‘Wellbeing is at the forefront of the Welsh act but no one seems to know what it is’

A Welsh practitioner shares his concerns about the upcoming implementation of the Social Services and Wellbeing (Wales) Act

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By Arthur Holden, Colwyn Bay

Wellbeing is at the forefront of the Welsh Government’s new social services act, but no one seems to know what wellbeing is. This may be because there is in fact no clear or measurable definition of wellbeing. The government appears to have invented eight main parts upon which they base their wellbeing act. These are often meaningless phrases such as “positive relationships with family and friends” or “being part of the community”.

The fact that wellbeing is not measurable means no study can be used to assess the effectiveness, for service users or service providers, of such government-backed and local authority-devised interventions. Ministers need to take the lead and more accurately define what they mean by wellbeing, or use more rigorous and tested tools such as the quality of life measurements.

The act also requires councils and local health boards to work collaboratively and use a common assessment template. This is very similar to the way intermediate or reablement care was set up in Wales some 15 years ago and, quite frankly, it’s a mess.

Reablement care in Wales, which can produce measurable improvements in the lives of older people in particular, has so far been unable to attain even a postcode lottery status. It is more akin to a ‘Wild West’ lottery, with health boards and councils each delivering their own versions of what may or not be intermediate or reablement care.

‘Silo systems’

Another big issue touched upon by the new act is the requirement that: “systems, forms, recording procedures and practices are consistent between councils and health boards in the local area”. The current geographical boundaries, coupled with silo management throughout these organisations, would seem to present a barrier to this happening, as has already been shown with other government initiatives.

IT systems are also a massive issue – they are often the elephant in the room at inter-agency meetings, particularly with regards to POVA or adult safeguarding. The Caldicott report (1997) and subsequent reviews have called for councils and health boards to share patient or client information effectively and appropriately, via controlled use of secure IT systems, email, and document sharing portals.

Frontline professionals called for information sharing between health and social services during the very early days of the Welsh Government. Those calls were ignored.

As a result, IT systems in Wales are now more siloed than ever in the everyday work of health and social care professionals. The expense that needs to be incurred to enable true joint IT working is now probably prohibitive. It has also never been recognised, with regard to adult safeguarding, that the police and inspectorate in Wales would also need to be included in any “secure information sharing” IT system.

With regard to health and social care in Wales, the Welsh Government has presided over a catalogue of missed opportunities to support frontline staff. This is due to their poor planning and implementation, based on otiose policy making.

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2 Responses to ‘Wellbeing is at the forefront of the Welsh act but no one seems to know what it is’

  1. yvonne bonifas February 10, 2016 at 3:03 pm #

    No one knows what wellbeing means. That’s why it is being used – it’s nice and fluffy and raises expectations in clients which we cant meet as resources don’t allow. This government places duties and expectations on local authorities then makes it impossible to carry them out, the public blame the front line workers or the council, bingo, ripe for privatisation.

  2. Andrew Burford February 13, 2016 at 10:26 am #

    This is a particularly pessimistic outlook that may not resonate across Wales. In my area, we do have an effective, integrated Health/Social Care structure, we do have a shared IT system and we are embracing a move towards wellbeing defined by the service-user. By placing the person at the centre of our multi-disciplinary responses, we have managed to navigate the organisational tribalism that has formerly beset us. I wouldn’t suggest it’s been easy, but we are seeing the benefits of a tenacious approach to making it work. Perhaps we need a similar approach to implementation of ‘the Act’, rather than labour reasons why it will be challenging, let’s focus on how we will collectively deliver.