Christine Hoy, the ALLIANCE, discusses the opportunities for a future caring system in a inter-connected world.
A recent ALLIANCE and RCGP Scotland partnership project (Improving Links in Primary Care) refers to the importance of social networks and concludes that a key feature of future caring systems will be the high value placed on the inter-connectedness of local formal and informal support.
This concept of health outside the usual health buildings was aired at the recent Next Steps for Primary Care in Scotland event. Views were offered from professionals from within and well beyond general practice about the urgent need for our systems to be better linked to manage the 90% of health contacts in a year, which take place in primary care.
There were some surprising facts, (for example, the average age of women retiring from general practice is 36 years) and dialogue about to respond quickly to the changing and unfamiliar demands being made on primary care. This generated comment about our present and future structures and processes.
A recurring theme was about the benefits of general practice staff of being better connected to other professionals, sectors and community resources and for, as RCGP Scotland’s Chair, Dr Miles Mack put it, improved “network literacy” (see his blog post here). Reference was made to the need for more signposting to encourage mutual support between local providers of care. The huge contribution of the voluntary and Third Sector was acknowledged but staff working in primary care often found this hard to find, understand and utilise. There seemed little doubt about the preparedness to pool resources, but conditions have to be right to encourage joint working.
Establishing these right conditions is urgent, as demand for primary care services continues to rise. Dr Ken Lawton reflected that A. J. Cronin’s Dr Finlay’s Casebook may have a part to play – as part of the nation may have a lingering memory of hard-pressed doctors, Dr Finlay and Dr Cameron, working night and day, familiar with every tonsil and family in Tannochbrae. Many will remember the two weary doctors scratching their heads about some never-seen-before illness, as housekeeper Janet serves up not just their tea, but inevitably the answer to some medical conundrum. Of course, the (usually) happy ending was all down to Janet’s chance encounter in the butcher’s, in other words, it was solved by her community connections.
The Health and Social Care Alliance Scotland is contributing to strengthening these vital community connections and constructing a sort of Dr Finlay’s Facebook, one which links the best of personal and local assets with modern digital technologies. This is being done through a number of programmes, but in particular through the Links Worker Programme and A Local Information System for Scotland (ALISS).
The ongoing Links Worker Programme aims to enable the primary care team to support people to live well in their community through enabling better access to information, knowledge, skills, relationships and resources.
ALISS is an innovative online system which has been developed with people with long term conditions and professionals to make it easy to find support. The ALISS system has harnessed 21st century technology to produce a tool which individuals, professionals and communities can use to gather, maintain and share information – a kind of “digital Janet”.
Conclusions of Improving Links in Primary Care supported the view that collaborative infrastructures are vital, especially to support lonely and vulnerable people in our society. The project highlighted the mutual benefits of strengthening local human relationships and linking both formal and informal providers of care, such as lunch and sports clubs, voluntary and 3rd sector organisations, general practice, police, librarians, pharmacists and many more. Project recommendations including: There should be
- “two-way electronic communication between NHS and non-NHS organisations to encourage signposting
- “All practices in Scotland should have an opportunity to access ALISS through their primary care systems”
- “For many practices, especially in more deprived areas, access to a model of links working may be the best way forward.”
Linking the unconditional care, which is offered through universal registration with general practices, with the excellent sources of support which lie in many communities must be at the heart of our new models of primary care.
 Dr Finlay’s Facebook is the title of the first section in The Talking cure, why conversation is the future of healthcare, Jack Stilgoe and Faizal Farook, DEMOS 2008 www.demos.co.uk