mainly due to communication breakdown leading to poor quality of care (Paterson, Nayda & Paterson, 2012). 

Task 3.2

 There are several barriers associated in working in partnership. For instance, there lacks a clear approach on ways to empower patients working with different professionals. This makes it difficult for a client to follow procedures as they have information that is confusing. Additionally, the different priorities, plans and goals of the agencies and professionals are huge hindrances when working in partnership.

According to Cameroon and colleagues (2013), lack of standardized systems for data collection and storing makes it difficult to share the information appropriately. This makes it difficult to analyze an issue, its consistency as well as the urgency of the matter. Therefore, the partnered agencies are expected to review their data collection and process in order to improve the expected plans. The differences in policies make it difficult to understand their different roles as well as responsibilities. This lack of role clarity often results to reduce collective decision making processes. If the organization lacks clear monitoring and accountability systems are main barriers in working with partnership. These barriers must be addressed in order to improve the working in partnership outcomes between the healthcare providers, service users and the organizations (Soni 2014).

Despite the fact that partnership in healthcare is associated with increased ability to deliver better services, there are several challenges that face organizations that work in partnership, hindering the effectiveness of working in collaboration. To start with, most of the organization lacks clear understanding of each other. The increased misunderstandings between the healthcare providers lead to development of biasness and misconceptions about one another. For instance, there has been a huge misunderstanding between the private rehabilitation centres and correctional centres in relation to rehabilitation of the inmates, which has resulted into increased mental health complications between the inmates (Cameroon et al. 2013).

Organizations working in partnership face conflict of interest, especially in cases where the organizations fails to establish boundaries or appropriately define specific roles of each other. In some cases, the conflict may arise if one partner focus more on one aspect than the other due to selfish interests (Soni, 2014).

  In some cases, the reduced commitment of the organization towards achieving specific goals as well as objectives could lead to poor delivery of services. For example, when a healthcare facility for geriatric population may be reluctant to admit new elderly due to lack of funding by the public health, leading to increased number of population who are not being care for. Lastly, one of the partners may not be willing to commit fully their time as well as arrangements. The inadequate allocation of time by the organizations could lead to lagged operations.  In some cases, inadequate training and profession development opportunities for staff members of the two organizations could lead to resistance to change by the staff members. This leads to poor coordination of activities and inadequate funding due to rigid and inflexible organization bureaucracy and culture (Cameroon et al., 2013).

Task 3.3

Improved staffing and access to resources is important. This is because staffing issues causes delay and reduced accountability in health services. Adequate staffing will increase professional accountability of their actions. This will make the professions preventive and proactive approach to improve, giving a better chance to improve equality and excellence in healthcare. Additionally, it is important to establish effective monitoring systems. This will help ensure that all projects and actions carried out in accordance to the legislations and established frameworks. The information sharing inclusion should be established. This will ensure that the service users obtain information, which will promote teamwork. This might call foe effective leadership and management to ensure that there are effective strategies established to improve the healthcare performances as intended (Greco, Webb, and Beecham 2012).

The working in partnership at each healthcare facility should be governed by the partnership philosophies such as respect, autonomy, and empowerment, power sharing, and making informed choices.  The philosophy of empowerment facilitates sharing power with other partners who may not have the power.  This focuses in healthcare service users and providers to enable them take greater charge of themselves which will improve outcome of working in partnership.   This is because it facilitates the process of recognizing, enhancing and empowering other people’s ability to meet their demands and to resolve their own issues with the available resources, making them feel in control of their lives.  This enriching experience is associated with satisfaction and often leads to smooth partnership relationship and positive outcomes (Paterson, Nayda & Paterson, 2012). 

Conclusion

 Working in partnership between the healthcare agencies and stakeholders in the UK still remains the government central focus. This is especially important due to the increased in complexity of health demands between the populations. In this regard, it is important to establish effective partnership across the various healthcare agencies, in order to ensure that they remain focused with quality delivery of services. Therefore, more need to be researched on the importance of effective partnership in improving the quality of services delivered in health care.

References

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Hibbard J.H. and Green J. 2013. ‘What the evidence shows about patient activation; better health outcomes and care experiences; fewer data on costs’. Health Affairs 2013; 32:222207-14 [Proquest]

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Paterson, G., Nayda, R., & Paterson, J. (2012). Chronic condition self-management: Working in partnership toward appropriate models for age and culturally diverse clients. Contemporary Nurse, 40(2), 169-178. doi:10.5172/conu.2012.40.2.169

Petch, A., Cook, A. and Miller, E. (2013). Partnership working and outcomes: do health and social care partnerships deliver for users and carers?. Health Soc Care Community, p.n/a-n/a.

Robert, G., & Cornwell, J. (2011). What matters to patients? Developing the evidence base for measuring and improving patient experience. Project Report for the Department of Health and NHS Institute for Innovation & ImprovementGlasby, J., Miller, R. and Dickinson, H. (2011). Partnership working in England” where we are now and where we’ve come from. Int J Integr Care, 11(E002).

Soni, H. (2014). Partnership Working in Health and Social Care Glasby Jon and Dickinson Helen Partnership Working in Health and Social Care128pp £9.99 Policy Press 9781447312819 1447312813. Nursing Management, 21(8), pp.12-12.

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