A successful collaborative team would include all health and social care specialists (Doctors, Social Workers, Nurses, Occupational Therapists, and Physiotherapists etc.) to gather on an equal level, to come up with a strategic hospital discharge plan to enable continuing care in the community. It is hoped, the meeting would decrease revolving hospital admissions; mainly by older people. Although, the questions are: Dose the means justify the end?
In theory, the perspective is endeavoured to reduce acute hospital bed blocking by older people. The answer would be to offer care to the aged in their own homes and in the community they are used to for as long as possible. In practice, however, some of the specialists are meddling with politics and show of professional know-how. The doctors for example, tend to over shadow the meeting and dominate decision-making whilst lowering other professionals to just audience and spectators, which collapses the collaboration.
Even so, social services suffer due to its inability to negotiate effectively on equal-terms with doctors, because of a "power of professionalism, politics, wide-ranging knowledge and influence". The differences between professional and political power versus doctors are very wide, which gives them a competitive advantage to make unilateral decisions. In this perspective, most professionals do not have the expertise to debate or argue on equal footings, failing to represent or advocate for service users, families and the wider organisations.
Unfortunately, political interference within the team and the wider health and social care institutions has renewed the gap between the two inter-related sectors. In light of this, it is now a common experience to see erratic hospital discharges of older people into community without adequate care to support them with their holistic needs. This is seen as the perils of social services that have a duty to assess and provide care within a critical and substantial matrix. Though, the eligibility criteria for care in the community is complex and not many service users would qualify and may not have enough money to buy private care and, or family members to assist them with their care needs. Equally, community nursing are rationed; they have long waiting lists, which are triggered by poor hospital discharge planning, that is in practice created by the doctors and hospital management.
A Multi-Disciplinary Team Approach is now the buzz word in practice, which is supported by both health/social care executives, and it is aimed to accelerate hospital discharges. Based on this assertion, the objectives in practice should be to piece together an integrated care management approach; something that is appropriate to simplify care provision in the community. The framework should take a holistic approach, which includes: mobility in and around the house/community, housing issues, benefits, family support systems, community nursing and care; rather than curative and biological pathways which has a narrow vision. The system must be free from politics and professional bigotry but, it needs to focus on the wellbeing of the service users, consumers, patients, clients and their families. Community care is not only to be used to rehabilitate patients/clients or consumers in their own house, it is also to improve their psychosocial wellbeing and recovery as they are in the community of their relatives whom they know well. Whole systems policy and practice reduces wastage and readmission costs to the wider organisations of health and social care on the long-run.
It is imperative to understand we live in an ageing society, this due to advancement in bio-technological systems and medical sciences as well as strategic investment in human resources, pharmacology and healthcare infrastructures. These have undoubtedly enhanced longevity of older people and those with chronic diseases, helping them; to live and immerse themselves with their wider community of relatives, friend and neighbours. However, there has been an increase in demand for care by significant number service users, which requires 24 hours care; ensuring their safety. In addition, the number of formal and informal caregivers is plummeting, this is presenting itself as a major challenge especially to the authorities, to provide and meet the care needs of the growing elder population. This indicates the beginning of a potential crisis, which would someday engulf the society in future only if both national and local governments, including health and social care authorities do not come up with strategic vision on how to tackle future care for the aged.
Society today has seen a multiplicity of developments, including the economic down turn, demographic change, politics and a declining family unit, as such; these are some of the pathways going against the increasing older people population to needed. Indeed, an integrated health and social care that has pooled budget might be the solution. This has the propensity to remove departmental financial interests, politics and cultural administrative dissimilarities. If we saw a merger of health and social care training policies, this would provide the staff with a wide range of knowledge-based experiences to address older people' needs. Additionally, joint training has the opportunity to address professional, knowledge-based experiences and bigotry which is evident in practice. Family support systems, training and engagement should be a priority as some older people would prefer their own relatives to support them in times of need and poor health. In most cases, their family know their needs and the standards they are used to, allowing care professionals to provide peripheral care support services.
Yet, the biggest treats are demographic change, cultural and administrative politics, which would continue to present tough problems for the authorities because longevity of older people and their demand for care. However, this could be minimised if the government would relax some of the legislation and current policies on immigration, health and social care funding mechanism and behaviours.
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