Conventional thinking conveniently conceptualises health and social care as self-contained areas with their respective spheres of financing, provision and research. Jon Glasby challenges this approach, highlighting how social care is integral to health services.
Over the last ten years, there have been three major policy initiatives to improve integrated health and social care in the United States. These initiatives have supported activities such as screening for social risk factors in primary care clinics and integrating social care into Medicaid public insurance.
Health
In the US, recent efforts to integrate health and social care have focused on identifying social risk and connecting patients with community-based services. These activities have ranged from individual-level screenings and referral tools (including standardized assessments and clinic-based food pantries) to broader collaborations between healthcare organizations and community-based organizations. These partnerships often include training and mentoring for both healthcare and social-service staff.
To improve their care, health and social-care professionals need to understand the complexity of a person’s needs. For instance, instead of using a medical-based approach that establishes rigid categories for disabilities, a needs-based assessment would consider the impact of the disability on a person’s daily life.
A health and social-care course will equip you with the skills and knowledge needed to work in this rewarding field. In addition to learning about a wide variety of topics, you will also gain practical experience working in a nursery, residential home or hospital. This will help you to build strong, trusting relationships with the people you care for.
Social care
Traditionally, health and social care has been studied as an optional school subject at key stage 4/GCSE level, with students often taking part in work placements in nurseries, residential homes or hospitals. It can also be studied at further education level, with many choosing to complete a full degree course.
Local commissioners (usually based in councils) oversee a market with many different types of social care provision available, either purchased by public bodies after assessment or accessed on a self funded basis by individuals. Services can include community support and activities, advisory services, home and domestic care, daycare, housing options with levels of care support attached, as well as residential nursing care.
Some countries tackle social care funding shortages by raising taxes, while others restructure their local government systems to ensure budgetary control and financial sustainability. However, there is a lack of rigorous research into what works best to integrate social care and healthcare. This includes exploring the benefits, challenges and barriers to successful integration.
Eligibility
Health and social care is a broad area of study. It combines elements of sociology, biology, nutrition and law and ethics. Students who choose to study H&SC often complete a work placement in a nursery, residential home or hospital.
Your local authority should assess you to decide whether your needs meet the eligibility criteria for social care. They should use the national eligibility frameworks to help them with this. They should make sure that you are involved in this process and that your care plan meets your needs and achieves the outcomes you want.
The local authority should also consider how much you have and your assets to decide if you are eligible for financial support to pay for your care and support. Your LA should not charge you more than you can afford to pay. If you do not have enough money to live on, they should offer other ways to help you. These might include money management and debt advice, or activities such as skill training to help you keep independent.
Planning
A health and social care planning process starts with the identification of goals. It then involves the selection of alternative courses of action to reach those goals. It also involves the appraisal of added benefits and lower costs, which is referred to as marginal analysis. It is a managerial function that is essential to the success of any organisation.
The new Dundee plan was developed through working with people who use services, unpaid carers, the health and social care workforce, and other stakeholders. It will also be evaluated on an annual basis to make sure the changes are working.
Policy practice over the past ten years has advanced integrated health and social care initiatives, particularly around the Medicaid public insurance program for poor Americans. These efforts range from screening patients for social risks and referring them to community support services to building new cross-sector partnerships and using innovative data platforms to link healthcare and community service delivery.
