Peter Thistlethwaite EDITOR This journal has incorporated a legal perspective on inter-professional working continues to sit outside current health and social care issues for most of the mainstream services and that integration and seamless years of its existence. Our established columnist, John service remain a significant challenge’. Knowsley is an Dow, has emphasised the often simple legal early adopter of integration, and has the governance foundations that can underpin some of the arrangements, with co-ordinated management, to dilemmas faced in practice, a process which can open provide the lead. No-one is saying there is a magic the way to confronting them systematically. So, while wand to deliver benefits in the wave of a hand. as a journal we have a strong taste for evidence-based The key point here is that a fully integrated approaches and their capacity to bring improved approach must, by definition, mean symmetry, and outcomes, we nevertheless understand that the same an effective inter-relationship, between different can be true of legal-based approaches. We have room organisational levels. By this I mainly mean strategic for different perspectives, and value them. control, operational management and multi- In this issue, John goes back to basics to look at the disciplinary practice. All must reflect the ideal of legal basis for partnership, and explores some of the integrated care to get the best value from available problems of understanding which commonly lead to resources; separation of strategic considerations and difficulties. What his explanations highlighted for me, duplication of management systems are going to as someone who, beyond editorial duties, has make it impossible for individual practitioners to involvement in R&D projects in a number of localities, deliver the best for service users. It is quite clear in my was the apparent contrast with reality. Not for me limited sample that the ideal is not in place, and partnership boards getting into a tangle over roles and certainly not reflected at all levels. Communication responsibilities while working to secure integrated between health and social care exists, but it is not service provision, but no partnership boards in taken forward into a unifying vision, which would position at all to lead developments. This has been my require something like a Partnership Board to govern. experience in all four new localities where I have Given that government policy requirements for started a project recently. And these are localities which this ideal could not be clearer, and that the emergent include PCTs unaffected by recent organisational evidence of benefits for users is worth attention even changes, and high-performing local authorities, both if it cannot be fully conclusive yet (as outlined counties and unitaries. Oh for a Partnership Board of carefully by Ailsa Cook and colleagues in the last some description to get my teeth into! Issue of JIC), what is to be done? An ethical I admit I am talking here about mainstream dimension to this scenario seems essential; if policy service links, and the big picture. All four localities and research about partnership are setting a strong have successful small-scale projects, especially of the direction, with benefit to service users at the heart of intermediate care type, reminding me of an both, how unethical is it to avoid robust strategic observation made by Doyle and Cornes in their case partnership which can lead the way to change? study on Knowsley (JIC, 2006, Vol 14, Issue 5): ‘most Totally unethical, I would say. 2 Journal of Integrated Care Volume 15 • Issue 5 • October 2007 © Pavilion Journals (Brighton) Ltd
Journal of Integrated Care – Emerald Publishing
Published: Oct 1, 2007
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