POLICY GPs and Social Workers: Partners for Better Care Integrated care practices of GPs and social workers are providing new models of community-based service delivery in which both professions have clearly defined roles, writes Jo Cleary H ealth and social care integration weve heard all about it, we all understand that its more than a worthy ambition and could improve the lives of many. Its even an issue on which there exists that rare form of joined-up thinking cross-party consensus. Yet for all the growing awareness that integration of the NHS and social care is essential to delivering high-quality care and for reducing costs, the question still remains: how can it work in reality? Its a question we at The College of Social Work (TCSW) and the Royal College of General Practitioners (RCGP) have sought to answer in our joint report, GPs and social workers: Partners for better care delivering health and social care integration together. The imperatives for action are stark. People with long-term conditions account for 50 per cent of all GP appointments and 70 per cent of hospital bed days. There continue to be huge pressures on council budgets. We know that heavy reliance on acute and long-term care is poor value, and often falls short of the aspirations set out by individuals and their families. Our report demonstrates that new models of community-based service delivery that put social workers and GPs in the driving seat are integral to the solution. It is precisely these professional groups that are best placed to lead the transition to more and better communityoriented services. The role of social work is key. The medical model has historically fostered dependency, yet independence, JOIN THE DEBATE addressed this issue directly in a recent article in the Guardian on integration, saying we still at times occupy parallel universes. In social care, the current talk is all about implementing the Care Act, but I know from talking to doctors that the principles (let alone the detail) of this transformative new legislation remain foreign and unknown to those working in health. The case studies in our report show that integration really is achievable, but rely on a commitment to clear leadership from both professions. As one GP from our reports Harrow case study told us: The greatest benefits from [working together] have been the breaking down of barriers and forging links. These are the links that really matter between professionals, service users and their families, and importantly communities. Local engagement is key to preventing people being taken into hospital unnecessarily, breaking down autonomy and choice are the mainstays of excellent social work. A dual approach allows GPs to return to their core role of providing care where it is most needed, while social workers provide leadership in genuinely person-centred practice. The case studies in our report are a testament to the strength of this partnership. In West Cheshire, integrated teams led by GPs and social workers are identifying older people at high risk of unnecessary admission to hospital, and working together to identify responses that allow those individuals to remain in their own homes. The benefits to the public purse are more than matched by the human impact: older people who are valued decision-makers for their own care. Clearly, whole-person care doesnt just involve GPs and social workers it involves other health and care professionals, consultants, nurses, OTs, home carers and many others but GPs and social workers are particularly well placed to become the linchpins for integration. Sharing their expertise can be the crucial factor that puts the team around the person rather than dividing the person between the team. isolation and loneliness among older people, and ensuring people lead more fulfilling lives by taking active roles in their communities. Who are better placed to make these links but social workers and GPs? As well as channelling expertise to where it is most effective, integration may ensure better use of the public purse. One study has projected savings of up to 1.6 billion a year through efficiencies in NHS and local authority budgets. Although there is a lack of consensus about whether integration will save the kind of sums that have been projected (a November report commissioned by Health Service Journal rejects the notion of significant, cashable savings from integration as a myth), there is little argument that better and more integrated care is the right way forward for people. And with the Better Care Fund now standing at 5.3 billion and backed by government, it is clear where the political will lies. Most commentators are united in the In partnership, sharing expertise can be the crucial factor that puts the team around the person rather than dividing the person between the team Naturally, there are some obstacles to overcome. A genuinely shared culture across the professions will need to be created, for example. Only in the autumn, care services minister Norman Lamb told the National Children and Adult Services (NCAS) conference that a lack of mutual understanding between health and social care was a real barrier. TCSW chief executive Annie Hudson G Ps can return to their core role, while social workers can provide leadership in genuinely personcentred practice belief that we need to move quickly success will involve large-scale roll-out of integrated schemes like the ones included in our report, and fast. Radical change is necessary, but were convinced that social workers and GPs, working in partnership, can make it happen. Jo Cleary is chair of The College of Social Work