Working in Partnership in Health and Social Care - Essay Example

Working in Partnership in Health and Social Care Summary This paper offers insights into the Stafford Hospital and death of Adult ‘A’ crisis by evaluating key factors which played out in the unfolding of the events. The paper relies on various health and social care services provision underlying factors that determine the quality and efficiency of the services provided. The paper looks at partnerships of working with health and social care as the major factor that caused the two crises. Firstly, the paper analysis the inherent lack of the partnerships, causes, and the effects that resulted thereafter. In analyzing the two crises, the paper relies on various theoretical models of partnerships working with health and social care in order to understand the various factors that caused the lapses and thus draw a viable conclusion. Secondly, the paper draws various recommendations based on the crises of how future problems can be evaded. The recommendations give guidelines on how working partnerships working with health and social care can be explored, developed and implemented in future. Introduction The health and social care services provision remains one of the most important sectors in the government. The efficiency with which these services are provided by the various government establishments ensure that people remain healthy and that they play a huge role in the economy of the country. It is crucial for people to access quality and efficient services. However, when these services lack or their provision is poor, there is a lot of failures both in the government and the management of the services. One of the major factors that can aid efficient and quality delivery of services is forming partnerships working with health and social care. These partnerships play a major role in ensuring that various players that include the services users, professionals and organizations aid one another in a mutual relationship that is beneficial to all. The lack of partnerships working with health and social care is a prerequisite for disasters in health and social care services provision. 1.0. Partnership philosophies and relationships in health and social care services One of the underlying factors in provision of quality health and social care services is the partnership that patients, professionals and authorities can forge. The Mid Staffs Hospital scandal at the Stafford Hospital and the death of a man with learning difficulties put the spotlight on the type and quality of health and social care given to people in hospitals and at home. Further, the two cases point towards a need to have a working relationship between various organizations and persons that are in need of health and social care, professionals and the authorities. The Stafford Hospital that serves the Stafford population had failed terribly in its duty to provide quality healthcare to the patients under its care. It is important to note that the provision of quality health and social care services remains a right to people and thus, denying the patients their rights was tantamount to committing a crime. The resulting negligence of the medical staff led to many deaths due to poor health care services. The high mortality rate in the hospital prompted the government to look into the matter (Campbell, 2013, par.3). The results of the inquiry led by Francis made a lot of appalling discoveries at the hospital, which showed the lack of coordination among the healthcare professionals serving in the hospital and those who regulated the operations of the hospital. Another incidence that is similar to the Mid Staffs Hospital scandal is the death of a man with learning disabilities in Manchester, UK. The death of the disabled man who had been terrorized and abused by gangs for over 10 years also left a question mark on the ability of different health and social care authorities to work together in protection and caring of the disabled in the society. For over 10 years, the man had been terrorized and verbally taunted despite the constant pleas to the authorities to provide security. These cases leave a lot to be desired on the partnerships between health and social care services sector and the legislation authorities that should be the primary agents in such issues (Francis, 2013, pp.4-6). A major factor in the two cases is the lack of a partnership philosophy that accumulated a lot of problems in the hospital and that led to the deaths of many patients. One of the key aspects that lacked in the Stafford case is the acknowledgement of the duties that healthcare givers are bound to give to those under their care. The healthcare givers failed to realize that each was expected to attend to their own duties and take responsibility of their actions. Further, there was total decadence of the need of a working relationship between the healthcare givers, patients and healthcare organizations. The negligence of the following philosophical underpinnings of partnership with the health and social care sector underlies the fundamental aspects that gave rise to the problems. A crucial lesson learned about the Stafford Hospital crisis and the death of the man with disabilities is the need to have a partnership between all the players in the health and social care services industry (Carter, 2010). For the smooth running and effective provision of health and social care services, a working relationship should be established where all the parties participate equally. The two cases point to lack of a definitive goals, lack of equity in health and social care provision, lack of efficiency and lack of quality health and social care, which should be addressed immediately. It is crucial that the ethical concerns in the health and social care services sector be addressed. The two cases show gross lack of respect towards patients, and fellow professionals, lack of dignity and fairness among the nurses directed to patients and lack of respect for patient choices. There are several issues that partnerships in the health and social care services sector should address. A patient-centered philosophy will allow the health sector to focus on providing quality and efficient health and social care services. The inability of patients to express their own wants and needs and to have them listened to was one of the critical factors in the Stafford Hospital crisis. Further, the inability of the junior staff to report the problems without the risk of being sacked or victimized also maimed the hospital. Respect for patients and their families was a major indicator of the rot in the hospital (Owen and Meikle, 2013). 1.1. Effectiveness of partnerships relationships within health and social care The effectiveness and quality of health and social care services depends on the success of partnerships within the health and social services sector. Partnerships define how well the health and social services providers react to varying needs of patients. A crucial element of partnerships is the mileage that it achieves in enhancing fairness, equality, respect, quality and independence among the professionals and patients. In essence the importance of partnerships underlies any health industries realm of caring for the patients. The collaborative process in partnerships allows empowerment of different players in the health and social care services industry. Empowerment will greatly solve the negligence of patients, who must be viewed as crucial in the process. The healthcare giver and the patient will create a partnership that will help the two help each other. The partnership must be based on the principle that decision making is for all and not a responsibility of one group. Health care seekers should participate in the process so as to aid the process of transformation and proper use of resources released by the government. Despite the ethical dilemmas involved in the provision of healthcare, the caregivers are supposed to give the patient the ability to make their decisions. In this scenario, patients must be exposed to all alternatives possible to help them make informed choices. Partnerships are vital in sharing of crucial medical information between organizations and people. Although, healthcare givers should keep confidentiality and privacy of patient’s information, the partnership will enable sharing of information. In the case of the man with disabilities, lack of information sharing between the persons involved and the various authorities proved the crucial tilting factor to the death of the man. Partnerships bring together various bodies concerned with healthcare in a forum that addresses the various health needs of the people. While the government provides funds to autonomous bodies like the Mid Staffordshire NHS Foundation Trust to run and manage hospitals, the people should be vigilant on how this is achieved. The only way to ensure that the autonomous bodies function effectively is through formation of partnerships. In addition, social care is another field that needs another type of partnership (Ashley and O’Rourke, 2002). It is important to note that caregivers should have the necessary support from the various bodies that ensure access to effective health and social care services. The role of providing the necessary support lies with the organizations ability to forge a working relationship with a common goal of addressing the patient needs rather than serving financial needs. Power sharing is another major element that partnerships aim to achieve. It is crucial that the various partners serve as equally and that the input should be considered. A curious case in the Stafford Hospital scandal was lack of power sharing. Complaints by nurses and patients were not considered due to the structure of the trust that managed the hospital. Lack of a working partnership between the trust and higher authorities ensured that the hospital remained marginalized. The formation of power cocoons within the hospital run down the structure to the nurses, who viewed themselves as powerful compared to the needs of the patients. It is ironical in the sense that the trust entrusted with providing health and social care services to the people was more powerful than the needs of the care users. One of the crucial aspects of the partnerships is the derivation of quality and effective health and social care services to the users (Owen and Meikle, 2013). 2.1. Models of partnership working across the health and social care sector The health and social care sector is a vital sector of the country and provides vital services to the population. The vast needs of the people and the conglomerate of various health and social care services players require a given organizational structure to effectively manage it. It is evident that the failure of the Stafford Hospital staff to give quality and effective care to the patients under its care was due to the poor model that the government employed in the management of the hospitals. The manner in which the hospital was run shows a deplorable state of partnership models that relegated running of hospitals to autonomous bodies with no reviews to assess their performance. The unified model is the model in use at the management of the hospital. The model relegates the running and decision making concerning a hospital to a trust, which has been passed by the Health Care Commission (HCC). The Stafford Hospital was under the management of the Mid Staffordshire NHS Foundation Trust, one of the many trusts that have been passed to run various hospitals in UK. Under the model, the trusts are given the funds and the authority to make decisions that ultimately affect the quality and efficiency of health and social care services provided by the hospitals. Under the leadership of the trust, the various sectors of the trusts failed terribly, with each blaming the other for the problems. The failure of the model to rule over the health and social care services sector is evident in the decisions made by the trust’s board with total disregard of the plight of the people they are supposed to care for. One of the worst decisions was to cut down the number of nurses in an attempt to cut down the costs, which highly limited the number of nurses available in the already under-staffed hospital. Further, the hierarchical nature of the management left no room for taking into consideration the opinions of those who were involved with the patients on daily basis. Equality and power sharing were simply out of question. In such an environment nurses and doctors were left with no choice but to turn their problems to the patient, who bore the full brunt of the failures. The inefficiency of the management could not be spotted as it remained autonomous and independent of reviews by any other authority in the health and social care sector. 2.2. Legislation and organizational practices and policies for partnership working in health and social care The health and social care services sector is highly regulated. The major legislation that regulates the health and social care services sector is the Human Rights Act of 1998. The European convention 2000 law has various Articles that deal with the rights of individuals to access and treatment when seeking health and social care services. The article in the law provides for the patients’ rejection of subjection to inhumane and humiliating treatment. Further the article provides for confidentiality of patients’ information. The UK has other major legislations that pertain to patients’ access to health and social care services and partnerships when working in the health and social care sectors. These laws and policies that encourage partnerships but were ignored in the Stafford Hospital scandal and the death of the disabled man include various legislations that require health and social care professionals to work together. It is ridiculous that many of these legislations were not effected during the two cases. The SOVA (Safeguarding of Vulnerable Adults) policy would have been effected to protect Adult A from succumbing to gang activities. The Stafford Hospital scandal ignored the implementation of the Laming reports and Putting People First policy that would have seen the nurses and hospital personnel prioritize the welfare of the patients. There are many other legal acts and legislations that uphold the wellbeing of people who seek health and social care services. The Care Standards Act of 2000 stipulates the level and quality of care that individuals should have access to. Various policies also exist that seek to safeguard care provision which include, Rights to Action, Children First, Quality Protects and Every Child Matters (ECM), among many other policies with regard to provision and access of health and social care services. The health and social care industry has Code of Practice for Employers of Social Care Workers and Code of Practice for Social Care Workers. These codes of conduct give the mandatory ethical guidelines that social and health workers including nurses and doctors should uphold in their services. All these policies and legislations were not factored in or adhered to in the two cases. 2.3. Working practices and policies’ differences and their effects on collaborative working Various professionals and management bodies use different policies and practices in delivering health and social care services. A major difference outlined in the two cases is lack of uniform working practices and policies that could help in addressing the needs of the people involved. However, one of the problematic facts that remain questionable is the use of the same policies by the people involved in the health and social care services provision. The underlying fact is the differences in working practices of the different organizations and individuals involved in the health and social care sector. These differences have profound effects on the success of collaborative working. One of the effects of the differences is the breakdown of flow of information from one sector to the other. The breakdown limits the availability of information to other sectors that are involved with implementing changes. In the Hospital scandal, working practices differences between the nurses and the management of the trust remained the barrier to the effective provision of health and social care services to the patients. In the case of Adult A, working practices hindered the security officers from reporting the same to social care givers about the problems of the disabled man. Working practices differences occur in various ways; key among them being the different procedures that health and social care professionals use in their working. While it appears normal to have the same policies that guide provision of health and social care services, it is apparent to note that individuals have different working practices, which may hinder collaborative working if common practices and policies are not established. 3.1. Outcomes of partnership working for users of services, professionals and organizations The Stafford Hospital scandal and the Adult A case all showcase lack of collaboration among the three groups in the health and social care (HSC) sector. There are many benefits that come with working in collaboration to the professionals, services users and organizations involved in the health and social care services sector. In order to resolve the problems of the hospital and other disability related maltreatment cases, there is need to evaluate the potential benefits of the partnership. Further, there is an immediate need to find ways of partnering among the players in the health industry. The partnership will ensure that users access quality and effective health and social care. The partnership will enable decision making to prioritize on the wellbeing of the patients as the major focus of the sector. Further, users will be empowered to make decisions that affect their health. These decisions must be based on the information that professionals give to the patients. As a result, informed decision making and confidentiality will be a positive outcome of the partnership (Baxter, Glendinning and Clarke, 2008). Professionals will also be empowered to make decisions and contributions without the fear of being sacrificed. The opinions that nurses and social care givers will contribute will enhance the level of health and social care given to patients. At the centre of the partnership is reduction of the workload on the professionals as it will be easy to perform their duties without the fear of persecution as well as patient interference. The mutual understanding that will be created by the partnership will go a long way in ensuring that health and social care services are patient-focused. The partnership will encourage a bottom-top approach to addressing the problems within the sector and not the other way round. Organizations will benefit from the ease of making decisions using the information gathered from the ground without comprising their roles. It is apparent that Stafford Hospital suffered from a top-bottom approach to decision making that was not consultative. This risked the patients’ welfare as most of the decisions were not practical, for example, reducing the number of nurses in the understaffed hospital. Another vital aspect of partnering is power sharing. Power sharing will enable all the parties to have an opinion over the processes that touch on them. However, the necessity to have a patient-focused paradigm will be important as an outcome of the partnership (Campbell, 2013, par.7). 3.2. Barriers to partnership working in health and social care services There are many barriers that prevent successful partnerships in the health care industry. One of the major barriers to partnerships is lack of common practices and policies governing the health and services care sector. Although the country has a lot legislations and policies that regulate services provisions, there was no clear mandate of how they were to be observed. This affected the way services were provided at the hospital with some nurses being bold enough to tackle the problem while other just went about their business as usual. Lack of common policies and practices allowed for neglect of patients and failure by the hospital’s management to address complaints from the patients’ families. The second barrier is lack of common decision making. It was important that decision making be subjected to all the players in the sector to ensure that decisions made are favorable to all. It is sad that the various departments of the management made decisions independent of each other and that weighed down to the patient. This allowed errors, bad decisions and implementation of the decisions poor. Lack of the management to partner with the nurses resulted to poor decisions. Another barrier is lack of follow-up. It is important that partnerships have follow-up mechanisms to ensure that decisions made are implemented and observed to the last one. However, follow-up lacked in both cases, which cut the partnership between the decision-making organ, and the implementing department. The quality and effective services delivery was thus compromised. Another barrier is lack of monitoring. Lack of monitoring was a major factor in the escalation of the Stafford Hospital scandal and the death of Adult A. monitoring ensures that partnerships are functional and if not, useful remedies are incorporated. Further, monitoring ensures that all players are active in their respective roles. If the HCC was monitoring health and social care provision, it would have discovered the problems at Stafford Hospital. Likewise Adult A would not have succumbed to gang-related activities (Campbell, 2013, par.8). 3.3. Strategies to improve outcomes for partnership working in health and social care services There are various strategies that can be implemented to ensure that partnership function effectively. The first strategy is to change the model of partnership from a unified model to a coordinated model. The Stafford Hospital scandal has highlighted the major problems of using the unified model of partnerships working with health and social care services. The use of an autonomous management to run hospitals provided avenues for the management to uphold their interests at the expense of what they were mandated to do. Further, the autonomous nature of the trust could not allow other bodies to infiltrate their management structure. The hierarchical nature of the management limited empowerment, information sharing, power sharing and other vital elements that enable partnerships to thrive. The trust will have to be dismantled and major smaller bodies that work together formed to ensure that they all partner to enhance services delivery. The second strategy is to provide common practices and policies for all players in the health and social care services sector. The existence of autonomous bodies created a culture of impunity where professionals failed to observe protocols, and code of conducts pertaining to their work. Further, the system did not focus on the welfare of patients but rather on the management interests. Failure to adhere to health and social care policies prevented the partnership of professionals, services users, and the organization. This interplay was felt by the patients. Thus, a system should be established to ensure that policies are adhered to and stern disciplinary measures taken to those who do not adhere to them. Another strategy that can be adopted is establishment of a monitoring agency to ensure that the decisions made are followed and implemented to the last one. This will ensure that all players focus on services delivery and not on personal interests. This will also enhance the partnerships as all professionals and organizations will be under one umbrella. Another strategy that can be adopted to ensure that partnerships working in health and social care services provision are successful is establishment of compatible systems in the various sectors where all the players can contribute and work together. A major failure in the management of the Stafford Hospital was lack of an open and compatible system that could allow patients, their families and concerned nurses to lodge complains directly to the management. The existing system allowed a hierarchical type of reporting that exposed concerned people to witch-hunting, intimidation, discrimination, abuse, humiliation and threats. Thus, the cooperation between the different players could not succeed due to these impediments. The death of Adult A can also be attributed to lack of a common system where observations, decisions made and action taken could be logged in and accessed by other people within the health and social services sector. However, establishment of a system where lodging complains will be private and confidential will help a great deal in ensuring that all the players cooperate in a successful partnership. Such systems will also helping tracking the type of interventions sought and accessed. Crucially, the system will ensure that each person is held responsible for their actions to patients or people under social care. Adopting a patient-centered philosophy is another major strategy that can be adopted to ensure that partnerships working with health and social care services are successful. The Stafford Hospital working philosophy was not streamlined to address the needs of the patients. Further, the management did not realize or neglected the need to have inputs from patients who were the main beneficiaries and were affected by their decisions. A patient-centered philosophy will ensure that the patients are consulted before any decisions are made. In addition, professionals and management will work together in ensuring that the necessary resources are availed for the welfare of the patients. 4.0. Conclusion The Stafford Hospital and Adult A crisis displayed serious health and social care lapses that cost lives of people. The two cases are an indicator of a failing health and social care system that needs upgrade. The major failures stemmed from lack of partnerships of working in health and social care that created huge gaps between the needs of the services users, professionals and organizations. Further, there was lack of a model that could integrate the three players together. The existence of different working practices, policies, and hierarchical system of management of the hospitals worsened the situation. Introduction of various plans like common policies and working practices, removal of the health and social care services management, reduction of barriers of partnerships working with health and social care will play a crucial role in ensuring that health and social care services provision as at its best. Bibliography Carter, H. 2010. Police investigates death of man with learning difficulties tormented for years by gangs. The Guardian, 12, March. [Online]. Available at [Accessed 14 March 2041]. Campbell, D. 2013. Mid Staffs Hospital Scandal: the essential guide. The Guardian, 6th Feb. [Online]. Available at [Accessed 14 March 2041]. Francis, R. 2013. Report of Mid Staffordshire NHS Foundation Trust public inquiry. [Online]. Available at [Accessed 14 March 2041]. Owen, P. and Meikle, J. 2013. Mid Staffordshire NHS trust inquiry report published. The Guardian, 6th Feb. [Online]. Available at [Accessed 14 March 2041]. Ashley, B. and O’Rourke, K. 2002. Ethics of Health Care: An Introductory Textbook. Washington: Georgetown University Press. Baxter, K., Glendinning, C. and Clarke, S. 2008. Making informed choices in social care: the importance of accessible information. Health and Social Care in the Community, 16(2): 197-207. Read More