Working in partnership in health and social care sector is seen as an effective and embracing strategy for the successful delivery of services for the service providers as well as the service users. According to Glendinning et al. (2002, p. 3), and Sullivan and Skelcher (2002), partnership working would involve at least two agencies with common interests of interdependencies and require a degree of trust, equality, a shared responsibility and an intention to deliver benefits or added values which could not have been achieved by a sole agency acting alone.
Therefore, in this essay various concepts for building effective partnership relationships to achieve positive outcomes will be discussed in detail. LO1 There are 6 different philosophies generally acknowledged and aspired to be fulfilled in health and social care partnership working which are as explained below. At first, Autonomy is conceptualised as ‘self-determination in health care ethics, which means if a person is autonomous, he or she can make own decisions regarding treatment and care’ (Widdershoven and Abma, 2012, p. 217).
Independence indicates playing self-governing roles around everything to do with oneself (Beales and Platz, 2008). For instance, allowing an elderly client to conduct easy daily tasks on her own and waiting till the completion of task can promote an independent achievement of the service user. At third, making informed choices implies ‘building up a picture of the available options, and understandable, relevant and high-quality information to compare the advantages and disadvantages of each for decision-making’ (Ovretveit, 1996; Rosen et al. , 2005, p. 8). In order to facilitate utmost choice from the service user side, the information given from the service provider should include what, where, when and how things can be done. Furthermore, empowerment is about ‘enabling people to take control over their lives through choices and be as independent as possible’ (Rasheed et al. , 2010, p, 24). As an important concept in the partnership relationships between the service providers and users, empowering clients could leads them to an achievement of autonomy, independence and making choices in their life.
For instance, giving information and possible treatment options and arranging regular health check-ups at a GP for a patient and a family member would allow the patient to organise proper dietary plan and take right dose of medication at right time with an assistance of family members and a home carer. It may also bring a more independent and autonomous self-image to the patient about him or herself, and a stronger responsibility of own health condition through self decision-making process under the empowerment philosophy.
At fifth, in the service user and provider relationships respect can be described ‘as a set of attitudes and behaviours displayed towards an individual or group which demonstrates politeness and consideration’ (NHS Dorset and Dorset County Council, 2009, p. 4). The feeling of being respected could be achieved for instance, when service user’s wish, interests and personal values are prioritised in care provision, and when there is an active service user inclusion in decision-making regarding to service provision.
Finally, power sharing is seen as ‘sharing of government responsibility and political co-operation between the two partners’ (Gottlieb et al. , 2005, p. 8). Specifically, among health and social care service professionals and providers, power sharing may be the prerequisite factor to develop a collaborative partnership relationship. For instance, when two different professionals, such as carers and nurses, work together in a team as a form of partnership work, certain responsibilities in professional conduct or perspectives could differ from each other.
In this case, these two different parties should reach to an agreement of shared objectives within the team in relation to work delegation balancing the possession of power, and be open to constructive feedback and ideas through developing a frank partnership relationship (Department of Health (DH), 2004). There are three different levels of partnership relationships, which are firstly, between the service users and service providers, secondly, among the health care and social care service professionals, and thirdly, among the health and social care organisations.
In the case of the service user – provider partnership relationship, there are several factors to consider in order achieving positive outcomes, and these positive outcomes may be linked to the accomplishment of user’s needs. Therefore, in the partner relationship, understanding and fulfilling the specific needs of the service users are critical. For instance, by using a person-centred approach, a social worker could learn about a particular client as a whole through effective communication, and customise certain healthcare and social services according to the preference and wish of the client.
This process would increase satisfaction and contribution level of the user as he or she and the social worker cooperatively produce service plan, and after all, it could lead to positive partnership relationship. Secondly, among the various health and social care professionals, their skills and abilities of working within a team may be the fundamental factor to maintain an effective partnership. Different professionals, such as nurses, carers, social workers and physiotherapist have their own specialty and knowledge in particular areas.
In order to pool their different skills, abilities and commitment, they need to be open to exchange ideas, encompass diverse professional areas, and clearly define work responsibilities (Greig and Poxton, 2001). For instance, when I was volunteering in a nursing home for the elderly, every staff who works in a team had to attend at meetings before and after they provide daily service. Throughout the team meeting, each professional was able to share necessary information and audit each other’s given duties within their work roles in order to achieve team goals which eventually link to the improved service quality.
As collaborative partners, each one had to make own contribution to the team performance, and when one does not achieve individual task, another member of the team became a mentor to advise and pull the potential ability by motivating the colleague. Thirdly, among health and social care organisations or agencies, successful partnership relationship may rely on various factors, such as understanding organisational cultures and behaviours, integrated objectives and policy making, agreement over the use of pooled resources and performance audit arrangement (Poxton, 2004).
Partner healthcare organisations, for instance, a GP and secondary care trust, will have to delegate work roles and functions to each other by developing an integrated policy framework over the use of funds and arrangement to transfer patients from one to another organisation without delay of service. -Words count 954- LO2 There are 4 different types of partnership working models found in health and social care settings, which are (1) integrated model, (2) coordinated model, (3) coalition model, and (4) hybrid model.
Firstly, the integrated model indicates structurally unified health and social care services which deliver seamless service provision to the public (Scottish Office, 1997, p. 2), and is found in Northern Ireland NHS. In this model, there is one single Trust which governs and provides both health and social care services therefore, service provision is well-organised through the close partnership between health care and social care professionals under one unified and agreed objectives and policy framework.
As advantages of this model compared to the other models, service users could be transferred to one service (health care) to another (social care) at right time without delay and possibly less blame culture between the two parties exists. Nevertheless, partnership working between NHS and social care sector in this model raises a concern of a loss of control and power over the resource distribution in social care side due to health care system priorities (Carnwell and Buchana, 2004).
Secondly, in the coordinated model, each health care, social care and many other organisations are functionally independent, autonomous and specialised in certain area but they coordinate to reduce any possible gaps within the service provisions, and there is no single authority to govern overall system, such as England NHS (Douglas, 2009). On one hand, compared to the integrated model, this model could advantage of balanced power sharing between different agencies and a system of pooled funds can take place which may lead to fair resource distribution due to health and social care divide.
On the other hand, there could be duplication of health or social care service provision and time delay in the transfer of one service to another for the patients. Thirdly, coalition model refers to a collaboration taking place among various professionals or agencies in their own self-interest, but to achieve mutual targets for a common cause (Coalition of Care and Support Providers in Scotland, 2012). This is also called as a joint action which partners share information, skills and resources for a certain period of time till each entity accomplishes their mutual targets.
Unlike to the integrated model, each health care and social care agency has separate roles and responsibilities, developed under respective organisational policies except for the overlapping areas where collaboration with another agency are necessarily required. Finally, hybrid model is the mixture form of the other three models discussed above. This model extracts advantageous features from each partnership relationship models and seeks for appropriate degree of partner-relationships in order to minimise limitations of each models.
Therefore, it has similarities and dissimilarities compared to the other different models. Current Acts, policies and practices of organisation for partnership working entail more or less the same purpose and requirements to the health and social care professionals and organisations to conform to certain guidelines. In other words, organisational policies and standards of professional conducts are actually in line with the context of legislative frameworks.
The Health and Social Care Act 2012 (DH, 2012) outlines the reform plan of NHS system which is the replacement of Primary Care Trusts (PCTs) and their roles to clinical commissioning groups, who are GPs and other clinicians, to allow greater accountability for using local resources efficiently under the support of NHS Commissioning Board. This Act aims at integrated and more accessible service provision placing the need of local people and patient in the centre, which would reduce unnecessary costs and time consumed during the administration work.
Secondly, the Equality Act 2010 (The National Archives, 2010) protects people who have different characteristics on the ground of disability, race, marriage status, religion or belief, sex and sexual orientation from being discriminated in the case of employment, perception, association, payment, access to health care and social services and so on. Accordingly, in the organisational policies and practices, these legislations are implemented as guidelines for the professionals to produce effective partnership work.
For instance, as a self-commissioning body, the practitioners of local clinics would assess the health care needs of the population and delegate necessary services to other health care organisations as they develop mutual organisational policy frameworks. Also, service providers of nursing homes would respect religious and cultural diversity of the service users and adopt an equal approach towards the disabled people as a good organisational practice.
In a partnership relationship, each professional and agency should agree and develop a partnership-based approach toward their joint-work (Dalrymple and Burke, 2006). If there are different terms and conditions applied to the joint services, it could hinder different professionals to act as a team and the smooth delivery of service to be in place. When there are differences in work practice in the partnership relationship of two separate GPs, they could simply encounter a number of conflicting situations resulting in onfusion to the patients. For instance, one patient who has complex needs to be dealt with various health and social care professionals, such as home carers and district nurses, for different services could experience repeated assessment process to identify what service was already given by other service provider, and it may be hard to achieve consistent and integrated service provision. When complaints arise, both carer and nurse could blame for the dissatisfaction of the patient to the other partner as well.
Similarly, absence of integrated policy in the different agencies could cause difficulties to equally pool and share resources, and achieve equal power-sharing among professionals because when there is no guideline or policy regulating partnership work standard, one party who has more power is likely to monopolise the resources, and therefore successful partnership relationship cannot be achieved. Words count 953- LO3 In partnership working, there are various possible outcomes that could be generated in each partnership relationship levels. Firstly, from the service user side, possible positive and negative outcomes could be increased chances to make informed choices and improved quality of life, but there could be abuse, confusion caused by miscommunication or information overload, and neglect.
For instance, when an elderly client is cared by nurses or carers who have ability to share information and knowledge regarding the medical condition of client, such as what dietary plan should be followed and the cause of certain symptoms the client suffers, and it would lead the client to change some diet habits and make right choices. Through the professional engagement with informative knowledge, the life of client could be much more supported and improved.
Whereas, as this relationship involves external service providers rather than family carers, there is a chance of any form of abuse to take place if the positive and healthy relationship are not built between the client and professionals. Also, excessive advice given from different professionals that may be incompatible with each one could cause confusion to the client. In the case where the health care and social divide takes place, there is a possibility for service providing professionals to deny own accountability and blame other parties if there are complaints raised in the process of transfer, and f this situation continues, the client could be neglected rather than placed in the centre of the service. Secondly, among different health and social care professionals the positive outcomes could be the increased reciprocity or support as each professional can make contribution that complements each other’s skills, and therefore prevented mistakes, and coordinated service provision but as negative outcomes time wasting and miscommunication could be listed.
As different professionals work as a partner or a team, each member of the team could pool strengths on skills and abilities to support another member of the professionals, and it could lead to reduced mistakes as each member monitor and complement weakness of other professionals. In the domiciliary care setting, a nurse and a carer can schedule certain tasks, for instance, changing bandages on the wound of the client from a nurse side, and it can be communicated to a carer such as not to contact water or apply medication cream on that area as a coordinated service.
However, when an integrated service is required from different professionals in order to produce a care plan, different professionals would have to receive information about the result of assessment and produce work based on an agreed time scale, however, if one party does not perform the duty on time, the other party is likely to waste time and the integrated service provision could be delayed.
Finally, in a partnership relationship among organisations, integrated service provision, the expansion of service domain and increased available resources can be the positive outcomes, but disjointed work, loss of shared purpose and blame-culture followed are the negative outcomes. For instance, if two GPs in different district work collaboratively providing coordinated service, they would pool resources such as funds and capabilities for greater purpose for the both parties to meet their self-interests as well as common purpose, and they could stretch their client group by encompassing more patients from the other areas.
On the other hand, when the two service providers do not agree with mutual outcomes to be achieved and rather focus on their own self-benefits, the joint work could easily collapse in the middle of partnership work and they could end up with blaming each other. Further potential barriers in the health and social care service partnership could be lack of communication, absence of information sharing, and different priorities and values.
In my experience, if carers face emergent situation in one client’s house or when there is traffic congestion, the next visit to the second client can be delayed therefore, carers normally inform the office manager or coordinator to make notification to the client. However, when the carer reaches to the client, it was often found that the client had not been informed about the delay and as a result, the client was feeling frustrated due to the absence of message delivery in communication process between the service provider and the user.
Similarly, absence of information sharing could lead to duplication of the service provision to the service users. In some cases, due to an absence of collaborative work practice, policy and patronising attitude towards other professional partner, based on their vocational status or position, could be the cause of not sharing critical information for the service provision. Also, having different priorities and organisational or personal values could cause disagreement over collaborative work and lead negative outcomes to be generated.
Therefore, to generate positive outcomes, as mentioned in the philosophies of working in partnership, service providers must preserve autonomy of service users and empower them as much as they can in order to prevent any abuse, neglect and confusion from taking place, and discreetly select communication mechanisms and comprehensible terms to avoid miscommunication as well as information overload.
Moreover, among different professionals and service providing organisations, to equip with professional approach by considering each partner as an equal entity and coordinate comprehensive service delivery devised by organised communication schemes and common work practice in terms of information sharing, converging different priorities and values, and audit partners’ performance would be the fundamental strategies to achieve positive outcomes in the health and social care settings.
Patient Health History
Patient Health History.
Patient Health History
Health History (minimum 1200 words) 1. provide an overview of interviewing techniques for patient’s health history 2. construct relevant health history questions for all body systems as included on the review of systems 3. provide the expected normal subjective findings for each body systems on the review of systems 4. explain advanced interview techniques. 5. Analyze and discuss how you might adapt your physical assessment skills or interviewing techniques to accommodate each of the following specific populations: Infant/pediatric, Pregnancy, Geriatric 6. identify one disease process or condition that may significantly hinder conducting a Health History interview. 7. Synthesis and discuss the expected abnormal physical examination findings that may be associated with this disease or disease process. 8. Summarize the key points.
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