Recently in NHS Category

• Greater involvement of mental health specialists in primary care.
• Much greater investment in liaison psychiatry services in acute hospitals to identify people with mental health problems.
• Training for physical healthcare staff in basic mental healthcare.

There is less about the role of social care professionals in this report, beyond stating that they have a role to play, particularly in relation to people with dementia and long-term conditions.

It would be good for this to be fleshed out as social workers and other care professionals have a crucial role in identifying people with co-morbidities, taking a holistic view of their condition and co-ordinating their support. Hopefully, this is something that can be addressed.

• Better information about the care pathways taken by people detained under the Act or placed on community treatment orders and about how long people are detained. Information on this could help improve the commissioning and design of services in local areas.
  
• Breaking down the use of compulsory powers under the Act by employment status, diagnosis and, crucially, ethnicity, rather than just gender, as the KP90 collection currently does.

So it's worth answering the consultation questionnaire if you get a moment.

Good Guardian piece this morning about bringing together health and social care from Pollyanna Perkins, aka a "director of adult social care for a large local authority".

Here's the secret of success in her view: "It's all about relationships, co-working, shared caseloads, but most importantly it's about individual clinicians and managers understanding the whole system - and not just their bit of it - on both sides of the house."

She then cites experience of this working in her area and now social workers are having daily virtual meetings with health colleagues to discuss older people on their joint caseloads.

What good joint working isn't about she says is structural change.

This is a particularly good articulation of a longstanding position. However, it often seems to me that for every person who makes the argument that good joint working is all about relationships, you will find another who will say that dependency on relationships is a dangerous thing. That when people move on, good joint working moves on with them.
We linked to a blog articulating this position from consultancy iMPOWER recently, which made the case for some level of structural change to secure joint working against dependency on particular individuals.

I am sure there is something in both these positions.
That you need strong relationships and also some rules in place to ensure security when people move on.

The secret to both appears to be strong leadership - a point made by Pollyanna Perkins - so the question is whether those leaders are working in local government and the NHS today or not. And if they are, what happens when they move on?

Another day, another report on integration for the government, this time from the NHS Future Forum (the advisory body set up to inject common sense into the government's NHS reforms).

The proposals are pretty similar to those put out in last week's report from think-tanks the King's Fund and the Nuffield Trust: strong support for social care and the NHS to be measured against the same performance indicators, for pooling budgets and commissioning and for building services around patients' needs.

Notably, for professionals, there is a call for every person with long-term conditions to have a named care co-ordinator, who could be a social worker.

The government has, largely, accepted the proposals.

However, the question is, will this work where other initiatives to do the same over previous decades have not? 

Social care academic Bob Hudson thinks not, in a powerful piece for The Guardian today, in which he argues that the whole issue is being looked at from an NHS perspective (with adult social care seen as the "handmaiden" to the health service), weakening its potential impact.

More significantly, he says the agenda amounts to yet more exhortation for health and social care organisations to integrate - precisely the approach that has failed for 40 years, he says.

Also, he notes the big tension in the government's NHS reforms between competition for business between providers and integration of care pathways for patients.

Not an easy square to circle, he says.

I fear we may be revisiting this topic with another mountain of reports in years to come.

(Added 13 January: Just spotted this blog post from social worker and psychotherapist Claudia Megele about the government's integration plans, which raises important concerns about the compatibility of these with other government actions, such as the injection of greater competition into healthcare through the Health and Social Care Bill).