Emerald Group Publishing Limited
Copyright © 2013, Emerald Group Publishing Limited
Article Type: Editorial From: Journal of Integrated Care, Volume 21, Issue 1
As we enter 2013, health and social services face a series of unprecedented pressures. The NHS is experiencing what looks like being one of the longest periods of sustained disinvestment in its history and certainly one of the biggest reorganisations it has ever witnessed – a set of changes described by the NHS chief executive as so large you can see them from space. Local authorities have to take staggering amounts of money out of the system, at a time when the strain on children’s services is immense and when the future funding of adult social care remains uncertain. Although councils are acquiring exciting new responsibilities for promoting health and well-being, they are going to have do much, much more with much, much less. All the signs suggest that these events could make joint working even more important, but probably even harder.
Against this background, readers of and contributors to the Journal of Integrated Care will be an invaluable resource as we try to protect existing relationships, reach out to new players and find joint ways forward. Partnership working is sometimes described as the setting aside of mutual loathing in order to get your hands on someone else’s money (!) – but such an approach would be disastrous. If we are to respond successfully to the challenges we face, we will have to find genuinely joint solutions and new ways of working – to borrow a common phrase, we will all be in it together.
Last year, the Journal of Integrated Care celebrated its 20th anniversary, and over time it has witnessed the advent of community care, New Labour’s emphasis on “joined-up solutions to joined-up problems”, devolution to the four nations of the UK, and the Coalition’s more recent commitment to “integrated care”. During all these changes the Journal has been instrumental in bringing together a series of reflective and thoughtful practitioners and managers with policy makers and researchers interested in understanding how best to deliver improved outcomes. Throughout, a key role has been played by the journal’s Founding Editor, Peter Thistlethwaite, and everyone involved in the journal and in trying to deliver integrated care has reason to be grateful for his hard work, vision and dedication. Always happy to help a new author develop their ideas and always committed to spanning the gap between research and practice, Peter has encouraged practitioners to analyse and share their successes and frustrations, academics to apply their findings to front-line practice and policy makers to reflect on the impact of their proposals (both intended and unintended).
After 20 years, Peter has bequeathed editorship of the journal to a new team at the University of Birmingham’s Health Services Management Centre (HSMC). Committed to a strapline of “rigor and relevance”, HSMC is a leading centre for research, professional development and consultancy in health and social care, and – like the journal – we work at the interface of research, policy and practice. Above all, we believe that research needs to have impact: to be useful for and actively used in everyday practice. However, we also believe that practice can help generate new evidence. While sometimes we need to be sure that something will be effective before we do it (what we describe as “evidence-based practice”), there are many situations where we have to focus on things we know are not working, make changes and learn by doing and reflecting (a form of “practice-based evidence”). Although a divided system often keeps these two ways of seeing the world separate and distinct from each other, we feel that they are two sides of the same coin and should always go hand in hand.
In pursuit of this mission, each member of the new editorial team combines a mix of research and practice. A qualified social worker by background, Jon Glasby is now Professor of Health and Social Care at HSMC and a Non-Executive Director of Birmingham Children’s Hospital. Specialising in joint work between the public and voluntary sectors, Robin Miller is a former practitioner and senior manager in a range of integrated health and social care systems. Lead author of The Policy Press’s “Better Partnership Working” series, Helen Dickinson is a Senior Lecturer working in health and social care, but also leads the University’s Public Service Academy (a high-level strategic relationship between Birmingham City Council and the university which aims to improve practice through academics and practitioners working together).
Although we highlight a series of current challenges above, there are also major opportunities in the current policy context – and the advent of Health and Well-being Boards is a good example. This themed edition of the journal has been co-ordinated by Richard Humphries at the King’s Fund, and we hope that the mixture of research, policy commentary and practical case studies is a helpful resource for health and social communities trying to find a way of making the new system work in practice. As the different contributors imply, health and well-being Boards could easily become “talking shops” that add little value to existing structures, but could equally be the glue that holds the rest of the system together in a difficult policy and financial context. How this plays out locally may well be a decision for local leaders as to the type of health and well-being board they want to have and the extent to which they can set aside day-to-day pressures to focus on a joint agenda. Of course, in many ways, such boards are merely the latest opportunity to continue a journey that health and social care partners have been on for many years – throughout the Journal’s 20 year history and throughout Peter’s inspirational leadership.
As we move into 2013 and take up a new editorial role, it feels as if the journal has just as much to offer now as it did when it began in the early 1990s – and as if this unlikely to change for the foreseeable future.
Jon Glasby, Robin Miller, Helen Dickinson