Our Brokerage and Professional Support Service is a large team and hosts a vast range of knowledge and skills. Breaking down barriers within health and social care has been imperative to the service we deliver. We provide long-term support to adults who are eligible for social care services, as well as occupational therapy and safeguarding responsibility.
We have to have positive relationships with health to be able to provide a fully integrated service to our clients. A service that meets their needs and aims to help them to be as independent as possible. We all know that integrated care is the best way forward, and that without clear communication between social care and health care we are going to stumble at the first hurdle.
Around a year and half ago, Optalis became part of the Wokingham Integrated Care Network (WICN), a network of core health and care services. We wanted to provide a seamless service, to help people live at home for longer, and to lower admission rates into hospital.
We meet together as one care team and discuss the patients we are supporting. Dependant on the individual, other services such as diabetic teams, or drug and alcohol services, will also be invited. It provides a clearer picture and we are able to take immediate actions and review the patients’ journey.
The WICN has already had a positive impact on those we support, and statistics show a reduction in hospital admissions. The network, without doubt, has broken down barriers and enabled us to be clearer on the needs of the patient. We are more prepared and able to create solutions quickly and efficiently.
Our YouTube video, from a patient we support, shows how his experience of the MDT meetings has benefited him.
There are other areas in Optalis where breaking down barriers is also proving to be beneficial. We are engaging with health partners across two Integrated Care Systems – Frimley Health and Berkshire West. In 2017, we became a participating partner organisation of the Integrated Referral and Information Service hub launched at Wexham Park hospital. The main goal of this project is to provide a good patient experience through integrated collaborative working relationships amongst health and social care professionals.
Optalis staff are physically based at the hub, along with acute hospital staff and CCG colleagues. This joint working has enabled professional case discussion, identification of patients’ needs and commissioning of appropriate service provision facilitated by timely hospital discharges. We were proud to announce recently that the hospital discharge delay transfer of care figures have been zero.
It is a rejuvenating experience for Optalis social care and hospital teams to start working together with acute health and CCG colleagues, aimed at a ‘system approach’ and to move away from the traditional ‘blame culture’ approach. This has supported a culture shift in the mind-set of staff that ‘silo working practice’ is ineffective and non–efficient.
The ethos of this joint working aims to improve the quality and cost-effectiveness of care by ensuring that services are well co-ordinated around an individual’s needs and that is both ‘patient-centred’ and ‘population-oriented’.
We are now looking to continually grow on this culture of integration across the organisation, and foster an environment of quick actions with more flexibility and less paperwork.