Health and Social Care Policy and the Interprofessional ... - CAIPE

The WHO is also calling for a complete overhaul of the healthcare workforce
training in order to best meet the rapidly increasing number of people living
with long term conditions. The WHO regrets that training of the workforce has
not kept pace with the changes required in practice. Core competences
applied to all members of the workforce are viewed as the best way forward
each focusing on a patient centred care model. Core communication skills are
keys to collaboration not only with patients and their carers, but also with
other health and social care providers (WHO 2005).
Integrated Care
Fragmented models of health and social care however remains a persistent
problem, one which causes inefficiency, patient dissatisfaction, impedes
quality and accessibility to the services required.
The WHO European Office for Integrated Health Care Services suggests a
working definition of integrated care as:
‘…a concept bringing together inputs, delivery, management and
Organisation of services related to diagnosis, treatment, care,
rehabilitation, and health promotion. Integration is a means to improve
services in relation to access, quality, user satisfaction and efficiency’
(Gröne & Garcia-Barbero, 2001).
The WHO Framework differentiates between ‘autonomous working’, a ‘coordinated
approach’ and ‘integration’. The expert view of integration is that it
is ‘a means to improve services in relation to access, quality, user satisfaction
and efficiency’. www.euro.who.int/document/ihb/Trendicreflconissue.pdf
Integrated care is adopted as a broad term for technological, managerial and
economic aspects of services whereas horizontal integration is viewed as
relating to strategies that link similar levels of care through overcoming
professional and departmental boundaries. Vertical integration however
suggests the strategies which link primary, secondary and tertiary levels of
care whilst continuity of care implies the user perspective, in other words the
patient’s experience of the care package they have received.
Intended for those who need to work together to provide care for people with
complex needs and their families, the WHO has published the Framework as
a web based exercise suitable they suggest for primary health and social care
teams where, providing time for learning is protected, a more collaborative
climate will emerge. Examples of where the exercise would be most useful
are cited as service provision to children living with disabilities, and older
people with mental health problems.
Organisations can use the WHO Framework as a basis for mapping emerging
local trends and health care needs of the population and comparing these
with the level and quality of integration and collaboration that has been
achieved. Identifying strengths and weaknesses is recommended followed by
an identification of immediate goals to resolve these.
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