Integrated working of GPs and social workers
Long term conditions
- University of Birmingham
- CLAHRC WM
31 March 2014
The integrated working of GPs and social workers programme has two major components: undertaking qualitative fieldwork with groups of professionals from the two services, which looked at the current perceptions and experiences of collaboration with one another; and developing training materials that would enable the two services to work better together.
The GPs and social workers' focus groups have provided rich detail on the realities of the collaboration between these two key services, which have been presented on national platforms and will be of considerable value to regional and national integrated care initiatives. It is also expected to generate insights that will be of international interest due to the importance of health and social care relationships. There has been considerable interest both regionally and nationally in the development resources.
Planned outcomes are:
- Explore the central and often difficult relationship in the health and social care system, namely that between the key entry points of general practice and adult social work teams
- Build on principles of interprofessional learning to create development activities that respond to the current tensions in this relationship
- Improve inter-professional working between general practice and adult social work teams, which in turn will support more holistic and person-centred care.
- Focus groups have been undertaken with general practices and their linked adult social work teams. There has been a good attendance from different professions and occupations at the focus groups. The focus groups have provided substantial data on the knowledge, behaviours and assumptions that currently support or prevent collaboration between these two services and the professionals that work within them. In doing so they have started to unlock the ‘black box’ of this area of integrated practice and so meet the first outcome of the project. The findings have been presented at a national conference and an article accepted in the UK’s leading practice journal for this area, the Journal for Integrated Care.
- Key to the WMAHSN support was engaging with CCGs, which along with the local authorities and general practices have multiple priorities during this period. There is also a tendency for commissioners to focus on the structures and processes around integration rather than the professional practices, and this has led to the importance of this aspect not always being recognised (despite the considerable international evidence that underlines its centrality).
- A final input from the project will reflect these challenges, as these have undoubtedly hindered previous attempts to address this vital aspect of integrated working.
- The focus groups have already provided rich detail on the realities of the collaboration between these two key services, which in itself will be of considerable value to regional and national integrated care initiatives. It is also expected to generate insights that will be of international interest due to the importance of health-social care relationships. Key findings to date are that while examples of positive interactions do exist, these are often related to primarily to the attitude of individuals rather than systemic initiatives. More commonly encountered were negative experiences based on perceptions of different value bases, a lack of knowledge about each other’s roles and responsibilities which resulted in stereotypes, poor interprofessional communication, and a sense of an unspoken professional hierarchy with GPs as the most powerful. The latter appeared to prevent a culture of appropriate inter-professional challenge.
- The training materials have been developed and are hosted exclusively for subscribers on Community Care Inform Adults.The training materials have been designed to try and address the quality of inter-professional relationships, building on the real life experiences and perspectives of social work teams and general practice to develop activities that open up dialogue about education, incentives, responsibilities and values.
- In terms of sustainability, there is considerable interest both regionally and nationally in the development resources. This has been generated through existing networks, a national event exploring general practice and adult social care working, and a developing partnership with the College of Social Work and the Royal College of General Practitioners.
Dr Robin Miller
t: 0121 371 8061