Partnership Working In Health And Social Care

Introduction 

 The health and wellbeing of individuals in the community is usually complex such that no single organization or profession can be able to meet individuals' health and wellbeing needs on its own.  For instance, a person at risk of heart disease would need nutrition advice, medication, and regular check-up from their local GP. Unfortunately, that would not be adequate to meet his or her health and wellbeing needs. In addition, they might also need an exercise program overseen by the local authority Leisure Centre. In other words, to meet the health and wellbeing of individuals in society, different organizations have to play a role in improving the health of an individual.  In addition, the collaboration between different professionals is necessary for delivering holistic and integrated care. For instance, Clinical psychologists might need to work with occupational therapy, speech learning therapists, or a team or nurse or social care workers to deliver holistic care to a patient. In addition, the patients themselves and their families usually have knowledge and skills that would make health and social care even more effective better and tailored to their needs. As such, evidence has shown that when health professionals work in partnership with patients or their families, better and effective care is developed and implemented (Smith, 2013). Unfortunately, health and social care have traditionally be delivered in a fragmented manner with little or no collaboration between organizations, professionals, or individuals and as result, the health and wellbeing of individuals suffered. Therefore, to improve the health and wellbeing of individuals in society, partnership working in health and social care has become necessary. Partnership working within the health and social context is defined by Sheehy (2017) as bringing together separate organizations, professions, and individuals to deliver integrated care to individuals in the society.  It is all about bringing separate organizations and professions together to pool resources, expertise, and share information to offer well-integrated care to the patients in the society.  This essay will discuss the key elements of partnership working, evaluate the importance of partnership working and discuss how to overcome barriers and solve the conflict in partnership working in health and social care. 

 a map of partnership working in health and social care

 The map above shows partnership working between care home, NHS and local authorities. For instance, though such partnership, the NHS release patients to the care home but through the partnership arrangement, the NHS will continue to provide support to the patients while in the care home. For instance, it would provide mental health team, therapists etc. equally through partnership with local authority, the care home would be able to meets some of the patients health and wellbeing. For instance, by accessing local authority’s leisure center. 

The key elements of partnership working 

 Partnership working in health and social care takes place at three different levels.   The first level is created at the service users’ level. This includes the relationship between the service users or their families, the organization, and the professionals. The second level is created at the professionals' level. This usually involves collaboration between different professionals in delivering care.  The third level is created at the organization level where different organizations work together to deliver integrated and improved care. Each of these levels of partnership is unique and has its own opportunities and challenges and therefore the key element required for effective partnership at each level varies from the other.  The key elements that are needed for effective partnership working at each level are as discussed below. 

 External organizations 

One level of partnership working in health and social care is the multiagency partnership. Multi-agencies partnership is a form of partnership where different organizations with different expertise work together to deliver well-integrated care to individuals to improve their overall health and wellbeing (Gasper, 2009).  So, when working with external organizations in a partnership arrangement, several key elements must be observed for such a type of partnership to be effective. These elements. 

Shared vision – there must be a shared vision between the organizations within the partnership arrangement. Share vision means that the parties to the partnership agreement agree on what is to be achieved i.e., the goals and how to achieve them i.e., the strategies. Partnership working that lacks shared vision cannot last for long since the bond between the partners is too weak (Carnwell & Buchanan, 2005). 

Autonomous- another key element of effective partnership at the organization level is autonomy. The partnership working arrangement should not undermine or threaten the independence of each of the partnering organizations.  Each organization should be able to remain independent and able to execute all its other mandates as usual (Atkinson, Jones & Lamont, 2007). As noted by Gasper (2009) when one organization feels the partnership is threatening their independence, they will be forced to withdraw from such arrangement to protect their autonomy. 

Transparency and Information Sharing -effective partnership with external organizations requires that all organizations are transparent and share all the necessary information with each other. 

This not only helps in creating trust among the partners but the free flow of information in the partnership allows all parties to plan and deliver well-coordinated and integrated care (Gillen, 2011). 

 Power-sharing- an effective partnership with other organizations requires that power is shared among all organizations involved.  No single organization should feel disadvantaged. This, therefore, require that authority and responsibilities are shared equally. Every partner should be part of the decision-making process (Glasby & Dickinson, 2014). 

 Colleagues

 Some forms of partnership are formed at the professional level. One such partnership is formed between colleagues from different professionals who work together to deliver better and integrated care to individuals within the society (Thomas, Pollard & Sellman, 2014). For instance, a clinical psychologist would need to work closely with occupational therapists, language therapists, and local learning disability nursing teams to care for a patient with multiple health problems. Some keys elements must be observed for such partnership to be effective. These elements are;

 Sharing of information – when working with other colleagues, all individuals involved must share all relevant information with each other.  As noted by Thomas, Pollard & Sellman, 2014) it is only through sharing of information that all the partners involved are able to plan together and deliver truly integrated care to the patients. if partners fail to share information with each other, then it became difficult to put in place a well-integrated care package in place and this is when opportunities for improving individuals' health and wellbeing are missed.   Also, as noted by Leathard (2003) when some of the colleagues in an interprofessional partnership withhold information from the other, mistrust occurs, and this usually leads to failure of the partnership. 

 Respect- when working with other individuals from different professions or disciplines to deliver care to the patients, it is important not only to consider others as partners but also to respect them, their contribution, and their profession (Glasby & Dickinson, 2014).  If some partners feel undermined or disrespected, they are most likely to pull out of the partnership or contribute.

Empowerment- When working in partnership with other professions, the partner should seek to empower each other's in that each partner will come out of the partnership stronger and better (Glasby & Dickinson, 2014). 

 Independence- working in partnership with others the partnership arrangement should be done in a manner that still allows each of the other colleagues to work independently on their other responsibilities. If the partnership working threatens the independence of other colleague or their profession, they are likely to withdraw from it or get less committed to it (Atkinson, Jones & Lamont, 2007). Therefore, to ensure an effective partnership is created, the independence of each individual and their profession should be maintained.

Power-sharing - when working in interdisciplinary partnership with others, decision-making power must be shared equally. No single individual or group of individuals should try to make the decision on their own and impose it on others. All the colleagues in the partnership need to be part of the decision-making process. As noted by Thomas, Pollard & Sellman, (2014), most interprofessional partnership usually fails when some of the individuals in the partnership feel left out of the decision-making process.  As such, no one should feel isolated, undermined or his or her input in the decision-making is undervalued.

 Individual

Health and social care workers are required to work in partnership with the individual being cared for.  The partnership between health and social care professionals and users of services requires that several key elements are observed. These elements are. 

Power shower sharing

The concept of power-sharing requires that health and social care workers involve the service users in making a decision affecting their care (Butt & McGuinness, 2008). in traditional health and social care, the health or social care professional used to be the primary or sole decision-maker in regard to the care the service users were to get. However, for partnership working at the service user level to be effective, the service users and the health and social care professional need to make the decisions together. 

Making informed choices

 This requires that service users are provided with all the necessary information and options available to them so that they can make a well-informed decision about their care. the health and social care workers should then respect the choices and decision made and should therefore work to ensure such choices or decision are properly implemented for the improvement of the health of the service users (Butt & McGuinness, 2008)

Independence

Partnership working is based on the principle of equality. I.e. no single party to the partnership should seek to exert their authority over the others.  Therefore, for partnership working to be effective when working with service users, their independence must be respected and promoted. Any attempt to interfere with their independence would result in service users withdrawing from the partnership and hence unable to deliver better care to the service users (Skillsforcare, 2017). 

Empowerment

As noted by Skillsforcare, (2017) in a partnership working between professionals and service users, the servicer users are usually the vulnerable and disadvantaged ones.  Therefore, the professionals involved must empower the service users by providing them with the necessary information to make well-informed choices and decisions about their care and life. 

Respect

One of the important elements of an effective partnership is respect. For effective partnership with service users to occurs, the professionals and organizations involved in their care must show and treat the service users with respect at all times. This means respecting their choice, decision, respect who they are e.g. respecting their culture, spiritual beliefs, etc. if service users feel they are not respected by the organizations or professionals involved in their care, it is most likely that they will not cooperate or use the service anymore (Skillsforcare, 2017).

Families

 As noted by Skills-for-care (2020), families and carers are often a vital part of service users, and thus working well with them is important in delivering effective and person–centered care. For this reason, the health and social care professionals must work in partnership with families or carers to deliver better, effective, and person-centered care.  To ensure there is an effective partnership with families or friends or carers, there are several keys elements that the health and social care professionals must observe. These are; 

 Empathy- when working in partnership with families, one of the key elements that are needed is empathy. The health or social care professionals must show that they understand the situations or the challenges the family is facing in their life and also be able to see the situation from their point of view. It is only by doing so will they be able to build a good working relationship with the family (Skills-for-care 2020). 

 Involvement- the family should be involved throughout the entire process when their relative starts to use the service. Involving the families is crucial for several reasons.  First, the families know their relative needs, and preference betters and therefore, they are a good source of information that can help plan and delivered person-centered care (Gillen 2011). Secondly, family involvement makes the family feel valued and also feel they have played a part in caring for their relative (Skills-for-care 2020). 

 Respect-Families have different needs and preferences. Therefore, to ensure the partnership with the families is effective, differences must be not only identified but also respected. When a family feel their needs and preferences are being respected, they are more likely to be cooperative and build a good relationship with the care professionals (Skills-for-care 2020)

 Humility-Effective partnership with families requires the health or social care professional to work within the context of an equal relationship where they use the families’ strengths, views, and knowledge alongside their own.  By doing so, the professional is not only able to build a good working relationship with families but since he or she taps into the families, strength, and knowledge, increases the chance for successful delivering person-center care (Skills-for-care 2020). 

 Communication-An effective partnership with families of those who are being cared for cannot be created in the absence of good communication. Therefore, one of the key elements for an effective partnership with families is creating two-way communication.  Two-way communication allows the families to share crucial information with a professional which can help in designing and delivering person-centered care. it also allows the health and social care professional to pass crucial information to the families some of which help them in making a well-informed decision about the care for their relative as well as empowering them to take better care of their loved one (Butt & McGuinness, 2008). 

Overcoming barriers of partnership working 

 There exist a lot of empirical evidence to shows that partnership working in health and social care leads to improved care and hence the health and wellbeing of individuals (Atkinson, Jones & Lamont (2007). However, in theory, the way the partnership working is presented sounds easy but in reality, the practitioners and services providers are faced with a lot of challenges and barriers that make partnership difficult (Butt & McGuinness, 2008).  For instance, according to the report by Kingsfund (2013), the resource deficit that NHS faces is usually a major barrier to an effective partnership with other multiagency such as local authorities, etc.  Apart from resource constraints, there other barriers to the partnership, and as such, it is important to overcome these barriers.  

 Training- some of the barriers of partnership working are caused by a lack of relevant knowledge and skills by the health and social care worker. For instance, as noted by The Challenging Behavior Foundation. (2012), the health and social care professional inability to listen, their defensiveness when being challenged and their tedious obsession with their organization systems is usually seen by family as lack of respect and humility which make partnership working difficult. This demonstrates that some health and social care professionals lack the necessary knowledge and skills needed to effectively manage partnership working arrangements. Therefore, when the barrier to working in partnership is a result of inadequate skills and knowledge, then training the health and social care professionals on relevant skills and knowledge can help remove the barrier to partnership working (Birrell & Deirdre 2018).

Communication is essential for effective partnership.   In some cases, poor communication usually acts as a barrier to effective partnership working.  To address such barriers, it becomes necessary for the health and social care professionals as well as service providers to established effective two ways communication systems to allow for the free flow of information. However, there is no single correct way to deal with this barrier since they are so many potential causes of poor communication.  As noted by Birrell & Deirdre (2018) at the individual and family partnership level, one of the causes of poor communication barriers is the inaccessibility of health and social care professionals. In such a case, creating good and effective communication systems would be necessary to deal with poor communication. At professional partnership level, poor communication arises when some of the professional use jargon which is specific to their professional and different from everyday language (Birrell & Deirdre, 2018). As a result, some people might feel excluded from contributing to the discussion. In such a case, poor communication as a barrier to effective partnership can be addressed by making sure the language use by all professionals involved is accessible and inclusive to reduce the power imbalance. 

At the multiagency level, one of the barriers to effective partnership working is lack of shared vision or lack of formal structure, accountability, and clear division of role (Birrell & Deirdre 2018; Butt & McGuinness, 2008).  To remove such barriers, it is important to carefully choose the right external partners. Only the external organizations that share the same vision should be selected (Butt & McGuinness, 2008). in addition to that, it is important, that when two or more organizations are working together to deliver integrated care, it is important that they discuss and agrees on how the roles and accountabilities would be divided among the partners and establish a formal structure for their partnership working arrangement.  Doing so would increase chances for effective partnership working (Birrell & Deirdre 2018). 

Resource deficit is also another key barrier to effective partnership working (Birrell & Deirdre 2018).  This barrier is so rampant, especially at the organizational level. For instance, partnership working between NHS and local authorities has often failed to lack adequate resources (kingsfund, 2013). Therefore, to improve the success rate of partnership working in health and social care, all the participating organizations must allocate adequate resources in the partnership arrangement.  All the organizations participating in the partnership arrangement should come to agree on a funding model that is suitable for all. This would ensure that each of the organizations contributes resources to the partnership hence eliminating change of partnership failure that result from inadequate resources. 

 One of the common barriers to partnership working especially at the organization's level is organizational culture (Butt & McGuinness, 2008). Every organization has its own culture which dictates ‘the way we do things around here’. No two organizations have the same culture. Organizational culture is so unique to each organization. When two or more organizations decide to work in partnership with each other to deliver better and integrated care to the society, their culture usually conflicts with each other’s and if not properly manage it led to the failure of the collaboration (Butt & McGuinness, 2008). For instance, one organization may have a culture that emphasis on punctuality. So, if someone attends a meeting late, they might be seen us non-committed to the partnership. In another organization, the meetings might be less important, and it might be deemed ok to attend meetings late if another urgent task needed to be completed. When organizations with such two different conflicting cultures team up to work with each other in delivering integrated care, there is a high chance of their partnership failure due to the differing culture. To address this barrier to effective partnership working, it is important out the formal rule of their engagement to reducing potential organization cultural conflict. 

 Resolving conflict in partnership working 

 Although partnership working means that everyone is striving toward the same goals, sometimes disagreements usually arise in the partnership. Such conflict usually has a far-reaching consequence to both individuals and organizations involved. As noted by Hardy, 2018) when conflicts arise in partnership, they must be resolved amicably so that partners can continue to work together effectively going forward. When conflicts arise in partnership, the first attempt should be to address it internally through negotiation and the established mechanisms if one exists. So, the partners should first attempt to negotiate and reach an amicable compromise. The ultimate goal of the negotiation would be to solve the conflict in a win-win situation and in a manner that does not jeopardize the collaboration relationship Kressel et al (2012). Hardy, (2018) note that during negotiation, parties to the conflict should avoid blame game instead they should focus on describing the situation, expressing their views of the situation,  explaining what they think needs to be done, and discussing the way they are going to move forward together. Hardy, (2018) also notes that effective communication is key to finding a common ground during conflict. This means that parties to the conflict need to be open, transparent, and honest and have a positive attitude with a genuine desire to resolve the conflict.  However, as noted by Hardy, (2018), internal negotiation does not always lead to amicable solutions. So, if internal negotiation does not help resolve the issues, the parties involved should seek the help of a third party. According to Kressel et al (2012), when internal negotiation does not yield any solution to the conflict, a third party should be called in to mediate the conflict. Third-party mediation can be defined as the voluntary, informal, non-binding process undertaken by a third external party to foster the settlement of disagreement between conflicting parties.  Mediators can be an individual, group or even organizations. For instance, in partnership working between professionals in health and social care settings, a conflict between different professionals can be mediated by a manager or a group of managers. The third and last option in solving conflict within the health and social care is through litigation. Litigation involves invoking the operation of the law to resolve the conflict (Kressel et al 2012). In this case, the warring parties would take their conflicts to the court of the law where the judges after hearing the views from all parties make a binding determination that would resolve the conflict.  While litigation is a way of solving disagreement especially at organizational levels, it is usually not the best method of doing so for various reasons. One, the process of litigation is not only time-consuming but also expensive. Secondly, mostly the litigation process even though helps resolve conflict, usually strains the relationship between parties as it pitches them against each other (Krisel et al 2012). 

 Conclusion

Partnership working in health and social care presents a unique opportunity for improving the health and wellbeing of the society. As seems in this essay, partnership working exists at three-levels. I.e., at the organization level (multi agencies partnership), at the professional level, i.e., interdisciplinary partnership or collaboration, and at the individual level where patients or their families are the centers of the care. Each of these levels of partnership is unique and as such there are key elements required at each level to make the partnership working more effectively. At multiagency partnership, the key elements needed are shared vision, equal decision making, transparency and sharing of information, clear resource contribution responsibility, and autonomy. at the professional level i.e. multidisciplinary partnership, the key element needed for effective partnership are respect for each other, sharing of information, empowerment, independence, shared responsibility & equal power-sharing. At the individuals’ level, the key elements are power-sharing, autonomy, informed choices, empowerment, and respect. When working with families, the key elements of effective partnership to be observed are humility, involvement, respect, empowerment, and independence.  The essay's finding also shows that partnership working faced a lot of barriers which can be eliminated or overcome through training, through establishing system and process, through respecting and embracing differences among others. Finally, the essay also argues that in health and social care conflict in partnership should first be dealt with through internal negotiation, then through third-party mediation and litigation as the last resort. 

Reflection 

 Through this unit and particularly through the research I conducted when preparing this essay, I have learned a lot about partnership working in health and social care. I will use the learned knowledge as well as my skills to develop and improve partnership working.  I will do this in several ways. One, when working with other colleagues, I will make sure that I not only respect them and treat them vs equal partner, but I will encourage them to participate in the decision-making process. By doing so, I will make the colleagues feel part of the decision-making process which is crucial for effective partnership. Also, when working with colleagues, I will not at any time withhold any information from them. I will share all information in my possession with them as well as encourage them to share what they have with me. This will ensure there is a free flow of information among me and my colleagues and will also bring in some transparency which will help in developing trust which is crucial for effective partnership working. When working with service users and their families, I will develop and improve the partnership by not only recognizing but also respecting differences. I will also nurture the partnership by empowering the families of service users with relevant information to helps make well-informed choices as well as to promote their independence. for instance, I will always make sure that I lay down all the options available to the service users, ensure they understand each one of them so that they can make good and well-informed choices about the care they want to receive and how they want to receive it. Also, I will improve the partnership by maintaining open communication at all times. This will allow a good flow of information between me and the service users or their families.  Finally, I will always listen, try to understand the situation from their perspective, respect their choices and preferences and most importantly show humility. 

 I do have several strengths that would make me work in partnership with others quite well. One of my strengths is being friendly and good interpersonal relationships. This characteristic helps me to interact well with others and I do believe it will make it easier for me to interact and establish positive working relationships with my colleagues, service users, and their families. Another of my strength as far as partnership working is concerned is my emotional intelligence. I am good at identifying y own emotions and other people's emotions as well as tailoring my behaviors, actions, and communication to ensure smooth interaction. Again, I believe this strength will help me establish a good professional relationship with others. Finally, I am a very empathetic person who not only listens to others but always strives to understand the situation from their perspective. This is a strength which I believe will help me not only understand other people point of views but also allow me to tolerate differences hence creating a good environment for the effective partnership to thrive.  On the other hand, I do have one weakness as far as partnership working is concerned.  I am productive and find comfort when working alone. I believe this is a weakness that can act as a barrier for me to effectively work in partnership with others. 

 To capitalize on my strength and address my weakness so that I can be able to work effectively in partnership working with other, I am going to do the following