By Robin Miller, Senior Fellow at the University of Birmingham and Co-Editor of the Journal of Integrated Care
The need for better integrated working between health and social care and acute and community services has been recognised for many years in policy and practice. However, despite this emphasis, many older people and their families continue to experience services that do not communicate effectively, are far from seamless, and require considerable persistence to successfully navigate. The increasing challenge of responding to our changing demography with limited resources means that it is more important than ever that we avoid wasteful duplication or gaps that result in older people being unnecessarily admitted to residential care or hospital.
Although much of the recent policy interest has related to how NHS and local authority services work together, third sector organisations actually have considerable potential as providers of direct care and as facilitators of dialogue and discussion between older people receiving support and those responsible for designing and delivering services. Countless patients and their families depend upon them for information, advice and emotional support and they also act as champions for patient and users groups, fund new developments and are a source of expertise for policy makers.
The current special issue (free to read until 14 December) of the Journal of Integrated Care, edited by myself, Helen Dickinson and John Glasby, explores the potential of the third sector to integrate in more depth. It evidences how third sector organisations have successfully ‘plugged the gaps’ left by statutory stroke services and have been able to provide holistic preventative services that are valued by older people and their commissioners.
However, the issue also draws attention to tensions which were also encountered in the relationship between third and public sectors. These were often based on funding, but there were also issues related to independence, styles of working, and alternative perspectives on what outcomes should be achieved. Resolving these tensions will require a willingness on both sectors to be open, transparent and respectful of each other’s values – if this can be achieved then the third sector may be the elusive dimension that we have been looking for.