Published: 05/02/2004, Volume II4, No. 5891 Page 20
Those working at the front line of service integration between health and social care need all the help they can get.
Three books to ease their progress will have varying degrees of success, says Amanda Elliot
Integrating Health and Social Care and Making it Work By Margaret Edwards and Clive Miller Publisher: OPM. ISBN: 189853179X.£18
Integrating Children's Services Issues and practice By Clive Miller and Ann McNicholl Publisher: OPM. ISBN: 1898531803.£18
Leading Change in Health and Social Care By Vivien Martin Publisher: Routledge. ISBN: 0415305462.£17.99
Three books tackle the complicated and often fraught process of service integration.
Integrating Health and Social Care and Making It Work distils the experiences of senior NHS and social care managers who have taken part in integration at various levels.
Born out of a series of 'action learning networks' in which managers shared information, the book provides a practical, hands-on guide. Littered with best-practice vignettes, every other page has a useful 'try this' box covering everything from getting the most from Health Act flexibilities to improve the management of large-scale use of direct payments to service users.
It takes a bottom-up approach starting with the point of view of users and front-line staff. Setting out how poorly co-ordinated services, multiple assessments, long waits and confusing care pathways impact on users, carers and staff, it stresses the benefits that integration can bring if managers focus on outcomes.
Integrating Children's Services:
issues and practice uses the same easy-to-navigate format and comes hard on the heels of green paper Every Child Matters.
The authors stress the importance of outcomes for children and families and suggest practical ideas for overcoming agencies'mutual mistrust and competing interests.
They explain how the current political climate emerged from the inquiry into the death of Victoria Climbié and how pressure to reorganise local services and pilot children's trusts issued from the children's risk review.
Leading Change in Health and Social Care argues that successful integration depends on strong leadership. The book uses a slow-build technique to guide senior managers through the integration process.
Author Vivien Martin, who is helping to set up the NHS University, liberally quotes theories of leadership to demonstrate how leaders must first undergo an odyssey of personal change through learning before engaging in 'transformational leadership'.
She explains clichés like 'thinking out of the box' and the difference between 'single and double-loop thinking' and how they lead to 'system thinking'.
The book includes timed selfassessment exercises and techniques for better practice.
But some suggestions are selfindulgent. In one model, Ms Martin suggests people at a meeting consider metaphors for the meeting like an 'oriental rug' or even 'rain'.
These suggestions are likely leave senior managers wondering how ruminations on rugs and rain can actually make social workers and doctors collaborate better. l