Enhancing Person Centered Care for Children through Improved

Introduction

The concept of inter-agency working has attracted policy and scholarly attention in the UK. Working in close conjunction with individuals, communities and families is important in understanding the cause of diseases. Besides, working together provides a basis for understanding safety issues and report them in time to relevant health professionals, adopting healthy behaviours to curb recurrence or occurrence of disease, self-diagnosing and treating mild diseases and in monitoring symptoms and treatment side effects (Wong and Sumsion, 2013). Other benefits of inter-agency cooperation and seamless teaming include collaborative advantage at agency level, improved value for money and ability to produce cohesive practice and policy. Working collaboratively enables individuals within the realm of vulnerable class to be provided with a broad array of support, on a timely basis through person-centred care. Moran et al., (2007) recognise a paradigm shift towards person-centred care which can only be best actualised through inter-agency collaboration. In Scotland, the Health and Social Care Act of 2014 enacted a legal duty for the NHS England to engage patients in their care; in UK, such a law had been passed in 2012. The Health and Social Care Integration (2019) proposes that the recent move to social and health care in Scotland is driven elevate care support and support persons using their services, their families and carers. In the context of Scotland, integration is a fundamental change to social and health care services since the conception of the National Health Service in 1948. As provided in the Health and Social Care Integration of 2016, merging services and concentrating on anticipatory and preventive care intends to improve health and social care, and provide support to people utilizing services, their families and carers. Inter-agency cooperation in children as a vulnerable group ensures that the efficiency of any given service benefits from being reinforced by other services working collaboratively for and with children. Every agency has a duty to articulate and respond on its own goals concerning shared outcomes and be clear as to how showcases that this is being done. The purpose of this study is to critically examine how improved inter-agency working could enhance person-centred care for children, as the vulnerable population.

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How Improved Inter-Agency Working could enhance Person-Centred Care for Children

McKeown (2012) suggests that person-centred care can be enhanced by inter-agency cooperation through sound inter-agency communication and social inclusion. The health care domain is highly interconnected, requiring various specialized groups to actualize effective delivery of care to many citizens in need. This view conceives a need for inter-agency working, to draw a pool of various competent talents and skills working together for a common agenda, which is to provide healthcare. Whereas social inclusion will induce a feeling of inclusivity to the young population in health care, it will also make them feel valued within their immediate societies. Inter-agency communication occurs in two or more agencies, and this would form a basis of collaboration to enhance effective care to not only children, but also to the community and families (Sloper et al., 2010).

Atkinson et al., (2002) propose a type of multi-agency collaboration fundamentally based on the role of multi-agency work. According to this model, multi-agency working is a crucial element of multidisciplinary team work and offering social care service. Multi-agency working encompasses different services, teams and agencies of experts working collaboratively to offer the services fully meeting social demands of the people consuming the service. Atkinson et al., (2002) identify five model include decision making groups, operational team delivery, centre-based delivery, consultation and training events and coordinated delivery. Further, these scholars locate these five models either strategic or operational divide; with decision making groups located in the strategic dimension and the rest in the operational one. Atkinson et al., (2002) perceive these models as coherent from decision making organs where experts from various agencies maintain their specific duties to operational teams where experts work closely. Atkinson et al., (2002) found the proposed models had positive impacts in multi-organisational agencies they involved, since they provided motivation for others to become involved. The essence of motivation inspires organizational involvement in inter-agency working which has become a key pillar in enhancing person-centred health care.

Townsley et al., (2003) s’ study found parents of children with disabilities reported on the efficiency accrued from inter-agency service providers; that the services offer them excellent and support-oriented service, which assist them to manage their children’ complex needs. Enabling families to be active stakeholders in matters of their health is one of the major health system reforms in UK. Inter-agency working has provided room for active patient involvement. This has been actualized through in-depth inter-agency policy formulation, and understanding of how the entire health cares can be framed to meet the numerous social needs.

Fieldhouse and Onyett (2012) suggest that inter-agency working offers a holistic approaches to resolving economic and social barriers cutting across the spheres of influence of involved organisations. This consequently indirectly impact positively on person-centred care for children by providing an excellent rapport which all agencies consider favourable as far as health care is concerned. In addition, the holistic approaches will offer suggestions on how to effectively work with vulnerable children, which information they need concerning how to manage their conditions. Consequently, the families of these children are able to embrace these mechanisms from the comfort of their homes as person-centred approaches to healthcare.

Atkinson, Jones and Lamont (2007) note effective inter-agency working simplifies and quickens access to healthcare services. Inter-agency working provides a mechanism for say quick referrals which at the end of the day minimizes on time spent on health care centres. In addition, inter-agency collaboration and working result in more efficient services to children, due to clearer identification of gaps, improved integration and involvement of the society and service users. The services become more integrated from the perspective of service users which in turn motivates person-centred care. Cambridge and Carnaby (2005) s’ study on the effect of inter-agency working for disabled children with severe health care needs showed that the major role played by inter-agency collaboration they studied was fundamental in initiating improved access to health care services. Furthermore, Glasby, Dickinson, and Miller (2011) study showed that inter-agency working provided direct access and self-referral to families, and provided quicker response times alongside referring clients to relevant agencies. All these advantages have contributed positively towards person-centred care for not only children but also other vulnerable populations in need of care.

Inter-agency working may implant capacity to resolve policy challenges, either through the improving the flow of information and partnerships between proponents or through the provision of grant regimes or leverage. Resolving these policy issues makes vulnerable children and families get to understand the policies, and become receptive to person-centre care. Through capacity building, the service users are empowered to take control of their health conditions, and take advantage of existing enabling conditions (Sloper et al., 2010).

Improved inter-agency working helps alleviating tensions or contradictions between interventions, programmes or policies which might be fabricated in various agencies. But by working together, clarifying these logistics become easier to grasp by the public especially the vulnerable class. Besides, eradication of such tensions may consequently results to the deployment and allocation of resources closer to children, through the eradication of duplication, achievement of economies of scale, securing better value for money and sharing of overheads. This will basically lead to a situation where health care services are equitable spread for easy access by the vulnerable children.

Holmesland, Seikkula, and Hopfenbeck (2014) suggest effective inter-agency working has potentials in increasing understanding and trust between various agencies, which consequently induces willingness to work together for a common course. This course, intending to elevate health care domain may lead to provision of necessary resources and services closer to the needy, which is instrumental for the implementation of person-centred care, especially where there are consensuses intending to bring services to the grass root.

Duggan, Corrigan, and Social (2009) propose that inter-agency working encompasses a broad arrays of activities which in the end contributes towards person-centred care. These activities include; communication, information exchange, consultation and planning clarity of purpose and organisational aspects. Having transparent structures in place for communication, maintaining steady communication throughout the entire life span of agencies with vulnerable children and families, and good inter-agency communication contribute not only to the success of multi-agency working but also spreads the multiplier effect to person-centred healthcare. In addition, considering the acquisition of simple, reliable and cost-effective communication tools fosters communication between vulnerable children and health carers, thus forming a basis of strengthening person-centred care (Whiting, 2013).

According to Atkinson et al., (2002), the presence of realistic and clearly defined inter-agency working objectives which are wholly comprehensive and accepted by all agencies create a shared and clear rationale for the group. Shared visions ought to define the cooperation purpose and scope, and be constructed on the threshold of jointly-held convictions and values. Having clear justifications for inter-agency working helps attaining a vision, which centres needs of person-centred care for vulnerable children. Besides, having clearly established justifications help inspiring families and children in need of care find easier pathways through which to engage with the care givers from the comforts of their homes, without necessarily visiting regularly health centres (Williams, 2009).

Effective planning and consultation as an element of inter-agency working is crucial to the success of multi-agency initiatives. Dickson et al., (2014) maintained that inclusive planning is a key driver to the implementation of inter-agency teamwork. Consulting service users (children families) on priorities and issues where deemed appropriate is necessary to help effective functioning of inter-agency cooperation. Extensive consultations result into in-depth widespread of commitment by not only health care agencies but also families (users) thus incurring huge potentials in the actualization of person-centred health care.

According to Calder, and Horwath (2018), organisational structures and arrangements inspire ethos of collaborative working. Initiating efficient systems, procedures and protocols for inter-agency working is an instrument facilitator of success. For instance, putting in place official protocols such as inter-agency agreements and having a vividly defined model explaining how inter-agency practices operate helps in facilitating inter-agency operations. These discourses when done in good faith, putting into consideration users-needs (children) will rekindle the need for person-centred health care, due to the inspiring conditions ensuing in terms of strategies and policies.

Information exchange as an element of inter-agency working helps in countering confidential issues which would otherwise form the foundation for inhibiting families from adopting person-centred care. According to Richardson and Asthana (2005), incapacitated information sharing is one of the inhibitors of inter-agency working. The issues revolving confidentiality confound information sharing and complicate efficient inter-agency working. In addition, ethical, legal, and practical impediments to information sharing are considered to be core obstacles to efficient inter-agency working. In contrary, when the information exchange landscape is sensitive to individuals’ confidentiality, and esteems the aspects of culture and legal frameworks, it receives warm adoption which significantly makes families adhere with person-centred care.

Conclusion

Person centred care at national level can be hindered by payment systems, alongside other organisational systems and processes such as application of IT to people who have no idea how it works. Besides, organisational culture is one of the biggest influences on whether individuals and teams are motivated towards the uptake of person-centred care. Other aspects such as personal characteristics may impact how a person reacts to person-centred care engagements based on tastes and preferences. These challenges should be rendered attention to increase adoption rates of person-centred care.

In conclusion, the intrigue of inter-agency working in health and social care aim at delivering services to vulnerable groups with diverse needs. Inter-agency working intends to eradicate challenges entrenched in the healthcare fabric, by drawing a pool of experience personnel from various agencies to come together and help facilitate the best healthcare experiences, especially person-centred care, which is one of the UK’s policies. As identified in this study, inter-agency working’s key elements including communication, information exchange, consultation and planning clarity of purpose and organisational aspects are crucial constructs in determining the role of inter-agency working in enhancing person-centred care. This study suggests more systematic study on the factors inhibiting uptake of person-centred care to provide useful insights for planners and policy makers to take necessary action against the same.

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References

Atkinson, M., Jones, M. and Lamont, E., 2007. Multi-agency working and its implications for practice. Reading: CfBT Education Trust.

Calder, M.C. and Horwath, J., 2018. Working for Children on the Child Protection Register: An Inter-Agency Practice Guide. Routledge.

Cambridge, P. and Carnaby, S., 2005. Person centred planning and care management with people with learning disabilities. Jessica Kingsley Publishers.

Duggan, C., Corrigan, C. and Social, W.R.C., 2009. A literature review of inter-agency work with a particular focus on children's services. Children Acts Advisory Board.

Fieldhouse, J. and Onyett, S., 2012. Community mental health and social exclusion: Working appreciatively towards inclusion. Action Research, 10(4), pp.356-372.

Glasby, J., Dickinson, H. and Miller, R., 2011. Partnership working in England—where we are now and where we’ve come from. International journal of integrated care, 11(Special 10th Anniversary Edition).

Health & Social Care Integration. (2019). Retrieved 20 September 2019, from

Holmesland, A.L., Seikkula, J. and Hopfenbeck, M., 2014. Inter-agency work in Open Dialogue: the significance of listening and authenticity. Journal of interprofessional care, 28(5), pp.433-439.

McKeown, K., 2012. Inter-agency cooperation between services for children and families in Ireland: does it improve outcomes? Journal of Children's Services, 7(3), pp.191-200.

Moran, P., Jacobs, C., Bunn, A. and Bifulco, A., 2007. Multi‐agency working: Implications for an early‐intervention social work team. Child & Family Social Work, 12(2), pp.143-151.

Richardson, S. and Asthana, S., 2005. Inter-agency information sharing in health and social care services: the role of professional culture. British Journal of Social Work, 36(4), pp.657-669.

Sloper, P., Beecham, J., Clarke, S., Franklin, A., Moran, N. and Cusworth, L., 2010. Models of Multi-agency Services for Transition to Adult Services for Disabled Young People and those with Complex Health Needs: Impact and Costs. Report to the Department of Health.

Whiting, M., 2013. Impact, meaning and need for help and support: The experience of parents caring for children with disabilities, life-limiting/life-threatening illness or technology dependence. Journal of Child Health Care, 17(1), pp.92-108.

Williams, I., 2009. Offender health and social care: a review of the evidence on inter‐agency collaboration. Health & social care in the community, 17(6), pp.573-580.

Wong, S. and Sumsion, J., 2013. Integrated early years services: A thematic literature review. Early Years, 33(4), pp.341-353.

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