Heatherbank

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Integration of health and social care A social
work perspective
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Outline

• Make my perspective clear
• Look at the drivers for change
• Ask questions about professionalism
• Summarise the research evidence

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My perspective

• Registered social worker
• Practice and management background, including
  partnership working
• Late onset academic
• Part-time secondment to GCU
• Involved in inter-professional education

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Would we have started from here?
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Drivers for change

• Demographics (more over 65s than under 15s)
• Improving outcomes
• Personalisation
• Putting leadership at the heart
• Perhaps most ambitiously, it is about
  establishing a public service landscape in which
  different public bodies are required to work
  together (Scottish Government, 2013)

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Drivers for change

• Money
• 4.5 billion on health and social
• care for over 65s
• Emergency admissions 1.4 billion
• 7 spent on care at home

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Scottish Government position (Feb 2013)

• Intention to legislate, including for outcomes
• Political accountability
• Financial
• It is therefore our intention, as respondents
  have suggested, to legislate for a duty on Health
  and Social Care Partnerships to engage
• with and involve, rather than merely to
  consult local professionals

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Lessons from England

• Integration needs to start from a focus on those
  who use services
• Crucial importance of leadership
• Policy should be tight on ends and loose on means
• Integration takes time to achieve
• Importance of evaluation
• (Ham and Oldham, 2009)

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Professionalism
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Petch review

• Social services for adults have delivered major
  achievements
• de-institutionalisation
• greater choice and control by the individual
• At the same time there has been recognition of
  key areas such as needs of carers and dementia

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Petch review (2)

• repeat and emergency hospital admissions
• enduring issues at the boundaries between
  systems, most notably between hospital and
  community
• a strong body of evidence demonstrating that
  structural integration between health and social
  care does not deliver.

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Different or the same?
(Hudson, 2007)
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Old or new?
(Hudson, 2007)
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Old or new?
(Petch, 2011)
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15
dasdddsadsasa
(Petch, 2011)
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References

• Ham, C. and Oldham, J., 2009, Integrating health
  and social care in England Lessons from early
  adopters and implications for policy, Journal of
  Integrated Care, vol. 16, no. 6., pp. 3-9.
• Hudson, B., 2007. Pessimism and optimism in
  inter-professional working The Sedgefield
  Integrated Team. Journal of Interprofessional
  Care, 21, 1, 3-15.
• Petch, A., 2011, An evidence base for the
  delivery of adult services, IRISS, Glasgow.
• Scottish Government, 2013, Integration of adult
  health and social care in Scotland consultation
  Scottish government response, Edinburgh, Scottish
  Government.