Health and Social care Workforce Integration
There is a body of work evidence that is being developed on integrated care across the UK based on national and local studies. In the West Midlands a Programme of 6 pilot projects under the Older Adults Workforce Integration Programme, hosted by Birmingham Community Healthcare NHS Trust (BCHCT) and sponsored by Health Education England West Midlands (HEEWM) was launched in 2014. The Programme intended to support the development of a fit for purpose integrated health and care workforce supporting the needs of the older adult population in the Birmingham and Black Country Local Education and Training Council (LETC) areas.
In particular, two of the pilot projects’ new models of care/care co-ordination demonstrated the strongest links between organisations participating – Integrated Care Model and Complete Care Programme. The relationship between the pilots’ capacity to deliver workforce integration and the strength / nature of the links was not to be underestimated for their strategic relevance and reach. The links irrespective of whether they were classified as partners or stakeholders collectively provided a comprehensive range of services no one agency could provide. In addition, the greater mobilising of a collective workforce enabled more people to access and benefit from services on offer in and across their community. What was evident was these two particular pilots was that:
- Managing collegiate interactions as a route to integration must be actively supported by senior managers to overcome professional silos, gave assurances that skills are valuable in workforce and service integration and to put in place policies and processes that underpin cultural change.
- What constitutes a ‘workforce’ for integration purposes is led by the service need. The appropriate use of volunteers, carers and service users must be clearly articulated and supported by the host organisation if they are to be considered part of the integration process.
- The integrated care model and complete care programme pilots both demonstrate the important contribution that volunteers and the volunteering service make to the integration agenda. The lessons learnt to date could be disseminated and used to develop a position statement for health and social care commissioners.
A recent project undertaken by the Kings Fund and commissioned by NHS Employers and the Local Government Association looked at the evidence available on new roles and ways of spanning organisational workforce boundaries to deliver integrated health and social care.
The project found an increasing focus on roles which facilitate co-ordination and management of care, development of existing roles to increase the skill-mix and enable provision of more holistic care, and a limited number of truly innovative roles, the most notable being care navigators and community facilitators, enablers or link workers. The report notes that many of the skills required for integrated care already exist within the workforce and raises a central question of how to use those skills more effectively to support boundary-spanning activities.
The project evidence highlighted the following findings:
- Where new roles have emerged, they have mainly done so due to developments in practice or to fill gaps in provision.
- There is a lack of evidence on the cost-effectiveness of new roles and the extent to which they improve patient outcomes.
- There are a number of ways in which integrated care is being delivered without the explicit need for new boundary-spanning roles.
- Engaging staff from the outset and building on the existing skills of the workforce can overcome cultural barriers between professionals and organisations to develop integrated ways of working.
The workforce represents the greatest resource in delivering integrated care. Developing integrated care has to be part of a system-wide process, of which workforce integration is
one component. There needs to be greater recognition of the underlying processes involved in building the relationships, systems and governance needed to support boundary-spanning, at a local level and throughout the wider system. In many cases new ways of working and models of care are likely to prove most effective. While new roles may prove valuable as part of a system of care, their need should be demonstrated rather than assumed and defined by the local context in which they are required.
To obtain a copy of the Kings Fund report click here