Partnership Working in Health and social care

Introduction to partnership working

Partnership working underpins all recent legislation in health and social care. This includes; the health and social care act 1999 that reinforces the importance of joint working in health and social care by allowing health bodies and authorities to set up pooled budgets, delegate functions by nominating a lead commissioner and transferring funds. (Connors & Maclean, 2012)

Tilmouth & Qualington (2016) State that ‘’The health and social care act 2012 introduces possibilities of NHS organisations entering into partnership with local authority to form care trust this means that all care needs are met by one trust instead of multiple services.’’(Pg 94.)

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The localism Act 2011 aims to give service users and local community’s the ability to have a say in the way services are developed and managed. This act states that services should be developed through effective partnership. (Connors & Maclean, 2012)

The National service framework 2002 recommends more formalised structures and systems to achieve joint aims (Department of health 2002.)

Partnership working is an important aspect of care; there are many benefits to partnership working however there are also many possible conflicts that may occur during partnership working. These are discussed in detail within this essay.

1.1 A description of partnership involved in service delivery Fareham and Gosport care services.

Fareham & Gosport Clinical Commissioning Group (2012) Specifies that ‘’our key service providers and partners are all also undergoing significant levels of transition as a result of the NHS reforms. These include other CCGs, Primary Care providers, acute and community care providers which are transitioning to Foundation Trusts, Local Authorities and Health and Well-Being boards. How we adjust to these new relationships will determine how we commission services and our success at doing so. Fareham & Gosport borders the CCGs of Portsmouth City and South East Hampshire and we will partner very closely with them. A joint compact has been agreed to ensure that we continue to pursue similar objectives and priorities. Part of our joint strategy is helping our local NHS Trusts to gain Foundation Trust status. A single Portsmouth and South East Hampshire commissioning support team has also been established which will also look to work closely together to maximise outcomes.’’

The diagram below displays the partnership involved in the delivering services in Fareham and Gosport care services.

(Fareham & Gosport Clinical Commissioning Group, 2012)

1.1.1 Describe key elements of partnership working with: External organisations, Colleagues, the individual and their families.

The health and social care act, 2012 declares that the key elements of partnership working are Openness, shared goals and values between all parties involved in partnership working. Also consistency in following the same approach to working in partnership can allow all parties to work together without conflict.

For the services and individual to be able to work in partnership the services need to take initiative to involve service users in their care decisions and planning. Connors & Maclean, (2012) expresses that ‘’services users need to be meaningfully involved in the care which requires effective communication between the service user and care provider.’’ (Pg 144)

For the service user to be involved in their care and decision making several means of contact must be used these include listening to the service users decisions, service user communities, service users representatives, ensuring an effective complaints procedure is followed and self-advocate groups (Connors & Maclean, 2012)

Cook et al (2007), Highlights that effective visionary leadership is essential in bringing people together in the beginning to allow for partnership working.

1.2 Evaluate the importance of partnership working with: External organisations, Colleagues, the individual and their families.

Partnership working is important for all individuals involved and can provide many benefits. These benefits include, that working in partnership can improved experience for the service user as it allows barriers to be reduced between the service user and the provider allowing open communication and the service users wishes being met. This also allows the service to be delivered more effectively through the delivery of holistic care by working with the individual and there family to meet their social needs and individual choices to be understood and applied through care plans. Working with external organisations allows the service users wider needs to be met (Connors & Maclean, 2012.)

Partnership working can also attract more financial benefits from a range of sources (Connors & Maclean, 2012)

Furthermore family carers are a large part of partnership working, it is important for health professionals to realise this, as over the last 20 years there has been greater recognition that service users being cared for in their own home has a positive impact on health and recovery. This is why is it important for family carers to be involved in the decisions regarding the service users care. (Department of health 2006)

Additionally partnership working allows for safe and effective policies to beimplanted around confidentiality and information sharing and professionals to grow in confidence with having knowledge and experience.(Connors & Maclean, 2012)

1.3 Explain how to overcome barriers to partnership working.

According to Glasby and Littlechild (2004) there are 5 main barriers to effective partnership working. These contain structural barriers caused the way responsibilities and roles are spread across and within agency boundaries. Procedural barriers can be caused by differences in planning and budgeting cycles within different agencies. Financial barriers can be produced by differences in funding resources. Professional barriers can be generated due to differences in ideologies, values and professional interests. Perceived threats are also another barrier to partnership working due to status, autonomy and legitimacy.

There are many ways to overcome barriers to effective partnership working; some of these are improving communication through regular meetings. Successful communication relies on open and transparent communication. Communication barriers can impact on this, therefore to reduce this barrier encourage health professional to keep quality records and follow policies regarding records. There also needs to be regular meetings with partnering services to allow for updates and concerns to be voiced. (Connors & Maclean.2012)

Clarifying job roles may also help to reduce barriers various roles coming together in partnership working can cause barriers in joint decisions if some practitioners feel that their role is threatened and professional status is overlooked. Clarifying job roles and duties can help to reduce this barrier(Department of health, 1998.)

The care act 2014 encourages person centred care which requires recognition of the individuals needs and choices. Engaging with families can help to overcome barriers between the service provider, the service user and their families. Listening to what they have to say and involving them in care choices allows the individual a better quality of care and encourages active participation in their own care. (Tilmouth & Qualington, 2016)

Challenge discrimination

1.4 Explain how to deal with conflict that may occur in partnership working.

The Oregon medical centre (2011)offers a useful typology witch identifies five type of conflict; Relationship conflicts, data conflicts, interest conflicts, structural conflicts and value conflicts.

Relationship conflicts can be due to poor communication, strong negative emotions, misrepresentation or repetitive poor behaviours by one or more parties.

Data conflict can be caused by; People are misinformed or lack the information necessary to make an informed decision.

Interest conflicts often take place due to conflict of interests. These result when one or more parties believe that another parties needs or interests must be sacrificed to allow their needs to be satisfied.

Structural conflict is caused by external forces unrelated to the individuals involved in the dispute. Often they are related to the construction of society such as limited physical resource, geographical constricts including distance or proximity to services and organisational changes. To address this form of conflict, it should be agreed by the parties that the conflict is an external source that is causing the effect and attempt to rectify the conflict by bringing people together to jointly address the issues

Value conflicts are often caused by perceived or actual incapability of value systems. This arises when people do not allow for divergent beliefs by attempting to force one set of values onto others or laying claim to exclusive value systems. More conflict can be caused where organisations values conflict with professional values. (The Oregon medical centre, 2011)

Shelton & Darling (2004) suggest that conflict is an essential part of life and can be viewed as a positive and educational experience. This can be a positive aspect of life as it enables a person to be aware of problems within their working relationships, be a learning experience and encourage change within the services, encourage people to deal with problems imminently and not allow tension to arise, stimulate interest and curiosity within the relationships, relieve tension, create more efficient approaches to decision making, promote self –awareness, enable colleagues to relieve unexpressed resentment within working relationships.

Borisoff and voctor 1998identified 5 stages of conflict resolution. The first stage is assessment where the parties gather information to decide what the problem is. They agree on the central cause of the conflict and decide how to resolve this, this includes all parties specifying what they would like to achieve and what they are willing to compromise to resolve the conflict.

In the second stage; acknowledgement each party actively listens to each other, this is important and each party should indicate to the others that they have acknowledged what they have said even if they do not agree with their opinion.

The third stage is attitude; this involves recognising the impact that lack of diversity may have on the situation and resolving any issues that arise.

 In the fourth stage, Action the parties implement the chosen conflict resolution technique. In the last stage, Analysis all parties involved discusses and agrees what to do as an outcome of the discussions. They should make an agreement of what will happen in the future. They should also evaluate short and long term results of the conflict.

Different writers have characterised conflict resolution including varied statements and number of stages. However from different varieties the general process of can be summarised as. Stage one when there is a situation where there could be conflict between several party it is important for them to have the attitude that they would like a resolution that pleases both party. For this to be achievable both parties must understand the needs to resolve the situation. When communicating their needs they must be assertive. If the other party is angry about the situation it is important for both parties to acknowledge that they understand their emotions and recognise how angry they are, they should not defend themselves as this can cause the other parties to become agitated, they should also make them aware that they understand their perspective of the situation, but do not however have to agree with them. (Wall and Cllister, 1995)

A large aspect of conflict resolution is attitude, the parties must be open to the benefits of different opinions, willing to adapt for mutual benefits for both parties, understand that the problem needs to be addressed, except that conflicts allow the opportunity to engage with other parties (Wall and Cllister, 1995.)

Stage 2 is negotiation, in this stage the focus must remain on the issues; the parties should acknowledge any common ground that they can agree on. If this is a large issue is it possible it can be broken down into small stages to resolve? If the negotiation becomes heated, the parties must remember to manage their emotions, not respond to provoking statements and attempt to make a short term agreement whilst the situation is being resolved (Wall and Cllister, 1995.)

In stage 3 if the parties cannot resolve the situation between themselves it may be necessary to include a mediator. The mediator requires several skills, these include; enforcing that mutual benefit should be the goal, should have a clear sense that both parties are willing to address and resolve the issues, they should also allow both parties to express their opinions and check that the other party understands the opinions, they should also discourage any personal comments about the other party that can cause the other party to be provoked (Wall and Cllister, 1995.)

The final stage is resolution the resolution should end with both parties being clear about the agreement that has been made, the agreement should be clear and specific to avoid misunderstandings between parties (Wall and Cllister, 1995.)

In conclusion this essay has described what partnership working is and the importance of partnership working within health care organisations. It also includes a description of partnership involved in service delivery for a selected provider and describes different types of conflicts that may occur in partnership working and ways to resolve described conflicts. This essay has also explained how partnership working within care services and with external organisations allows high standards of care for the service user and how this can assist with person centred care. In this essay it is also described why family carers should be included in their relatives care decisions and needs.

Reference Page

• Bodrisoff, D & Victor, D.A. (1998). Conflict management, A communication approach. 2^nd edition. Boston, Allyn and Bacon.
• Cook, A, Petch, A, Glendinning, C & Glasby, J. (2007) Building capacity in health and social care partnership. Key messages from multi-stake holder’s network. Journal of integrated care. 15 (4). PP 3-10.
• Connors, P & Maclean, S. (2012) Leadership for health and social care. A straightforward guide to the diploma. GB, Kirwin Maclean associations.
• Department of health. (2006) Our health, our care, our say: A new direction for community services. London, HMSO.
• Department of health. (2002) National service framework. A practical aid for implementation in primary care. London, HMSO.
• Department of health. (1998) Information for health, an information strategy for modern NHS 1998-2005. Executive summary, Crown copyright.
• Fareham & Gosport Clinical Commissioning Group. (2012) Improving health and wellbeing in Fareham & Gosport. Available at: https://www.farehamandgosportccg.nhs.uk/Downloads/Publication%20Scheme/Class%203%20What%20are%20our%20priorities%20and%20how%20we%20are%20doing/FG%20CCG%20Operating%20Plan.pdf [Accessed 13-05-19]
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• Oregon Medication Centre. (2011). Types of conflict. Available at: WWW.internetmediator.com/medres/pg18.cfm. [Accessed 12/05/19]
• Shelton, C.D, & Darling, J.R. (2004) Exploring new frontiers in conflict management. Organisational development Journal. 22 (3). PP 22-41.
• Tilmouth,T & Qualington, J. (2016) Diploma in leadership for Health and social care. 2^nd edition. London, Hodder education.
• Wall, J.A. & Callister, R.R. (1995). Conflict and its management. Journal of management. 22. PP 515-558.