Unison report calls for accelerated integration efforts in Wales

Integrated services helped to 'reduce bureaucracy' and led to 'significant change' in the three case studies reviewed

Report authors: Mark Llewellyn; Tony Garthwaite and Heulwen Blackmore: Natasha Hirst

Unison has released a report calling for the acceleration of health and social care integration within Wales.

Written by the Welsh Institute for Health and Social Care (WIHSC) at the University of South Wales, the ‘Working for a shared common purpose’ report studied three examples of integrated care in Monmouthshire, Bridgend and Anglesey, concluding that integrated services allowed service users and their families greater control over the planning of their own care.

However, a lack of trust and poor communication between different agencies within integrated services at present was found to be causing confusion and disruption of care, the report found.

‘Strong leadership’ key to integration

The paper was commissioned following complaints from care and health workers that those receiving care were being failed by a disjointed system.

“Strong leadership” and “clear direction” were two important factors in achieving integration, it said.

In particular, strong guidance from managers was stated as being “essential at all levels” of the process as those behind the report said a shared vision was also “critical in maintaining support for integration” within the workfare.

Despite this, the report found a “top down approach” was not necessarily required, saying that a desire “to engage staff at all levels and develop a mutual understanding” was equally as important.

Professor Mark Llewellyn, one of the report authors, commented on the need for collaboration between the two divisions.

“Quality care is focused on the individual and their needs, not the structure delivering care. Everyone needs to share that common purpose. The positive message of our report is any obstacles to excellence in care can be overcome if you take the workforce with you and trust their judgement.”

A need for ‘mutual trust’

Relationships between decision-makers was another factor considered by the Unison review.

It found that establishing a “mutual trust” between those “around the table” allowed staff to reduce bureaucracy. However, information sharing was said to need further development, with systems and procedures “not yet set up” to enable information sharing to take place routinely between agencies.

“Unison members working across care and health services know we can do better than this in Wales. They want to be involved in planning care and trusted to make decisions, so the needs of the individual are at the centre,” Margaret Thomas, Unison regional secretary, said.

“This report calls for an acceleration in the scale and pace of health and social care integration. We’ve got to have a more effective service which will help service users and employees alike,” she added.

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