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.
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.