Implications of Integrated Working
January 8, 2016
Part I: Overview of the Scenario Selected
Based on the presented child cases, I will focus on George’s case because it provides one of the best opportunities of depicting the implication and benefits of the integrated working. Specifically, at 6 years of age and in year one of study, George has a confirmed diagnosis of asthma that requires him to take medications on daily basis. His medical history shows that George has had a number of hospital admissions to manage asthma.
Nevertheless, the management of George’s condition is seemingly not convincing since he has a history of an asthmatic attack at school. Worryingly, his father (Winston) is a known smoker, although he has tried smoking cessation without success. George’s father serves as an administrator in a local council while his mother (Yvonne) is a full time mum. Since George’s parents need him to participate in various school activities, it is extremely important to have an integrated working strategy of helping George to be ready for the activities and at the same time achieve the necessary growth milestones at the right time.
Part 2: Contributions of Various Professionals/ Individuals in relation to Every Child Matters Outcomes, as well as Integrated Working
Before describing the role that each member of the interdisciplinary team plays in helping George, it is important to understand the meaning of integrated working and Every Child Matters Outcomes. Integrated working occurs when different individuals supporting young people and children work together in making every child the center of attention, meeting their daily needs and ameliorating their lives (CWDC, 2008). Therefore, whether a nurse, sports coach, teacher, youth worker, or social worker, integrated working requires teamwork and consultations. Integrated working helps in ensuring that the children and their immediate families get simple and swift access to a range of complementary skills from a team of individuals or professionals.
By contrast, the aforementioned entail being healthy, staying or living safe, being able to enjoy/achieve in life, making positive contributions and attaining economic well-being (HCESC, 2005). The outcomes are enshrined in the 2004 Children Act, and serves as a national framework for improving the life of every child while narrowing gaps between lives of the children who do very well and the ones who do poorly.
In the case of George, various individuals/professionals may add value in his care. As an exemplar, George would require a school nurse, pediatrician, health visitor, teachers, counselor, carer, nutritionist, sports coach, the parents, the clergy, social worker and the family. Approaching the individual/ professionals’ roles from the outcomes, being healthy in this case as an outcome entails physical health, mental health, emotional health, healthy lifestyle and avoidance of drug abuse (HLT, 2014). For the achievement of this outcome, the school nurse would be very important in order to monitor George while in school so that he does not lack proper health care in case he develops an asthmatic attack.
Moreover, the nurse will work closely with George to make sure that he adheres to his medications. The nurse is also responsible for helping George’s father in stopping smoking for the benefit of George’s health. The nurse should thus emphasize to the father that smoking makes George to be a passive smoker, and may equally trigger an asthmatic attack. Furthermore, the pediatrician would help in guiding the nurse on how to manage George and will assess him regularly. Accordingly, the health visitor would pay frequent visits to George’s home in order to assess their living conditions and teach them how to avoid any allergens at home that may make George have frequent acute asthmatic attacks.
In addition, the counselor will address any stresses that George could encounter as he grows and hence help him to remain emotionally and mentally healthy (HLT, 2014). Finally, a nutritionist would suffice in prescribing a good diet for George, especially when he is sick so that he can be able to remain healthy even when he has an asthmatic attack. The sports coach should also ensure that George is active and fit to participate in the school activities that his parents want to see him engaging in during his academic journey.
The other outcome entailing staying safe encompasses safety from neglect, sexual exploitation, violence, and maltreatment (HM Government, 2013). Staying safe also means safety from death, accidental injury, discrimination, bullying, anti-social behavior and crime. Furthermore, staying safe equally means having security, being cared for and having stability.
For this outcome, the pediatrician would firstly be very important. Research indicates that wherever pediatricians work, they often encounter cases of child neglect and abuse (HM Government, 2010). The pediatrician can thus aid in recognizing any abuse to George and providing the reports for criminal investigations and civil proceedings. Accordingly, the teachers, parents, carers and the family need to work closely with George to protect him from any risks of abuse, neglect and maltreatment, among other safety issues mentioned above.
Furthermore, regarding the enjoyment, as well as achievement outcome, the members of the integrated working group should make sure that the child is ready to attend school when in session, enjoy schooling and attain the set primary education standards by the completion of primary school. The team should also work to ensure that George attains social and personal development, enjoys recreation and attains secondary school academic standards after his primary education (HCESC, 2005). In order to achieve the elements of this outcome, the parents and teachers need to collaborate in supporting George’s learning. The social worker can also be of great help in ensuring that George receives the appropriate learning support and if possible financial support where necessary.
In terms of the outcome on making positive contributions, George should be able to do certain things as he grows up. For instance, he should be able to participate in decision-making while at the same time supporting the environment and his community. Furthermore, he should be able to engage in positive and law-abiding behavior while in school and out of school (HM Government, 2013). Moreover, George should be able to develop some positive relationships, self-confidence and enterprising behavior.
In order to achieve the aforementioned outcome, George’s teachers should mentor him to doing the right things and engaging with the right clique of peers. From another perspective, his parents and the clergy should be ready to assist George to become a moral and God-fearing person so that he can remain ethical and equally get the healing that comes from God. His teachers should also be important, especially with respect to disciplining George whenever he commits a mistake.
Regarding the last outcome on attaining economic well-being, the multidisciplinary team should work to ensure that George grows to further his education, acquires more training and employment, lives in sustainable communities and decent homes, accesses material goods and transport while at the same time living in homes free from poverty or low income. The teachers, parents, extended family and carers should thus collaborate in helping George attain the elements of the aforementioned outcome or prepare to achieve them.
Part 3: How the Aforementioned Professionals/Individuals can Work with George’s Family in Providing the Integrated Service
For purposes of effective integrated care for George, there is need for the team members to work together in setting realistic objectives and goals. More often than not, planning determines the ease with which the team is able to achieve the outcomes. For effective planning, there is need for a leader to coordinate the process. In the case of George, it would be better if the parents played the leadership role.
Each member of the integrated working group should thus know the roles and responsibilities to pursue in caring for George. Moreover, each member should show utmost commitment to caring for George without slackening on the commitments.
Importantly, the leader should also arrange for occasional meetings where the team members would come together and discuss the way forward for George’s care. For instance, a formal meeting should take place once a month. The meetings would greatly help them to communicate whatever they would not have been able to communicate well through the online communication system if any is available.
In addition, the leader should prioritize the members who need to see George frequently and those that need to see him occasionally. For instance, a pediatrician can see George monthly or on demand. However, the school nurse should be able to talk to George on daily basis or at least thrice weekly. Furthermore, the health visitor can pay George’s parents a visit every month and the same for the nutritionist.
Part 4: Factors Enhancing/Inhibiting Integrated Working
As the above-highlighted team integrates their care for George, there are certain factors that may enhance the care while others may hinder the care. In terms of the enhancers/enablers, commitment at every level of the partnership can act as a good facilitator. The commitment helps the team members to focus on their vision and have accountability for al resources that will help George. The other enhancer would be the clarity of the purpose of collaboration (Cameron et al. 2015). The team members thus need to have a long-term and coherent vision for George and work with common aims while ensuring collective ownership of the integrated work.
Furthermore, trust and strong relationships between the team members would be very important and hence the need for George’s parents to look for members who may have previously worked together, or they can even provide pragmatic timeframe for the team members to develop trust. In addition, strong leadership for the team is a major enhancer for purposes of directing the group, supervision, accountability and assisting in organizing who attends to George and on what day. The other enhancer would be an explicit understanding of responsibilities and roles for each team member (Robinson, Atkinson & Downing, 2008). The aforementioned professional/individuals thus need to comprehend the ways in which their respective roles fit with the integrated working structure.
Accordingly, good communication among the team of professionals/individuals can enhance good management of any problem that George encounters as he grows (Cameron et al. 2015). Finally yet importantly, regular assessment of George’s needs can be a great enabler of the collaborative working because the assessment will help in the development or restructuring of new set of services to meet George’s needs as he grows.
One of the inhibiting factors for the integrated working may be commitment obstacles whereby some team members may have other priorities, which may compromise the care given to George. In fact, that is the reason as to why effective leadership is imperative in order to organize and plan for the flow of the integrated work (Robinson, Atkinson & Downing, 2008).
From another perspective, cultural obstacles may inhibit effective collaboration because the team members may have varied professional beliefs and views (Brown & White, 2006). Actually, differing experience and qualification levels can cause conflicting views among the team members. Perhaps, that is the reason as to why everyone involved in the care of George should look at the work as a continuous learning process, which is prone to difficulties, tensions, and sometimes innovation and insights.
The other hindrance could involve organizational challenges whereby the team members fail to share the information they gather from George in good time. For instance, a pediatrician may assess George and fail to inform the school nurse of the new findings. In such a case, the nurse may not be aware of the new developments. Therefore, leadership is important in making sure that the professionals involved communicate effectively perhaps through a common online system (Cameron et al. 2015).
Finally yet importantly, contextual factors can hinder effective collaboration among the team members (Brown & White, 2006). As an exemplar, George’s parents may not be very welcoming or cooperative with every member in the team. Moreover, financial constraints may prevent George’s parents from implementing the integrated working for a long period since each professional would require receiving some pay.
Concisely, from the above discussion, it is clear that integrated working has various implications to the care of a young child, especially when the child has a chronic condition. Through integrated working, the child is able to get comprehensive quality care from specialists. In turn, the child grows appropriately and free of significant dangers or major challenges in life. However, good leadership and respect are key factors towards the effective working of the integrated working. Perhaps, it is a good time that all parents devised a workable integrated working plan for their children.
Brown, K & White, K 2006, ‘Exploring the evidence base for integrated children’s services’, Scottish Executive Education Department , vol. 1, no. 1, pp. 1-29, < http://www.gov.scot/resource/doc/90282/0021746.pdf >
Cameron, A, Lart, R & Bostock, L 2015, ‘Factors that promote and hinder joint integrated working between health and social care services’, Social Care Institute for Excellence , vol. 2, no. 41, pp. 1-23, < http://www.scie.org.uk/publications/briefings/files/briefing41.pdf >
Children’s Workforce Development Council [CWDC] 2008, ‘Integrated working explained’, Children’s Workforce Development Council Publication, vol. 1, no. 1, pp. 1-8, < https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/182200/int egrated_working_explained.pdf >
Hackney Learning Trust [HLT] 2014, ‘Children and young people’s services’, Resource Guide for Professionals , vol. 1, no. 1, pp. 1-110, < http://www.hackney.gov.uk/Assets/Documents/CYPS_resource_guide.pdf >
HM Government 2013, ‘Every child matters: Change for children’, HM Government Publication , vol. 1, no. 1, pp. 1-32, < http://webarchive.nationalarchives.gov.uk/20130401151715/http://www.education.gov.u k/publications/eOrderingDownload/DfES10812004.pdf >
HM Government 2010, ‘Working together to safeguard children’, Department for Children, Schools and Families , vol. 1, no. 1, pp. 1-393, < http://webarchive.nationalarchives.gov.uk/20130401151715/https://www.education.gov.u k/publications/eorderingdownload/00305-2010dom-en-v3.pdf >
House of Commons Education and Skills Committee [HCESC] 2005, ‘Every Child Matters: ninth report of session 2004-05’, House of commons education and skills committee Publication, vol. 1, no. 1, pp. 1-79, <http://www.publications.parliament.uk/pa/cm200405/cmselect/cmeduski/40/40.pdf>
Robinson, M, Atkinson, M & Downing, D 2008, ‘Integrated Children’s services: enablers challenges and impact’, Research Briefing vol .1, no. 1, pp. 1-8, < https://www.nfer.ac.uk/publications/CYl02/CYl02.pdf >