Transcript Document
Critical Factors of Integration-UK & Learning from Wales
Wendy Harrington; Policy Manger ADSW Amira Irshad; Social Services & Integration Directorate; Welsh Government
Background
• • • March 2013- collaboration Gap in evidence - literature -UK practice SW contribution 2011-12 England - 1.5m service (1.23m community) - 1m staff. £16 b budget.
Wales - 78, 000 service (82% community) Scotland - 198, 000 staff; 684, 000 home care hrs per week for 63 500 people.
NI - 12, 421 staff; 41, 534 supported.
Aim - identify critical factors of success (common denominators) -unique, positive contribution of social care services.
‘ready reckoner’ for change managers - establish UK network to build capacity for change.
Organisational factors
-whole system working - avoid destabilising good arrangements.
“small- scale pilots focused on the needs of people with single diseases & conditions are unlikely to deliver benefits on the scale needed” . “Leaders need to plan over at least 5 years..& be willing to adjust direction” Ham C (2011; 2010)
-organise support around individual not targets.
- place based partnership.
- coherent local & national context.
“investment will need to be made in new innovation before funds are released from existing models..
Little evidence that integrated care can be delivered more cheaply.” Ham C (2013)
- realistic scale, pace & cost of change.
Culture, leadership & governance
- culture- binds; values; behaviours; performance.
- persuasive vision – why , how & for what purpose..
- collaborative leadership- joint financial governance frameworks/ strategic plans.
- empower staff; users; communities –identify outcomes..
- culture of learning and clarity.
- leadership- common causes; multi lingual.
- Public health approach.
“conveying knowledge to patients, who are the most undervalued resource in our system, is key to managing long term conditions” Sir John Oldham (2011) “Securing the understanding & commitment of staff to the aims & desired outcomes of new partnerships is crucial..particularly amongst health professionals.” Cameron et al (2012)
Professional issues - stratify population needs; data - risk profiling vs prevention - target workforce & skills - engage champions -multi- discipl teams/ jointly commissioned services
“ a hallmark of a maturing & self confident profession is the ability to transcend a task- based approach to focus on broad themes & principles of professional practice” NISCC(2008) “need (for) high quality, large scale research..test the underpinning assumptions..in a more robust manner & assess from the perspective of service users & carers as well as from an economic perspective” Cameron (2010)
Social works services contribution
promote human rights & citizen contribution…………
(social justice) -
engage assets…………………………………………
(community development) -
provide clarity locally on implications of policy
(democratic engagement)
- prepare culture; staff; organisation
(collaborative leadership & professional governance) -
shared mandate for public health …………….
(constructive alliances)
safeguarding; risk enablement …………………….…...
(risk management)
Self directed support……………………………………….……...
(self management)
engagement with users/ carers…
( informed planning/ outcomes) -
assessment of need/ charging policies…………………….…
(gatekeeping) -
understanding wider influences……………………...
(whole life approach)