Foundations for self-directed support in Scotland
Foundations for self-directed support in Scotland

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Foundations for self-directed support in Scotland

6.3 Working together with adults

Earlier in this section you identified some of your own experiences of when services work together well, as well as times when services failed to 'join up' in a way that has been helpful to you. You also considered ways of improving how services work together.

The Scottish Government has made a commitment to achieve greater integration between health and social care services. ‘Integration’ is seen as a way of improving both the quality and efficiency of services. The Public Bodies (Joint Working)(Scotland) Act 2014 was introduced to the Scottish Parliament in 2013 to require health boards and local authorities to create an integration plan for adult care in each council area in Scotland.

Activity 6.6 Wendy's experience of working together

Timing: (Allow about 20 minutes)

Listen to Wendy, whose son, Gavin, has an acquired brain injury. Wendy describes her experiences shortly after her son's accident. Use your learning log to note down your reflections on these questions:

Download this audio clip.Audio player: kg097_activity_6.6.mp3
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What barriers did you identify to health professionals working together to meet Gavin's needs?

What could have helped them work better together?


In Gavin's case, there was one very clear barrier to practitioners working together to meet his needs: the nurse – who was concerned about his health – felt unable to approach the doctor because she believed she would not be listened to. The service was not ‘joined up’ because there were communication problems between health professionals that appear to relate to power and status, as well as the nurse's lack of confidence.

You may have suggested a range of ways in which the service to Gavin could have been improved. Perhaps one of your first thoughts was that the consultant should have been more attentive to Gavin's health and to the views of colleagues, including nursing staff. Gavin might have ended up ‘falling’ between the gaps created by different systems that did not work together well, share their knowledge, or prioritise his needs. Fortunately the outcome was a good one, partly because of the nurse's concern about Gavin's medication – though in the end it was Wendy, and not the health professionals, who 'brokered' better health care for her son. Many carers would not have the confidence to do this, nor indeed should be expected to. This example of fragmentation stemming from practitioners working and thinking in isolation is not confined to health services or people with brain injury of course. This activity is a reminder that professionals – even those employed by the same organisation – don't always together well. The next section examines what the challenges are in working together for adults.


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