Health and Social Care: Establishing a Joint Future?

By Alison Petch | Go to book overview

Appendix
Matrix of Drivers and Barriers to Integrated Working

Source: Stewart, Petch and Curtice, 2003

NATIONAL POLICY FRAMEWORKS
DriversBarriers
comprehensive and integratedpiecemeal and contradictory
encourage strategic approachpromote 'projectitis'
legal, financial and guidance frameworks facilitatelegal, financial and guidance frameworks inhibit
realistic timetablesunrealistic timescales/change agenda
some non-negotiablesanything goes
establish accountability for user-focused outcomesno national pressure to demonstrate user benefits
LOCAL PLANN ING CONTEXT
DriversBarriers
planning and decision cycles meshincompatible planning and decision cycles
all stakeholders involved from the beginning, unions, operational staff, users and carerspartial/tokenistic involvement of stakeholders
joint acceptance of unmet neednot needs led
agreed, comprehensive vision, owned at all levelsissues seen in isolation, priorities not agreed, based on lowest common denominator
user outcome drivendriven by vested interests
evidence baseda paper strategy
runs with 'good enough' plan, 'leap of faith'waits for the perfect plan
use of budgets reflects strategic priorities'spend this money NOW'
some stabilityconstant restructuring
shared locationdispersed locations
small can be good —— knowing the people (but no alternatives)complexity a barrier (but can be an incentive too)
builds on existing good working relationships, 'success breeds success'no track record of successful collaboration, 'it has never worked here'
restricted resources induce innovation – need to share, 'less means more', Dunkirk spiritresources induce complacency —— rest on laurels, 'more of the same'
pressure to innovate/change to meet need, 'we can't do it alone' 'necessity is the mother of invention'no incentives to change, 'it won't work here', 'it won't work now'
sense of momentum – 'the time is now'baggage of the past

-89-

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