“We’re all in this together”

Establishing and Nurturing Connections between Health, Social Care, Private and Voluntary Services

Traditionally, care settings have tended to be shut off from their surrounding community. In most care facilities, services are provided ‘in-house’, and this has the effect of reducing the need to reach out to the wider community. We know that more recently the focus has shifted to create better links with organisations and services in the local area to provide benefits for people requiring care and support, as well as enriching the local community as well.   

I believe that community links should focus not just on this, but also focus on establishing and nurturing connections between health and care providers too.  Having spent much of my working life as a community based occupational therapist, I have come to realise it is so important to establish and nurture these links. 

People who require care and support at home, or who live in care homes don’t only require support through one service provider.  As the need arises, people transition through a range of care and services.  Many support services can come into people’s homes to provide the support people may require, for example, a hairdresser, podiatrist or physiotherapist.  However, some care and services, cannot be provided in the home. 

As service providers, we are often not very good at supporting a smooth transition between care environments.  A good example of this is when someone is admitted or discharged from hospital.  Whether this is a smooth process or not, is rather hit and miss.  This is a real concern, as the consequences (good or bad) have a very real impact on the person receiving care and support, as well as their families and carers. 

I can recall some great examples where the effort put in by care and service providers working together to establish good connections has resulted in fantastic outcomes for the people receiving care.  For example, when I worked for disability services, there was a person who was very frightened of going to the dentist, and a visit to the dentist usually required a general anaesthetic.  Through a process of several pre-arranged visits, they were able to become familiar with the dental facility and clinic room, the dentist and various equipment.  In turn, they were able to have their teeth cleaned without a general anaesthetic. 

I can also think of other examples working in community health, where we were able to foster good relationships between the various community and hospital-based teams to facilitate smooth admission and discharge [SK1] from hospital, and in some cases avoid hospital admission and attend to the person in their own home. 

These successes didn’t just happen by chance.  It was achieved by:

• A system wide approach:  rather than focussing on any one service, we looked broadly across the region, and mapped a typical ‘patient’ journey across various services, with an effort to focus on improving communication and coordination.   This focus on the person receiving care, became the common thread.
• Communication/Relationships: effective communication at every level (top to bottom and across) both within services, externally and via inter-agency / service forums is essential.  In particular, the division of general practice (primary health care network) was very effective for this.  Networking through shared education and training initiatives was also well received and fostered relationship building between key direct care team members.  Meetings that provided morning or afternoon tea also encouraged attendance, particularly if there was a shared focus such as an International Older Person’s Day or International Nurse’s Day, etc.
• Sharing tools / governance arrangements:  a key feature of this approach was developing and agreeing to shared communication tools.  This included understanding what information was required by all services and could reasonably be communicated via a shared tool. This also avoids lots of duplicated questions which can be very frustrating for the person receiving care and their families.
• Safety culture:  integral to this approach was understanding the importance of safety for all; for the people we support and ourselves.  Identifying areas of highest risk and addressing those first helps all involved feel confident and secure.  It is important to avoid a ‘blame’ culture where different services point the finger at other services when things go wrong.

If you don’t already have a strong focus on improving connections between care and services for the people you support, can I encourage you to make a first step.  If you do already have established connections, make sure you continue to nurture them, so they grow and thrive.