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Why it’s good to talk

28 February 2017

Sharon Blackburn CBE has written this blog for NHS England as part of their Chief Nursing Officer for England's Summit section 

Ahead of the CNO Summit in Birmingham on March 14 and 15, Sharon gives a care sector perspective on the realities of integration: 

Integration is not a new concept. It has long been spoken about and many attempts have been made over many years to make it a reality.

People who use services, the general public, generally assume it happens – that is until they need to access or use a service. I believe many of us, if we haven’t already, have stood where the people we serve stand. Working within health and social care does not make you immune from responsibilities for your own or loved one’s health and care needs.

Over the last year I have had the opportunity as part of my Florence Nightingale Leadership scholarship to look at integration more closely. There is no shortage of text written about what should be happening, yet if it were so simple, surely it should be much more of our everyday experience and reality?

I really believe that integration at its best is when two or more people from different parts of the system are working with an individual or group of people and agree  what needs to be done is done.

People who use services, that is you and me, not them, have a realistic expectation that staff from different sectors talk to each other and plan and coordinate care in a way that is in their best interests. Whilst there are numerous examples of where this is happening, it sadly doesn’t happen often enough and consistently enough.

The NHS England New Models of Care – Enhanced Healthcare in Care Homes have significantly contributed to the excellent work that was already taking place. Great clinical outcomes have been reported but one of the richest outcomes is that people from different parts of the system are talking to each other; understanding each other and creating solutions together, including those who use services.

Over the last year I’ve had numerous conversations across the devolved administrations. No one disagrees with my fundamental belief regarding integration.

As you read this you may be saying but we need new structures; possibly legislation, pooled budgets, leadership, organisations to change their cultures, the list could go on. The answer would be a resounding yes to all of this. However, at the heart of what we do are people. Relationships are key to any change that needs to take place. Within those relationships we need trust and willingness to question and learn from each other to explore what we don’t know. I am a huge advocate of being the change we want to see.

Our behaviours lead to unintended consequences, because we do not know what we don’t know about the different environments each of us work in, and the stresses and strains each part of the system faces. If we could start to recognise and constructively help each other about our practice and the ways in which we communicate and the use of language across different settings, positive changes can be made enabling us to learn together and behave in a different way.

Leading Change, Adding Value, a framework for nursing, midwifery and care staff, enables all nursing, midwifery and care staff to be that change. To change the narrative of how we communicate with each other and the people who use services.

This excerpt from the framework gets to the heart of what we need to achieve not just for the people we serve, but for us:

“In embracing the framework and the ten commitments, they can drive essential change to improve their own and their teams’ abilities to create new ways of working and build a strong foundation for the future.

For people using social care the commitments in the framework together with the 6Cs make sure that people can say:

I can live the life I want and am supported to manage any risks;
I have choice and control and feel safe;
I have the information and advice I need to stay healthy and as independent as I want;
I am still connected to my local community through friends and family;
I have a voice to control the planning and delivery of my care and support;
I have caring compassionate support delivered by competent people;
My family is supported to care which helps us all to cope.”
As I mentioned before, we do need new structures; possibly legislation, pooled budgets, leadership and organisations to change their cultures. However, if we do not talk to each other, learn to trust each other and learn from and with each other, all of the above will not achieve the desired outcomes we all need to achieve.

I look forward to seeing you all at the 2017 CNO Summit in two weeks’ time.

Follow Sharon on twitter @NCFsharon

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