'I see a red door and I want to paint it black' - Can old ways really open new doors?

11 December 2018

Tim Pope, Associate Director

Can old ways really open new doors

Last month, the National Association of Primary Care (NAPC) and Association of Directors of Adult Social Services (ADASS) published a guide on Primary Care Home and Social Care Home. This guide highlights the benefit for primary care and social care in working together at scale.

Both share pressures around funding, finance, workforce and demand. Both want to help people live as independently and as healthily as possible in their own homes and communities for as long as possible. Both want to be rooted in local communities and strengthen bonds between distinct, different but dependent professions. The narrative of the guide centres on how these mutual dependencies mean that primary care home and social care would be stronger working together for a shared future.

The guide provides examples of how this is being done in practice and of areas starting to develop more effective solutions that work for their local context. Nevertheless, while it would be difficult to argue with many of the recommendations, the reality for many practitioners is this is not an easy transition.

Building trust and relationships takes time and needs space. Start off too ambitious and no-one believes the change can be done. Start off with limited ambitions and it is never a priority. Finding the right level to start somewhere is easy to say and hard to do.

Understanding other professions also requires different professionals to put themselves in each others’ shoes and see things from different perspectives. Some people find this easier to do than others, particularly where people have to change what they have always done as a consequence of seeing a different perspective.

Encouraging multi-disciplinary teams is one thing but championing and challenging colleagues to get on board can easily become a job in itself. Making the time and retaining resilience to keep going needs someone or a core nucleus of people to go over and above the day job.

Having a supportive leadership makes it easier to make this effort and know it is being recognised – until they leave and you have to start again or recast to meet a different agenda. And it might not be your leader’s agenda but another powerful influence in an organisation you know little about.

Even where people are willing and able, practical difficulties make the job harder. Whether it is incompatible systems, a practical lack of meeting space for joint teams or differing geographical boundaries, there will inevitably be something you have not thought of that can set you back.

Behind the case studies in this guide will be real stories of frustrations, of challenges and of disputes. Yet the guide shows it is possible. There are people who are knocking on new doors, changing old ways and making change happen. Those are the people we enjoy working with and supporting on their journey.