ICS leads must ensure a public health approach to wellbeing is central to their plan
In our recent report ‘5 Fast-Forwards for Social Care’, we identified five actions to respond to the challenges currently facing the adult social care sector. One of these is ‘Managing Interfaces’ as finding sustainable solutions to the challenges facing health and social care means crossing the boundaries between organisations, people and processes, and managing the interfaces between them.
In a sustainable state, leaders and their organisations work together to build trust across interfaces. This means improving behaviours, not just tinkering with structures and processes. Our clients have shown that by getting this right, they can demonstrably and sustainably improve outcomes for people within the reach of local health and care organisations.
Here are some of the insights from a recent project that I have been involved with at the health and social care interface:
- There are significant opportunities to avoid demand
Multidisciplinary case-note reviews, with professionals from social care, GP practices, hospitals and community organisations, identified that admission to hospital could have been avoided in nearly half of all cases. Case reviewers based their findings on information from across the system, building up a more complete picture of a patient’s journey into and out of hospital. Despite new initiatives, particularly those to support over 65s to be treated in a community setting rather than in hospital, case reviewers still identified opportunities to avoid demand altogether including managing health and social care needs differently in the community and being more consistent in applying the new initiatives.
- Behaviours drive decisions
This isn’t new; we all know that an individual’s choices and behaviours create different types of demand. In the project, feedback from across the system, particularly from frontline staff, identified that both staff and patient behaviour impact demand on health and social care. For example, pressure from families and other hospital teams affected decision-making at admission; and focus on freeing up beds frequently affected discharge decisions. Solutions to address this challenge often related to changing systems and processes, downplaying or ignoring behaviour and culture. Applied Behavioural Science is an essential component of EDGEWORK, IMPOWER’s approach to achieving sustainable change within complex systems. Applying behavioural science unlocks new insight.
- Organisations and teams within the health and care system struggle to consistently translate transformation into operational delivery
We found that those working at the health and care interface have detailed knowledge of the challenges across their different organisations, relationships were strong, and colleagues were able to discuss solutions together. However, they were struggling to deploy these solutions effectively and embed new ways of working. A key component of EDGEWORK is delivering at the frontline; effective change in complex systems is dependent on the decisions and actions of teams working within frontline services. To enable successful change, frontline staff need to be empowered to ensure the best outcomes for the people they are working with.