Sue Evans, Chief Executive of Social Care Wales, discusses the importance of an integrated approach between healthcare and social care innovation.
Sue Evans (Guest)
Chief Executive Officer, Social Care Wales
All organisations in a network have commonalities and differences, with an awareness of these helping to drive partners towards shared goals. After all, we always work best when we have a strong understanding of our partner’s strengths, best practices and working culture.
This is certainly the case for social care organisations striving to innovate – whether that is changing practices or transforming on a team or service level. This is covered in Life Sciences Hub Wales’ Achieving Innovation in Health and Social Care report, where Juliette Malley’s section explores such similarities and differences.
I have spent decades working across both healthcare and social care, which provides a useful perspective on what each can learn from the other. Both are united by their shared goal of delivering large-scale systematic change that benefits services users, staff, and the wider economy. There are often similarities between those delivering services, organisational values and wider social and economic pressures impacting what they do.
While social care innovation does not overlap with healthcare on areas such as medicine, it does play an important role in aiding well-being and independent living, adaption to life after illness or disability and virtual improvements that may support better communication, advice, assessments, case recording and care management. Such factors are important in healthcare innovation. However, the administration of such services and products is often left to front line staff, demonstrating the clear crossover.
Social care staff often work with individuals who have high clinical needs. Understanding these clinical conditions and prognoses makes them better equipped to support them to remain independent and improve their wellbeing. And when thinking about innovation to help with this, multiagency teams from across health and social care can ensure all needs are well met, if they continue to understand and utilise each other’s knowledge and skills.
Creating a common culture
Finding a common language across such multidisciplinary teams is critical. Indeed, this can be applied to all health and social care collaboration across the innovation landscape. Improvement projects translate more easily between teams when they fully understand how each other works.
Not having a common language can be a significant barrier to those working throughout health and social care. However, there are limited opportunities for this in the early stages of their careers: social workers train with social workers, nurses train with nurses, and doctors train with doctors. Then they will typically work in junior positions within networks largely relevant to their roles. It may only be when they are established into a career that they find themselves “thrown” into working in multidisciplinary teams.
Starting them off together, during their professional development, could help us to innovate better across health and social care by sharing ways of working, best practices and methodologies. However, this culture does not yet exist, and it will be difficult to create it within risk-averse organisations. People are often afraid to experiment, and this can be seen from executive-level staff through to the junior workforce. Creating a culture of innovation from the top down can help address this by empowering those on the front line to experiment more and try things out. People need to feel safe to try out new things and new ways of working.
Understanding and utilising differences
This common language could also help support health and social care’s awareness of the useful differences between each other. Take research and datasets and their applications in both sectors. They support innovation in practice by helping you to understand what is happening and how to maximise outputs for your service users and staff. However, when compared to the investment in research and data in the NHS, social care has more limited evidence, which is an important consideration when developing a multidisciplinary innovation project. Social Care Wales is developing research and data strategies for social care, which aims to improve the current situation over time.
The social care infrastructure also differs significantly from healthcare’s, which could influence the ability to deliver joint innovations. The NHS and Health Boards are large, complex structures, often resulting in a big distance between executive directors and the frontline. They have the benefit of a national governance framework, headed up by the Chief Executive of NHS Wales.
Conversely, social care sits under local government infrastructure which puts executive level staff closer to those delivering services to their local populations. When I was a statutory director of Social Services, the Head of adult services and some of her teams were in the adjoining room and the Head of Children services and some of her teams were in the same building – making it easier to have real-time conversations with the front line about challenges, innovation, and improvement.
Cabinet members with responsibility for citizen wellbeing are also able to bring the needs of the population and the constituent voice directly to the service. This local governance ensures that all those working in Councils are better able to respond to the needs of their populations, working with neighbouring Councils when a regional approach may be beneficial.
A future perspective
The Covid-19 pandemic demonstrated the impact of working using a whole system approach and sharing a common language and endeavour. It enabled people working across health and social care to break down organisational and professional barriers and showcased the power of cross-sector collaborative efforts spanning healthcare, social care and industry.
Further supporting this integrated model, long-term joint innovation funding for both health and social care could help to deliver transformation change across both sectors. This could enable organisations to share risk and double run projects, so that transition into new service models can be implemented on a sustainable basis. Short term funding is less likely to have the desired impact.
The future of innovation across both sectors will undoubtedly be driven by the incredible individuals working across the landscape, with the voice of citizens informing the change needed. It is of course the people who make things happen. However, a common language and more integrated approach will play a critical role in achieving this.