Time to change the tune…

What do we mean by ‘Strengthening the Connections’?  Two examples show what this is really all about…

Richard is an 88 year old man living alone at home.  One Friday afternoon, his neighbour becomes worried about his condition, and calls the local surgery.  The GP visits before evening clinic and quickly realizes that Richard has an infection which needs immediate treatment.  It is perfectly feasible to treat him at home, but Richard is going to need nursing input, and some other care at home over the weekend to ensure that he is properly looked after.  If the GP can arrange this quickly, Richard can stay at home.  Is that package of care immediately available, or will Richard have to be admitted to hospital, with the very real risk that his capacity for independent living will never recover?

Eileen has a terminal condition, but since it is temporarily under control, she is about to be discharged from hospital.  Her daughter is phoned by the social worker to tell her that Eileen is about to come home to the daughter’s house, since that was where he was admitted from.  ‘But I can’t provide the level of support she now needs, I’m out at work all day’, she tells the social worker.  ‘Anyway, why wasn’t this thought about when she was first admitted?’ ‘Well, we are where we are.  We will have to declare your mum homeless, and then ask Housing to assess her needs.’ ‘But that’s going to take days… Can’t you sort something out directly with your Housing colleagues?’ ‘Oh no, not unless she’s actually homeless’.  Is Eileen going to spend precious days waiting on the ward for the system to work for her?

Care and support services are fundamentally about meeting the needs of individuals yet the government agencies which organise and deliver those services are big bureaucracies whose focus often seems to be on a mixture of politics, budgets, systems and strategies.  So, how can we ensure that the individual, who by definition is at a vulnerable point in life, remains the primary attention of commissioners and providers, with the bureaucracy becoming at most an invisible backcloth?

The “Strengthening the Connections” initiative has been designed to colleagues in the public, voluntary and independent sectors closer together in ensuring people receive services without feeling the lumps and bumps of being transferred from one to the other. Lessons learned elsewhere suggest leaders and managers must resist the temptation to concentrate their integration efforts on structures and organisational change and, instead, prioritise the care needed by service users, carers and patients at the individual level. Of course, changes in systems and processes will be critical to making the necessary changes but only if they are made on behalf of the individual.

WIHSC – the Welsh Institute for Health and Social Care – is pleased to be supporting ADSS Cymru and the Welsh NHS Confederation, and their partners, with their “Strengthening the Connections” project through the organisation of four major regional demonstration events across Wales. These will bring together a range of people from across health, social care and the voluntary and independent sectors to hear about successful initiatives in integrating services and to discuss how progress can be made on a regional and national basis.

WIHSC will also be working closely with key leaders and managers in the seven Welsh health and social care communities to assist in finding ways of moving the integration agenda forward. These ‘strategic conversations’ will help identify the enablers and barriers to progress and identify the key actions needed.

Integration has shot up the buzz word charts recently. If it’s to make a difference to the care and support people receive, the familiar tune of “To You, To Me” must change.

If you would like to know more about the Strengthening the Connections Project please contact Dr Mark Llewellyn.


Written by Professor Marcus Longley, Director, WIHSC and Tony Garthwaite, Senior Fellow, WIHSC



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