Interprofessional working is one of the key processes in which care is currently managed within the National Health Service (NHS) (Atwal and Caldwell 2005). Therefore, it’s important to understand how this process is carried from education through to current UK health and social services and what key strategies are being used to strengthen this collaborative process.
Demographic changes are said to occur over the next 20 years, such as a continuing shift towards long-term conditions and a growing number of older people with multiple conditions and complex needs, which will require a higher demand of health and social care and financial constraints on the NHS affecting the resources available to respond to the increase in demand (Scottish Government 2010). Moreover, there is a rise in the public’s expectation as to what the NHS and social care services can do for them. The integration of health and social care and leadership are two strategies being used currently to help assist with these current changes in health care.
An interview was conducted and held within Queen Margaret University, whereby we explored the reality of teamwork and how it operates within diverse health and social care systems in the current political and economic climate. We interviewed the integrated response team (IRT) of a local NHS location, brought together over the last year. The interviewees were comprised of an OT, physiotherapist and social worker each of who are highly experienced in their profession. The IRT is part of a larger organisation known as the Integrated Community Assessment and Support Services, which is completed by a hospital at home team and a care at home team. Their team promotes early discharge and prevention of admissions to hospital.
The team expressed the main strategies used to strengthen interprofessional working within their department are collaborative team leadership, the integration of health and social care, informal communication and the blurring of roles. Leadership and the integration of health and social care have growing evidence to support the importance of better teamwork and collaborative care delivery, by building on the work at local, regional and national levels. The integration of health and social care is a strategy used at national and provincial level, whereas leadership is a strategy managed regionally and institutionally. These strategies will be discussed based upon a review of the evidence which underpins them.
The term ‘integrated care’ is used to refer to a wide range of services including; health and social services delivered by single or multiple organisations; links between primary and secondary health care; joining care within a single sector and joining prevention and treatment services (RCN 2011). It can take place at various levels of care; within the team, the service or the organisation and is thought of as the answer to maintaining a more effective and efficient healthcare system that takes a patient centered focus as they share the common theme of collaborative and interprofessional working (RCN 2011). Integrated care can be seen as a gold standard for interprofessional working as it limits organisational and political barriers to care. The Healthcare Quality Strategy identified the need for a dedicated quality improvement infrastructure to support NHS staff to achieve the quality ambition, which is refocusing alignment and integration (Scottish Government 2010). Following this, there have been improvements in terms of standards and outcomes in waiting times and patient safety (Scottish Government 2012a). The impact of this integration aims to meet the needs of the Healthcare Quality Strategy to reduce demands on acute services and improving efficiency (RCN 2011). In May 2012, the Scottish Government published a consultation document introducing this integration (Scottish Government 2012b). Currently, health and social...
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