Supporting the Individual Journey through Integrated Health and Social Care

Supporting the Individual Journey through Integrated
Health and Social Care
Contents
INTRODUCTION...........................................................................................................................................2
LO1..............................................................................................................................................................3
P1................................................................................................................................................................4
P2................................................................................................................................................................6
M1...............................................................................................................................................................8
LO 2...........................................................................................................................................................10
P3..............................................................................................................................................................10
P4..............................................................................................................................................................12
M2.............................................................................................................................................................14
LO 3...........................................................................................................................................................16
P5..............................................................................................................................................................16
P6..............................................................................................................................................................18
M3.............................................................................................................................................................20
LO 4...........................................................................................................................................................22
P7..............................................................................................................................................................22
P8..............................................................................................................................................................25
CONCLUSION–......................................................................................................................................27
REFERENCES..............................................................................................................................................29

INTRODUCTION
Integrated health care is defined as comprehensive care which consists of innovative
and new organizational arrangements that focuses on the integrated form of care that is
care from the various sections of the organization and health and social care sectors
linked together and coordinated to provide care to an individual.

LO1
Multidisciplinary care is care which includes a range of professionals with their different-
different discipline, experience in particular discipline, knowledge, and skills to give an
inclusive and complete healthcare treatment to an individual at their best possible
outcome depends on the individuals need which are physical and psychological. The
health care and support services available for an individual in London requiring
multidisciplinary are Multidisciplinary team coordinator, General physicians, Clinical
nurse, Surgeons, Physiotherapist, Histopathologist, Radiologist and Dentists.
 Multidisciplinary team coordinator
A team coordinator is a person who coordinates between all the sections of
health and social care with the people and staffs related to it and manage to work
together, which results in fulfilment of the requirement of patients and get the
desired outcome.
 General physicians
A general physician in a multidisciplinary team will diagnose and handle the
normal sickness and illness and gives basic treatment to people.
 Clinical nurse
A clinical nurse supports all the treatments, procedures and diagnosis of a
patient to provide care, advise, support and information to the doctor as well as
to the patient.

P1
There were several local resources and provide that support integrated care working.
Local resources and provision are as follows:
LOCAL RESOURCES PROVISIONS
NHS (National health system) NHS works to fulfil the health need of an
individual’s also for them who are not able
to pay. As it is working free in delivering
services, maintaining equity among all and
works under all the legislative acts and
regulation. It provides care to all the
citizens of the country.
PCT’s (Primary Care Trust) It controls the budget of the NHS Trust.
They are providing funds and financial
support to other health and social care
agencies.
CQC (Care Quality Commission) CQC maintains and regulates all the
health and social care of adults in
England. It generates guidelines of quality
care.
NICE (National Institute for Health and
Clinical Excellence)
This is responsible for developing national
standards and guidelines related to health
promotion, treatment, and technology.
VHA (Veteran Health Administration ) It is the largest integrated system as it

provides care to veterans only.
LINks (Local Involvement Networks ) It supports patient and people by taking
and understanding their feedbacks.
PALS ( Patient Advice Liaison Service ) It also provides support to patients by
listening to advises and feedbacks about
the care service.
Ambulance service NHS trust This service provides ambulance in case
of emergency as well as also provides
transport facilities for patients.
Child care services It deals with child health and development.
It also helps parents and family to
understand and advice about children. It
protects children and also the decision
making in case of child custody referrals.

P2
An unmet need is described as the needs of the individual under certain age group want
or felt needed in health care but does not receive it, because of some factors such as
long waiting lists, lack of financial support, knowledge and information and
transportation problems. As unmet need also includes the unsatisfactory method of
diagnosis treatment, delay in treatment or poor quality work. For the needs to be
fulfilled, people need to express them to the authorities and if the needs expressed and
not met then they are referred to unmet needs. In England, the unmet needs of people
are described below (Lewis et al, 2003).
Poverty
There are many people whose demands are not met as they live in a low
socioeconomic culture where not many facilities are available. In terms of food, clothing,
lifestyle, children and adults suffer due to low pay and unmet needs (Hood, 2017). It
was observed that 330,000 houses were required in Great Britain with a safe and clean
environment and surrounding to solve issues like homelessness and crowding. 2017
polls of UK on poverty suggest 14 million people suffering from poverty o corresponding
to 1 in every 5 people is suffering. Off these 14 million people, 8.1 million are adults, 4.1
million are children and 1.9 million are aged people (Statistics on poverty England,
2018).
Mental health
Work satisfaction and mental needs are very much necessary for the government for
the accurate functioning of the economy. It is required to focus on the polls that suggest
depression and anxiety in 1 of every 6 people in England which suggest that people
require sound mental health which eventually will help the working of government. The
polls in 2018 also suggest that people living in deprived areas are likely to not recover
after psychological therapy which is because of their lifestyle and their everyday
struggle and unmet needs. For every person to be mentally sound, housing, positive

working environment, governmental support is necessary to prevent stressful situations
regarding living conditions. Also, it is the need of every mental patient receiving
psychological therapy to get through the therapy quickly without any delays but it is
observed that people in Waltham wait for 16 days while in Leicester it is 167 days
(Mental health foundation, 2017).
Maternity and infant care
Women in their pregnancy and infants require immediate care and support from health
care facilities. There are many needs of maternity mother regarding her health, infant
health, immediate check-ups, and regular routine check-ups etc. reports of NHS in 2018
suggested a decline in deliveries in hospitals by 1.6% from 2017-2018. This suggests
women being more comfortable with at home delivery because of delays in
appointments and poor quality work. They find themselves comfortable in a home
environment rather n hospitals. It is a growing concern as at home deliveries can be
lethal and thus serious actions need to be taken (NHS, 2018).
The above categories suggest unmet needs of people which lead to lethal events or
results both for the individual as well as the government.

M1
Healthcare providers are very different from social care providers but if they work
together it can be effective and helpful for the people. Healthcare providers are focused
on providing the health needs of people that are concerned with the diagnosis,
treatment, and prevention of diseases. This sector involves nurses, doctors, and
professionals who help to keep the individual healthy and sound and thus it is required
for them to work effectively to manage the health of every patient. Every patient in
health centres has different needs which are to be fulfilled by healthcare providers for
quick recovery of patients. Health care providers help patients by curing or treating the
disease and the nurses provide necessary support to help people with a certain
disease. Also, emotional attachment of health care providers is not good for their
profession as it can affect them and their work in delivering services. For healthcare
workers, any mistake or error can be lethal to the patient and can risk their life (Naylor
et al, 2010).
Social care providers on the other hand focus on the living conditions of people, support
the vulnerable population, care, and support for homeless people, assisting people in
their daily chores, helping people live independently, helping mentally challenged to
lead life normally and support them to be of importance to themselves and the country.

Social care providers focus not just focus on the physical health of people but provide
social wellbeing as well which is very important for a person. Social wellbeing of a
person is important for a person's mental and physical health. Social care providers help
patients with their overall health and daily work, there is no precision or limit and they
support them for easy independent living. Any error or mistake by the provider is not
lethal to the person and can be managed and social care providers often are attached
to their patients emotionally which helps them connect with them and in turn care and
support them (Andrews et al, 2013).
The collaboration of both healthcare providers and social providers is beneficial for the
patients as they receive both physical health and social wellbeing. Thus it is required for
hospitals to work in collaboration with social services such that people who require
social care and assistance can attain both the services easily and it will be effective for
the patient as well (Hurlburt et al, 2014).
There is much interagency collaboration that can take place for making it easy and
convenient for people. The collaboration of health, housing, and social care will help
people in physical and their mental health. Every agency has its own rules and
regulations and their own way of working and thus working in collaboration with multiple
agencies can be a difficult task (Aarons et al, 2014).
Interagency collaboration is very convenient and helpful for people as they don't have to
run to other services and start the process from the beginning and can easily get
guidance on different available services at one place and receive the benefit. For the
agencies to work in collaboration effectively, it is required for them to understand the
working of every sector and make rules and regulations in their collaboration to help
them avoid issues. Routine conferences and required changes should be made to
facilitate the needs of patients and benefit and health of patient should be the priority of
every agency working together (Schmied et al, 2010).
As for health and social care, working in collaboration will always help both the agencies
as they are similar in function and thus it is easy to merge and help patients receive the
benefit of both the services.

LO 2
P3
Lucy is a 75-year-old living alone with her grandchildren and children settled in another
city. She has Alzheimer’s and stays at service home in the UK and is keen on painting,
she loves to live her life independently but her condition led her to the social service
centre. She has asthma and needs to visit her doctor often for check-ups. She also has
a heart condition and takes regular medication for high blood pressure. She had a
severe asthmatic attack and almost lost her life till she was saved by doctors at the
hospital but it is suggested by doctors that she is supported and cared for and that she
will under observation for some days (Oliver, 2012).
Lucy's Alzheimer's along with these health conditions have made her more dependent
on others for her daily work. Managing Lucy is difficult as she forgets about her
conditions and being at the hospital and it becomes difficult to manage her. With her
multiple problems, her needs increase as well. Patient like Lucy require 24/7 care and
support, she needs doctors and nurses to monitor her physical health routinely along
with social care providers to help her and assist her in daily work, she also requires the
support of psychologist and counselling sessions to help her deal with Alzheimer's and
other health condition easily. She requires care providers to be by her side always to
help her with daily work and also to manage her asthma problems (Baillie, 2012).
To support Lucy health care practitioners arranged a wheelchair for her while social
care providers helped her by having a volunteer 24/7 with her to move her around and
help in her daily work. To facilitate with her Alzheimer's regular visit of her psychologist
was made to ensure she was calm and at ease and social providers made the effort to
have normal conversations with her regarding her paintings. To distract her mind,
Healthcare providers along with social care providers set up canvas and paints to help
her be engaged in painting. This will maintain her blood pressure and relax her heart at
the same tie she will not wonder about being in the hospital. Even after being shifted to
the social service centre, Lucy was visited regularly by doctors to check her medical
health and ensure everything is well (Clegg et al, 2013).

With all the help and support, there were times when she missed her children and
grandchildren and to keep her happy and ensure her health, her children visited her
every 3rd week to ensure she was healthy. She always was delighted to see her
grandchildren even when she did not recognise them at times. Fulfilling her
requirements and ensuring her health, helped her to be better and improved both her
physical and mental health (Zautra, 2010).

P4
The patient centred approach is important to be adapted to facilitate patients in health
and social care centres. Patient centred approach means caring and supporting patients
by considering their choices and need. It is the responsibility of health professionals to
keep patient requirement and choices as the centre of care and treatment and focus on
providing and benefitting patients. Social care providers as well need to work according
to the choices of the patient and prioritise their health and care when treating them.
When care is provided in the best interest of patients, it leads to faster and better
recovery thus helping both patients and care providers (Epstein, 2011).

In Lucy's case, she needed support and care from every sector as she was a vulnerable
75-year-old lady with no support. To help Lucy health practitioners helped her by
assessing her requirement of the wheelchair. In this case, the understood the need of
the patient and took required measures to help the patient which provides an example
for a patient centred approach. Health professionals and social care providers prioritised
the needs and requirement of their patient and facilitated her by providing care and
support that was required. Helping her 24/6 with her daily work and understanding and
assessing her requirements made it obvious that health professionals and social
providers provided patent centred approach. Not just that they helped her meet her
family regularly to help her and ease her pain and sufferings in old age (Mezzich, 2010).
Lucy had multiple requirements and needs considering her condition, a visit from doctor
regularly, visit from her psychologist, seeking help from social providers, volunteering
24/7, helping with routine work, everything was necessary and required for her. Patient
centred approach adapted by health professionals and social providers in helping Lucy
allowed and provided her support and care with which she could be better. The focus
was to help her lead a normal life even with so many health issues and to help with that
arrangement of painting session helped to keep her calm and relaxed during the
treatment. This step suggests the importance of care and health for health professionals
and social providers taking into consideration the requirements and choices of the
patient (Rathert, 2013).
Thus it suggests that patient centred approach helps the patient receive best care and
support which is in their interest and the help and care Lucy received is an example of
patient centred approach as her interest and her choices were kept as a priority for
health professionals and social care providers. Thus it is relevant to say that patient
centred approach adapted by health professionals is necessary and helpful in achieving
good health of patients. To adapt to this method allows, patients, to be satisfied with
their treatment and care and it becomes helpful and easy for health professionals to
provide services in the interest of patients (Entwistle, 2013).

M2
Every individual and patient has a different journey of care and support. Just like the
requirements of every individual, their care pathways differ as well. Some people
believe being cared in a certain way while others have a different opinion. Patient
centred approach is to focus on the needs and requirement of patients and work
according to their interest. For healthy and quick recovery patient involvement and
patient motivation is required and that can be achieved with the patient centred
approach. In my practice, I have seen many people being provided a patient centred
approach and being successfully recovering from their bad health or misery (Pulvirenti,
2014).
Patient centred care can be assessed with patient satisfaction and recovery growth
which indicates whether the care provided is in the best interest of patients. I have seen
many patients who prefer being treated normally and not being sympathised with which
helps them to recover faster.
As for my practice, I have always been concerned with patient needs and requirements,
I always assess the interest of patients and help them accordingly. I respect their
choices and motivate them by helping them according to themselves which motivates
them to recover faster. Like treating patients in a normal way helped them to feel normal
about themselves and thus help them to recover. I focused on how patients wanted to
be cared and supported and delivered them accordingly. There were patients who did
not prefer taking medications orally and it was a challenge for me to deliver the services
in the interest of patients. I worked on patients and provided the medications that
needed to be delivered orally by convincing them and delivered other medications
through IV (Epstein, 2010). I learned in my practice that you cannot force treatment on
anybody and that it was required for health professionals to understand the
requirements and interest of people and work accordingly. The patients I worked on, I
managed to provide them patient centred care and realised the improvement in them
was quick and effective which is because of their effort on working on their health.
Sometimes working in the interest of patients can be dangerous for the health of
patients as certain patients possess obstacles in delivering better services. In such

cases convincing and guiding patients towards health and safety are necessary to
convince them of the right path is necessary to deliver effective services. It is difficult to
convince such patients but counselling and help from a psychologist can help patients
think differently and prioritise health which is effective for them (Singer et al, 2011).
My approach to care and support of patients have always been patient centred,
respecting interest and choice of patients. For difficult patients, I chose to convince
them of better treatment but ensured I never go against their choices. I realised the
importance of patient centred approach and thus I worked to deliver it to every patient
effectively. Working by this approach not just made my job easier but helped me have a
good bond with my patients; they trusted me and always wanted to care under me
(Bechtel, 2010).

LO 3
P5
Leadership brings quality goals into existence which includes forming a vision, a
deliberative plan in the direction of goals and execution procedures. To deliver high
quality of care services, care management needs to have a high-quality leadership plan,
will give a successive and satisfactory outcome for an organization. (Swanwick,
McKimm,2017).
Leadership can be described as per there role and styles as below
Transactional Leadership
This kind of leadership integrates rewards and recognitions in a result of employee
appraisement. The leader and care staff member, both agree on some common goals
and their execution plans to achieve it. Direction is provided by leader on which
employees will work upon and on the basis of performance employees are reviewed. If
employees met their expected goals then they are rewarded and if they exceed the

expected goals then rewarded with special bonus. Vice versa if employees failed to
meet their required goals then they are punished. (Clarke, 2013)
Transformational Leadership
These types of leaders structure a perception for their employees and discuss with them
often. These leaders’ task is to gather requirement of change and then accordingly get
the work done through employees by inspiring and motivating them. This leadership
style will helpful in improving employees moral and results in better performance. This
type of leadership keeps happy environment within the employees. (Clarke, 2013)
Participative Leadership
This is parliamentary kind of leadership. In this kind of leadership involves active
participation of employees in decision-making. This results in increasing employee
moral as they feel respected and valued. Here employees become self-sustained and
independent. But this type of style not worked so well because situations changes
rapidly where participation of employees takes time to resolve the issue. (Arnold, 2013)

P6
Multidisciplinary teamwork is important to give healthy and good health care. The
healthcare team communicate to confirm patient safety and how much it is beneficial to
the patient. The measures will be in sequences, higher the rating of experience
teamwork (O'leary (2012). there is higher patient satisfaction with a low-cost hospital.
Sometimes there is unacceptable harm to the patient due to lack of communication
between health care team, to overcome such situation the Morden healthcare (Weller,
2014). is introduced by the multidiscipline team. The team has many challenges and
responsibility to create a healthy environment which can be done by providing
healthcare education and organization. Interaction through educational view improves
the principles of teamwork, these bring better understanding between staff to
communicate. The responsibility of the team is to provided intercession figures in
hospitals such as physician’s availability, daily targets, creating health care and
checklist, check-up rounds and proper training for the healthcare team. Few types of
research provide to assess the influence on patients results, these results help the team
to improve the knowledge of patients care plan and also helps the team to adapt the
patient in the clinical environment.

Multidisciplinary teamwork is a difficult process in which much different staff works with
different knowledge, skills which may affect the patient care, this difficulty may
overcome by an environmental factor of teamwork hence the mixed skill, proper care,
relationship with individuals can be managed.
The ward safety checklist is designed and implemented to avoid risk factor which should
be checked on a daily basis. The multidisciplinary team provide clarification between
staff and patient during ward rounds. The conception of checklist updates the ward
round by many team members, but the collection of information in checklist may vary,
hence the multidisciplinary ward round is preferred as in good practice, but the
sometimes professionals and the nursing team fail to interrelate work which is getting
difficult to come up with multidisciplinary rounds. The significance of multidisciplinary
ward round gives proof for patient safety and interaction (Amin, 2012).

M3
The research of multidisciplinary team leadership acts on skills which are necessary to
guide and direct team. The leaders of the team are selected or elected by the previous
research experience. The multidisciplinary team leaders are chosen by management or
leaders are appointed within team members by previous work. Depending upon global
economy leaders decide to guide the team on their own. The impact of the team has
less effectiveness which leads to arising of competence leadership. The methodology of
competences leadership is a mixed study of volunteer survey, documentation and
communication information used to elaborate. The experienced professionals needed to
research the current study to assess the team and analyse different individuals’ case
which provides the different care services to the different individual case. The duty of
team leader is to give a conclusion at the end of the case study and guide the team to
provide a solution for the problem and fix it in final considered design. (Ziek, Smulowitz,
2014)

A competency-based approach is playing a significant role in supervising professional
activities and educational training to increase the performance of employees. A
competency-based approach is playing a significant role in supervising a professional
activity and educational training to increase the performance of employees. Required
Training, Disciplinary regulation, authorizing is subjected to competencies. Leadership
competencies are required to pay attention to the supervisory approach (Kaslow,
Falender, 2012). Nowadays a Transformational approach is very famous. It encourages
the transition of knowledge between leaders and co-workers. Sharing information
includes information and communication exchange, problem-solving and team decision
-making. Competencies enhance capabilities like authorizing, prioritizing, learning new
things and searching for new ideas and techniques. This approach is dependent on the
active contribution of leaders. Sharing information is creating a culture and job
satisfaction between the employees. Information sharing to the care employees will
increase their competencies which results in better performance in care services of an
individual. And another type of team is the staff of the health care organisation, sharing
information will increase knowledge and work satisfaction (Trivellas, 2015).

LO 4
P7
Communication is very important in various health fields. Various types of data and
statistic are transfer between employees, patients, and their attendees. There are
different types of communication are used in social and health care sector are given
below –
Vocal Communication –
The workers of HCS connect through vocal communication with each other because it
transfers information very quickly. Vocal communication may arise between employees,
nursing staff and doctors. Vocal communication also plays an important role between
doctors and patients. Vocal communication help patients to communicate with doctors
and understand their problems and health-related issues.
On paper communication –
Healthcare practitioner and patient also communicate with the help of paper in written
form. Doctors and medical practitioners give prescription in written form to help patients
to understand their conditions and other health-related issues and prescribed
medicines. This communication is also used to convey information and other health-
related issues to the patient's family members.
Official communication –

Different health care system includes official communication with the patients and staff
members. Official communication also occurs between health practitioners and the
system with families, society etc. Official communication also helps to maintain a formal
relationship with the employees and gives them various responsibilities. It maintains the
stream of facts and information in a specific manner so that the person meets his all
needs. (Anhang et.al, 2014)
Unofficial communication –
Unofficial information includes the transfer of information to the employees of healthcare
sectors to maintain the effective and rapid transfer of information. It builds up a
connection with a person, who generally communicate with their attendees.
Interrogative –
With the help of different types of questions, doctors or nurses can recognize the
patient's needs. This will confirm that the whole actions of the system are running
successfully.
For a successful organization, communication is key to attain the aims and objectives.
Poor management leads to increased stress and misunderstanding among staff
members. New planning and strategies are required for efficient working of the
organization. it will include all the aspects such as physical, mental etc. For good
communication, management has to create a friendly and social environment for the
patient as well as to their family members. A staff member has to inspire patient and
make them comfortable in each and every service which they provided. Feedback from
employees and patient will increase the working pattern of the organization. firstly, we
should recognize the various types of messages such as supportive and defensive.
Which will develop positive and negative communication? Good communication
improves patient satisfaction. Lack of communication will lead to decreased patient
satisfaction. In an organization multidisciplinary team is involved such as doctors,

nurses, workers, physiotherapist, occupational therapy etc, with these team many
communication problems arise. It may occur due to misunderstanding. In the
organization, management should take responsibilities for patient care. Breaking down
all barriers of communication helps an organization working efficiently. The expectation
of patient will be very high in terms of care, they expect from doctors, the nursing
department and other staff members etc. Communication of all these members with the
patient is important to find patients needs and to satisfy them. Hospital equipment’s and
all the facilities can be utilized to perform the best and to improve the quality of care of
the organization. health practitioner with effective knowledge and skills can
communicate better with patients. To make a powerful connection with the patient and
with their care members, the organization has to teach staff members about principle
and guidelines of communication. (Arnold et.al, 2015)

P8
Social and health care sector uses different types of communication to recognize and
answer to different needs of various services in health and social care sectors. Proper
communication planning helps to create successful communication among employees
and patients. Employees of the health sectors should create an environment and
recognize the patient culture. A medical practitioner should modify the information and
message according to the need to avoid any conflicts between patients and other staff.
Various disciplines team helps the patient to meet their needs and staff also
communicate with the patients to help them. These team and staff should develop a
sociable atmosphere to inspire the patient and help them to convey their health-related
problems without any hesitation. Developing a sociable environment will help the patient
to convey their all problems and health-related issues. ( Batra and Keller 2016).
Communication between a medical practitioner and the patient is very important. It will
build up trust and it will make a comfortable environment for the patient. The doctor
should describe the health condition of the patient and their procedure of treatment to
the patient family members. Personalized care and treatment should be given to the
patient and their family members to develop trust and truthful communication. Assisting
the patient to manage their integrity towards legal obligation to ensure the safety and
wellbeing authorizing the citizen to share their change in needs and requirements.
Apprehension and personal qualities are needed to apply according to the patient. To
maintain quality care, it is important to use proper support it will eventually support an
individual. It is important to use communication as per the individual needs so that we
can understand the individual needs according to their culture. Individual impairment is
also a major criterion for selecting and taking various types of communication. The
healthcare team member should respect the dignity and solitude of the patient.
(Batterham et.al, 2016) The patient may suffer from any type of injury which will affect
its communication. It may be any head injury, CVA or difficulty in speaking. These
diseases will create speaking difficulty and communication problems. These types of
cases should deal with special treatment. Health practitioner and other team members

should communicate in an efficient manner and provide proper care to the patient. They
should treat equally as they treat normal patients. Communicate with these patients
may become difficult. Another difficulty in improper communication is to deal with a
patient suffering from any mental disabilities. This will create communication more
challenging and proper planning is needed to treat this type of patients. Some members
have to work in the field of alcoholic and drug abuse patient, the members have to work
efficiently and become active communicators. Effective communication needs the trust
of patient and service users. The patient should show confidence in the health
practitioner and his team members. The main role of a health care worker is to identify
the barriers of communication. These barriers may be lack of privacy, cultural
difference, behavior problem, language problem etc. (Bradby et.al, 2015)

CONCLUSION–
Healthcare practitioner, nurses and other team members are important for all the
patients affected with any disease or have any medical problems. In the UK, NHS
provide functional care with the help of the government. This service needs many
resources to function properly. Sometimes all efforts are not sufficient, so it will not meet
the individual needs. A person should be knowledgeable enough to recognize their
needs. Doctors are the main component of health care units. The management should
take all the responsibilities for the efficient working of the organization and apply
suitable planning in order to achieve good communication skill of staff members.
Management should take regular feedback from employees and patients as well.
Communication is very important to share various facts and information among the
doctors, nurses and staff members etc. Good communication will make the patient
comfortable and help the patient to speak about its medical condition and other issues.
Barriers should remove to make communication more effective. The action of

communication has too strong enough to motivate patient and modify their behavior.
(Freund et.al, 2015)

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