Clare Hammond looks at why health, social care and employment are so important to each other.
18 months ago, we were working with a Scottish Health and Social Care Partnership (HSCP) and were struck by what we found. This HSCP was spending the equivalent of 50% of the value of the new national programme for those further from work, on helping their service users into employment. How does a HSCP end up being such a big player in employment?
More and more, services are stepping back from a diagnosis, or presenting issue, and looking at the whole person. A perfect illustration of buzz words such as ‘person centred’ and ‘holistic’. In health and social care, this is driven by a growing understanding that medical conditions are often driven by, and in turn drive, other issues such as trauma, poverty, social inclusion, and worklessness.
These intersections are what has driven the growth in health and social care integration, information and support services, complementary therapies, and social prescribing, and where prevention has found a practical expression.
Subsequently, services have needed to work across their typical service boundaries. These partnerships find two main forms (1) strategic and structural partnerships, and (2) practical and operational partnerships at the coal face.
Much of the focus on health and social care integration in both England and Scotland has focused on structural integration. However, we have found numerous examples of long standing, pragmatic and effective operational partnerships as front-line staff recognise the need to engage with other services to get the best outcome for their clients.
So, while strategic partnerships often feel that they a have responsibility to support partnership working across every level, there is a lot that strategic partners can learn from front line delivery staff for whom partnership working has long been part of their everyday approach to support provision.
Coming back to the HSCP mentioned at the beginning of this blog, how did they end up here? This HSCP had 16 employability related projects covering a variety of health and social care services. Despite operating independently over a period of more than 5 years, front-line staff working across all projects had identified the important role that employment (or the prospect of employment) could play in managing an individual’s health and wellbeing and maintaining their progression. As such, working towards employment became part of a recovery journey in mental health, addictions and criminal justice, and a way of improving health and care outcomes for those with disabilities, or young people raised in care.
From an employability perspective, these service users were effectively pre-stage 1 in the Strategic Skills Pipeline. By encouraging participants to lift their aspirations of future employment and begin setting goals. these HSCP services effectively prepare them for mainstream employment services.
This approach is echoed by new national employability programmes (Work and Health Programme and Fair Start Scotland) being developed across the UK which have a particular focus on supporting those with multiple barriers to employment. The only way these programmes are going to be successful is if they link in with projects like those being delivered through the HSCP and encourage people to think about employment as part of their recovery journey. Doing so should improve the level of engagement when they enter the first stage of the employability pipeline and the outcomes achieved.
To reach this point, health and social care services can learn from this HSCP, step back from the diagnosis and consider how they can help service users make the next steps on their longer term pathway to employment.
Clare Hammond is an Associate Director at Rocket Science specialising in health and social care including evaluation, strategy and organisational development, cost modelling and cost benefit analysis. You can check out her profile here.
This blog is part of a wider series on Health and Social Care Integration. Other blogs in this series can be found here