Tearing down the Berlin wall: social workers' perspectives on joint working with general practice
Background. The arrangements for delivering social work and primary health care to older people in England and Wales are currently subject to rapid re-configuration, with the development of integrated primary care and social services trusts. Objective. To investigate perceptions of joint working in...
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| Published in: | Family practice Vol. 22; no. 4; pp. 399 - 405 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Oxford University Press
01-08-2005
Oxford Publishing Limited (England) |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Background. The arrangements for delivering social work and primary health care to older people in England and Wales are currently subject to rapid re-configuration, with the development of integrated primary care and social services trusts. Objective. To investigate perceptions of joint working in social services and general practice. Methods. The study setting was two London boroughs covered by one health authority, one NHS Community Health Services Trust, four Primary Care Groups and two social services departments. All social work team managers in both areas were interviewed together with a purposive sample of social workers with a high number of older clients on their caseloads. A sample of GPs was sought using a sampling frame of practice size in each borough. Structured interviews with open and closed questions were used. Tape-recorded interviews were transcribed and subject to thematic analysis. Analysis of emergent themes was aided by the use of Atlas-ti. Results. Social workers and GPs agree on the need for joint working, but have different understandings of it, each profession wanting the other to change its organizational culture. Co-location of social and health care is seen as desirable, but threatening to social work. Concerns about differences in power and hierarchical authority are evident and explicit in social work perspectives. Conflict resolution strategies include risk minimization, adopting pragmatic, case-specific solutions rather than remaining consistent with policy, using nurses as mediators, and resorting to authority. Conclusions. Although this is a study from urban areas in England, its findings may have wider significance since we have found that resources and professional skills may be more important than organizational arrangements in collaborative working between disciplines. Primary Care Trusts in England and Wales should promote awareness of these different perspectives, perceived risks and conflict minimization strategies in their work on clinical governance and professional development. |
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| Bibliography: | ark:/67375/HXZ-NFG1FDTL-6 Kharicha K, Iliffe S, Levin E, Davey B and Fleming C. Tearing down the Berlin wall: social workers' perspectives on joint working with general practice. Family Practice 2005; 22: 399–405. Correspondence to Kalpa Kharicha, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, UK; Email: k.kharicha@pcps.ucl.ac.uk istex:FC73D3D6F0D3D910E49C6EED48B8EC9C650807FB local:cmi010 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0263-2136 1460-2229 |
| DOI: | 10.1093/fampra/cmi010 |