What goes around comes around is a familiar phrase that is used to convey the idea that there is rarely any radical change but instead old ways of doing things are reintroduced as though they were something completely new. The reorganisation of the NHS in 2013 which saw public health services being the responsibility of local government was not new as this arrangement was in place in the last century.
The phrase came to my mind when I learned that we were considering trying to group together our GP practices with community nursing and associated health services and council social care staff in four parts of the Borough. The proposal is to have one group in Darwen and three in Blackburn. This was discussed at a meeting of our Senate (consisting of all our GP members) on October 22. The Senate gave a mandate to the Governing Body to develop the proposal. The size of the groupings should mean that most of the needs can be met from the locality but for very specialist help there will be a need to call on the expertise of people outside of the group. We expect that by April next year the new arrangements will be in operation.
When in the 1970s I worked as a social worker in Blackburn East at Larkhill close to the health centre. We were one of four teams the others being North, in Wellington St., St John, West, in Oakenhurst Road next door to the Montague Health centre, and Darwen, in Union St opposite the Darwen health centre. So although health and social care staff were not in the same buildings, in three instances they were almost next door. However even then if a family I was working with moved from Shadsworth to Roman Road then I had to transfer responsibility to someone from the West area team who would have to start over again building up a relationship with the family.
As each of these social work teams had their own management structure and administrative team they were thought to be too costly and so a District team covering Blackburn was created and there have been various changes since then as council social care organisations have separated commissioners from providers and children’s services from those for adults. Similarly in the NHS community nurses have been organised geographically rather than being linked to one or more practice.
How many of the reorganisations were a response to requests from the public and actually made things better for people using the services is difficult to discover. I know that people I talk to like the idea of health and social care services being close together and like to see familiar faces if they need repeated care.
When I talked to the Senate I said that from a patient perspective care would be better if the people providing it worked together to understand me and my carers, allowed me control and brought together services to achieve the outcomes important to me. So having teams of people who work together on a regular basis, know each other’s strengths and skills and can easily communicate with information flowing two ways to ensure the appropriate help is given in a timely fashion is welcomed. In addition if the GP record which should contain information about me from my birth to the present time is able to be the basis of an integrated record, I should not have to repeat my story to each person who provides care for me.
More benefits will flow from these arrangements if representatives from the voluntary, community and faith sector in the area are involved as by making more use of people who live locally and local buildings and other resources it should be possible to overcome some of the problems which cause people to feel isolated and unsupported.
I think that integrated teams have many advantages and hope that this change will lead to improvements in care for all the public of Blackburn and Darwen.
Chair, NHS Blackburn with Darwen Clinical Commissioning Group