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Level 2 - Working In Partnership What do we mean by working in Partnership and why is it important? This section answers these questions. Click on the questions to jump to those answers.
- What is the purpose of partnership working
- What different types of partnerships are there?
- What are the benefits of working in partnership?
- How do we know where to start?
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What is the purpose of partnership working? The purpose of partnership here is to help people with a learning disability to lead fulfilling lives. This means that local partnership working should ensure that:
- All aspects of a person's aspirations (not just health and social care) should be embraced by partnership arrangements
- The organisations involved in the partnership must therefore include all those with an interest or responsibility across this full range of issues (at strategic as well as operational management and practitioner levels)
- The partnership must operate with the person with a learning disability and their wishes and interests at the centre of the decision making process in some way.
Enabling people with a learning disability to live fulfilling lives is being moved forward at individual level by the development of person centred planning. More information about person centred planning can be found on our person centred planning page Quite a lot has been written and shared about the processes required to make this work really inclusive. While always keeping the twin objectives of inclusion and
effectiveness in mind, our focus here is on effectiveness in delivering positive change. Recent Government policy frameworks place the responsibility for determining ways forward upon local agencies working in partnership, but generally within a tightly defined set of expectations and process requirements. The various relevant policies were shown in Keys to Partnership A common theme is that of organisations performing as though they were an integrated whole, even though they remain organisationally separate. This operates at three key levels of decision making:
- At a strategic level agencies are required to plan together and share information about the use of resources, for example through Local Strategic Partnerships, Health Improvement and Modernisation Plans and Joint Investment Plans.
- At the level of operational management a range of policies require a demonstration of partnership. For example, the Mental Health National Service Framework (NSF) expects integrated specialist health and social care teams and the Older People NSF requires the implementation of a single assessment process that covers both health and social care needs.
- At the level of individual care and support these operational requirements are taken further with expectations of a single point of access, shared information systems and joint training across health and social care staff.
Valuing People goes further than some other national policy documents in its expectations of partnerships that extend well beyond health and social care. But it is also worth remembering that more formal partnership working may not always be necessary or appropriate. The key is to understand why partnership working is required, apply it thoughtfully and purposefully, and to know when a single agency's responsibility can best be addressed by them simply getting
on with it.
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What different types of partnerships are there?  At operational level an array of new joint working has now developed, for example projects described in Joint Investment Plans, joint assessments and the establishment of joint community teams. These and other sorts of joint working can go ahead on the basis of simple agreements between the
different partners. Indeed sometimes such developments occur in very informal ways just by individuals deciding together. Informal arrangements can be very important in breaking down old barriers, but it is important to be able to consolidate good practice by way of formal agreements and protocols. This makes sure that the improvements become part of the organisations' work and are not dependent on certain individuals (who may leave at some point)
Example
Manchester is an example of a long-standing partnership that is now using Health Act Flexibilities and has developed a number of interesting ways of improving access for people with learning disabilities to mainstream healthcare. (See Valuing Health for All - an action guide available from the Foundation for People with Learning Disabilities.) |
Partnerships that use 1999 Health Act Flexibilities By introducing new powers, the 1999 Health Act removed some legal and financial constraints and so enabled the NHS and local authorities to provide and commission more integrated services. Very briefly the new powers are:
- Pooled budgets - health and local authorities can pool their resources to develop packages of care tailored to individual needs;
- Lead commissioning - one authority, Local Authority or PCT, takes the lead in commissioning a range of services for a particular group
- Integrated provision - a single agency provides both health services and some of those that are the Local Authority's responsibility
It is worth remembering that these powers can be used to emcompass a range of Local Authority services beyond social care
Example
Manchester is an example of a long-standing partnership that is now using Health Act Flexibilities and has developed a number of interesting ways of improving access for people with learning disabilities to mainstream healthcare. (See Valuing Health for All - an action guide available from the Foundation for People with Learning Disabilities.) |
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Care Trusts The NHS Plan (DH, 2000) included proposals to strengthen the connections between health and social care. The Health and Social Care Act (DH, 2001) developed these proposals with the idea of new Care Trusts for both health and social care. Whilst
these are seen as useful vehicles for further promoting the integration of health and social care services the Government will not require a universal move in that direction. The Department of Health background briefing for Care Trusts emphasised the importance of the social model of care for people with learning disabilities, and indicated that this may mean learning disability services being best served by the local council taking the lead using Health Act
flexibilities. A further clarification note examined this issue in more detail, including giving criteria against which any proposal for the inclusion of learning disabilities within a Care Trust should be judged and assessed. For more information visit Link to DH Care Trusts page Link to learning disability care trusts clarification note
Example
In Northumberland a Care Trust was seen as the natural development of strong joint working between health and social services across the whole county and for all services for adults. Within the CareTrust there is a clear focus for learning disability services, includingrepresentation on the Professional Executive Committee. |
Children's Trusts Children who need help from social services very often need help from other services as well. But the boundaries between the different organisations - who are there to help them - and the different processes and the different bureaucracies mean that too often those services don't join up. It's the child and the child's parents who have to adapt to the needs of the services, not the other way round. This is wasteful of time and resource,
frustrating for the people trying to deliver the services and is not delivering for the children who most need help. Children's Trusts are being explored as a way for local partners to jointly plan, commission, finance and deliver services for children. The Government's aim is to put children's needs rather than agency boundaries at the centre of policy. Some of the proposed Trusts (as at July 2003) are specifically for children with disabilities. The Green
Paper Every Child Matters proposes that every area should have a children's trust and a director of children's services. It will of course be important to review and strengthen local transition planning arrangements to ensure that new organisations do not put extra hurdles in the way of young people as they move towards adulthood. For more information visit http://www.dfes.gov.uk/childrenstrusts/ Other
partnerships include partnerships with the private and independent sector. An introduction to these partnerships can be found on the HM Treasury website - www.hm-treasury.gov.uk/Documents/Enterprise_and_Productivity/public_services_productivity/ent_services_index.cfm
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Local Strategic Partnerships Local Strategic Partnerships bring together stakeholders such as local residents, communities, businesses and voluntary groups. Their aim is to develop ways in which local people can be involved in shaping the future of their community and the way in which local services are provided. Local Strategic Partnerships (LSPs) are central to the delivery of the New Commitment to Neighbourhood Renewal - National
Strategy Action Plan (National Strategy). They are non-statutory bodies, which aim to bring together at a local level a range of stakeholders - from the public, private, voluntary and community sectors. Local partners working through a LSP will be expected to take many of the major decisions about priorities and funding for their local area. The Neighbourhood Renewal Fact Sheet No. 8: The
Role of Local Strategic Partnerships in Neighbourhood Renewal (Neighbourhood Renewal Unit, ODPM, 2002) provides a useful summary of the key issues associated with Local Strategic Partnerships.LSPs should become increasingly important in creating the local conditions for people with learning disabilities to have better opportunities, alongside other citizens.
Example
In Newham the LSP has led action to increase take-up of benefits.This has included a campaign aimed specifically at people with learningdisabilities. |
Further information relating to LSPs can be obtained from the national policy document What are the benefits of working in partnership? The main benefits are, of course, enabling local people to access a full range of services more effectively so as to meet their needs and aspirations. But
working together can alos make a difference at a number of different levels and often the key focus is the processes that help organisations work together better. The Integrated Care Network website discusses the benefits of integrated working between health and social care in more detail. But it must be emphasised that for people with a learning disability this by no means represents
the "whole system". In many cases other issues such as education and employment will be just as if not more important. http://www.integratedcarenetwork.gov.uk/themes/integration3.php Some benefits include:
- Improved communication between agencies delivering the service, professionals, users and carers
- Increased management efficiency by removing barriers between agencies
- Clear leadership and clear accountability
- Multi-agency and multi-professional teams working towards the same goal.
- A simplified system of decision making
- A single system that is better understood by people who use services, families, practitioners and managers
- One point of referral and access with a one step process for assessing eligibility for services
- One combined approach to the person centred planning process
- One complaints procedure
- More co-ordinated support and care
- One common budget that is accessible to staff from different organisations
- access to different sources of funding
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Example
In Lambeth the Partnership Board agreed with Connexions and the Quality Protects initiative that they would jointly fund a transition worker to help young people make a smooth transition to adulthood. The North East London Workforce Confederation is supporting person centred planning training, using it to help change attitudes in a variety of services and organisations. |
How do we know where to start? There are a several different factors that can help partnerships get started. The Partnership Development Framework detailed in Section three: What do we know about making partnerships work? Keys to Partnership outlines nine building blocks that can be used to help you assess where to devote your efforts for
partnership working. It acts as a checklist of issues to think about to help get your partnerships off to a good start.
Example
People worked in 12 project sites across England to improve access to health services for people with learning disabilities. They found that it was really important to understand the 'mainstream' priorities of Primary Care Trusts and hospitals. Then they could show how including people with learning disabilities could help those organisations do their jobs better and achieve their targets. For example, there are targets for breast and cervical screening.
Making sure women with learning disabilities are included helps GPs meet their targets. |
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Level 3
Level 3 gives you more resources and help
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