To engage the Wealth Of Wisdom to be
found amongst older people
ORGANISATION OF
HEALTH AND SOCIAL SERVICES
Services have grown up incrementally on the basis of what professionals do and agencies provide and, in consequence, are riddled with top down functionalism. In consequence, no one agency has responsibility for all the help that is required in any one situation.
Evidence from the United States (Programme
for All-Inclusive Care of Elders) and elsewhere would suggest that a more
integrated approach would lead to a better quality of care at between 10%
and 30% greater output.
The
1999 Health Act has enabled Health and Social Services to pool their
budgets, and the 2001 Health and Social
Care Act has enabled the creation of Health and Social Care Trusts.
The Green Paper, “Independence, Well-being and Choice” – March 2005 – describes joint working as “ranging from information sharing and joint planning between separate agencies, to pooling budgets and sharing staff, or the establishment of CARE TRUSTS.” The creation of Adult Service Departments and reconfiguration of health opens up all kinds of opportunities. It must be remembered that “collaboration” and “co-ordination” have not produced the goods, resulting in a proliferation of costly and ineffective cross boundary joint planning and co-ordinating mechanisms which would not be required if services were truly integrated. Problems arise every time a “patient pathway” crosses an organisational or professional boundary – evidence “waiting lists” and “delayed discharge”. What is required is “whole task right sized teams” aligned to outcome, not process, along patient pathways with all the expertise, finance, equipment and buildings under common immediate management.
CAMPAIGNING
FOR THE INTEGRATED HOLISTIC CARE OF OLDER PEOPLE
Putting the
WOW
into retirement
