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

previous practices where professionals worked in isolation. 'Making a
Difference' (DH, 1999a) and 'The NHS Plan' (DH, 2000a) promoted multidisciplinary
and interprofessional working across areas of health and social
care and emphasised that the approach to the educational preparation of
future health professionals should be integrated and patient centred.
A consultation document ‘A Health Service of all the Talents: Developing the
NHS Workforce’ recommended a complete overhaul of workforce planning
(DH, 2000b). New models of service delivery were identified, each of which
depended on individual professions being prepared to move out of their silos
and work across professional and organisational boundaries. To ensure that
the workforce is fully equipped for their new roles, and acquire the skills these
would require, a complete overhaul of their education and training would be
necessary and there is an explicit acknowledgement that it is vital to engage
the Regulatory Bodies and the trade unions.
The Government’s modernisation programme is having a profound impact on
not only the NHS but also agencies such as local government and social
services. Policy changes outlining increased interagency, interprofessional
care can be identified within The Local Government Act 1999; The White
Paper ‘Modernising Social Services’ (DH, 1998d); The White Paper
‘Modernising Mental Health Services’ (DH, 1998e); The Green Paper ‘Our
Healthier Nation’ (DH, 1998c); ‘Modernising Health and Social Services:
National Priorities Guidance 2000/2001, 2002/2003’ (DH, 1999b); ‘The Health
Act 1999’ and its accompanying discussion document ‘Partnership in Action’
(DH, 1998b); ‘The Crime and Disorder Act 1998’; and the ‘Quality Protects’
initiative by DfES. Each of these focuses on the need to extend strategic
alliances.
Moreover, the National Institute for Health and Clinical Excellence (NICE) is
an independent organisation that publishes guidance in public health, health
technologies and clinical practice. The Health Development Agency merged
with NICE in 2005. NICE guidelines implicitly recognise a flexible workforce
and also promote and reinforce partnership working (http://www.nice.org.uk/).
A major issue that arises time and time again in Government publications is
the continuing reluctance to use terminology that leaves the reader in doubt
that there is a mandate to implement policy. Even in White Papers, which by
definition are commands, words such as ‘may’, ‘might’ or ‘could’ rather than
‘must’ or ‘should’ are used. This in effect, gives the reader an opportunity to
opt out if a particular directive does not suit. Particularly good examples of
this relate to ‘The Disability Discrimination Act’ (1995) and ‘The Human Rights
Act’ (1998). The White Paper ‘Our Healthier Nation’ (DH, 1998c) observes for
example ‘we need to encourage different professional groups to learn
together and to think about how we plan our workforce to meet the challenges
we face’. If only the word ‘must’ had been inserted rather than the much less
emphatic ‘think about’ planning the workforce, much more progress would
have been made towards delivering a service that patients want and need. In
the same year another White Paper ‘Modernising Social Services’ suggested
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