Journal of Community Nursing - page 14

14 JCN
2013,Vol 27, No 4
The big issue
Crossing the health
and social care divide
Michael Hurt, Joint Commissioner for Mental Health and Dementia, Walsall.
here’s a reason why singularity
of purpose is valued in many
spheres of life — after all,
imagine trying to run a football team
with two managers, or a Michelin-
starred restaurant with two head
chefs. If Gordon Ramsay has taught us
anything, it’s that having a clear vision
about what you want to achieve is
vital (even if random swearing is not).
The knowledge that clarity and
clear leadership result in successful
enterprise makes it all the more
puzzling that in the UK we persist
with two distinct systems for looking
after our vulnerable people, even
though they have overlapping needs,
which rarely fit neatly into the terms
‘health’or‘social care’.
In modern times, or at least
since 1948 when the NHS came
However, recently, there has
been a drive from government to
merge the two sets of services to
improve communication, share
resources and, of course, save
money, resulting in the current
proposals on closer collaboration
between health and social care
by-2018). The aim is integration,
with social workers, nurses and
GPs being asked to share the
same workspace, procedures and
caseloads, with the hope that
patients will no longer fall through
the cracks or feel passed ‘from pillar
to post’.
But, what does that mean for
community nursing and how will
it affect the way you work in the
future? It may simply require nurses
and social workers to share premises
so that they can liaise over patients;
in some areas it may mean joint
visits and consultations; or even
commissioning services together.
In some places this work has
already begun. In Walsall, Michael
Hurt is the Joint Commissioner
for Older People’s Mental Health
and Dementia and he has put a
lot of effort into bringing health
and social care together for the
benefit of patients, in particular in
preventing people getting admitted
in the first place.
‘We are developing a crisis
model,’Michael says,‘where staff
from mental and physical health will
work closely with social workers to
assess a person holistically.’
As government reforms seek to encourage health and social care
professionals to work closer together,
Jason Beckford-Ball
Binkie Mais
investigate what this means for community nursing services.
into being, health and social care
in the UK have been provided
by separate professional groups
with their own services, budgets
and regulatory frameworks. The
division originally arose partly from
the need to charge for ongoing
social ‘care and attention’ for the
elderly population in nursing and
residential homes, while the NHS
was provided free for people who
were considered ‘sick’.
There has always been much
debate on the blurred lines
between the two, with arguments
over whether helping an elderly
person bathe, for example, is a
medical or a social issue, and
there has always been a transfer
of patients and resources between
the two spheres, sometimes more
successfully than others.
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