Published: 01/04/2004, Volume II4, No. 5899 Page 21
The government is waking up to the fact that the key to good partnership-working between health and social services lies at the frontline, says Val Hudson
Interprofessional Collaboration: from policy to practice in health and social care Ed Audrey Leathard Publisher: Brunner Routledge.
Social Work Theory and Practice for a Changing Profession By Lena Dominelli Publisher: Polity Press.
Managing in Health and Social Care: essential checklists for frontline staff By William Bryans Publisher: William Bryans.
Interprofessional Collaboration edited by Audrey Leathard, and Social Work by Lena Dominelli are significant titles in a climate where partnership working in health and social care continues to stretch the minds of those in both professions.
Leathard edits a series of international papers that give an honest assessment of the state of interprofessional working. The first part of the book deals with policy issues, including an interesting overview by Richard Hugman on interprofessional dynamics in Australian health and social care.
The most interesting chapter in this section is by Leathard herself on 'models for interprofessional collaboration', something for which she explores a vast array of models for assessment and evaluation.
This will be of value to any NHS manager.
The second section moves from policy to practice. The first chapter on clinical teamwork tries to gauge the impact on patients of interprofessional working, while the next two identify the need to support families and safeguard children by working together.
An excellent chapter by Hugh Barr gives an array of evidence to show why collaboration needs to start with undergraduate education.
The book is worth reading, but my main criticism would be that because of the great pace of change in this area it has probably been superseded already.
For instance, there is only passing mention of Lord Laming's report into the death of Victoria Climbié and nothing about the enormous implications for interprofessional working of the children's services green paper.
Dominelli's excellent book examines the neo-liberal political traditions that have resulted in social work becoming such a 'troubled and troubling profession'.
Her conclusions are that social work needs to reposition itself to work in partnership with service users and communities to challenge not only the personal but also the structural problems that cause exclusion.
She argues that social work should 'support clients by arguing for needs-led universal, rather than stigmatised residual, services'.
Tackling the causes of inequality is exactly what Dominelli says social workers should be doing in partnership with clients and other professionals.
She does not excuse clients from their responsibilities in this partnership, but argues they would be in a better position to accept these if other aspects of their lives were not so impoverished. The argument for tackling inequality is no longer one that can be attributed to the 'loony left' of social work; it must be embraced by all who are serious about real partnership working Managing in Health and Social Care describes itself as an essential checklist for frontline staff. It is a strange book because it deals with issues that in most health and social care settings are decided strategically, rather than at the frontline.
Bryans talks about bringing business competences into the public sector - for example, by setting up procedures to deal with concerns such as receiving gifts and hospitality, and dealing with cash and security.
At its best this book may be useful to small voluntary sector organisations at their inception, but it has nothing to offer frontline staff in the statutory sector.
Interprofessional working will be one of the growth sectors of the next decade.
Having spent several years trying to sort out inter-agency working, it has now dawned upon the government that the real action takes place at the front line, where traditionally separate professions intersect in their dealings with service users and patients.
In the case of health-social care partnerships, NHS colleagues first of all need to understand where social work is coming from, and Dominelli offers this perspective.
The next step is to begin to unpick the nature of interprofessional working and how it might be advanced, and Leathard's collection makes a useful contribution to this debate.
Val Hudson is senior lecturer in social work at Sunderland University