Guest article: Working together to improve health and social care for all
The government has recently published a paper setting out legislative proposals for a Health and Care Bill, which focuses on collaboration and integration across health and social care. In this article, David Griffiths, Managing Director at Medequip, explains why the community equipment specialist wants to see a focus on behaviours, as well as policy and legislation.
As a family-owned business operating since 1998, Medequip has worked through many policy changes in health and social care. Over this period, we have always worked in partnership with contracting authorities, the people who use our services and the many organisations working to support them.
The most recent paper on the subject is hard to argue with. Who wouldn’t support integration and innovation if it helps to improve health and care for all?
But has this government and the NHS learned the lessons of the previous NHS reorganisations?
Is it simply a shuffling of responsibilities with only lip-service paid to the fundamental challenges facing our society and the behaviour change needed to address them? At Medequip, we see those challenges every day. At Medequip, we reflect on our behaviour every day.
For example, does this policy and the impending legislation deal with the systemic issues that challenge true pooled budget arrangements? I know they are only one aspect of integration but we feel there is more that could be done.
Integrated Community Equipment Service budgets are a longstanding example of pooled budgets. The theory behind them is simple. It can be a fruitless exercise trying to work out whether it is the NHS budget or social care budget that should fund particular items of community equipment and even more complicated to establish which budget benefits in the long-term. So, much simpler to pool the budget, focus on outcomes and share the risks of an overspend.
Even with these longstanding arrangements and history of partnership working, we are seeing increasing requests to separate out health and care spend. With years of underfunding, the pressure had to come out somewhere. Budget pressures have damaged the trust between partners.
We work with over 40 contracting authorities, countless public, private and voluntary sector providers and a whole warehouse full of different suppliers and manufacturers. Through this, we have learned one thing about true partnership working: it happens when people trust each other and when they take the time to understand each other’s position, challenges and cultures.
Then, and only then, will we achieve more by working together than we do trying to address the challenges individually.
Without that trust, the system will grow layers and layers of bureaucracy, financial controls and governance. Not only between the partners, but between the organisations and the people we are here to serve and support.
So, whilst commentators debate whether the policy does enough to address social care as the poor relation, the merits of “a duty to collaborate” and the technical challenge of having two parallel governance structures for Integrated Care Systems, we at Medequip would encourage policymakers to focus on supporting the behaviours that grow trust between organisations so that we can better earn the trust of the people we are here to serve.
While that debate happens, we will continue to deliver, service and collect over four million items of equipment a year, to listen to and learn from the 1.3-million people we support each year, and work in partnership with those that trust us to provide public services on their behalf.
If you would like to work in partnership with Medequip, why not contact me or one of my trusted team at firstname.lastname@example.org.