Service overview:
The Integrated Neighbourhood Care Aberdeen (INCA) service was launched by Aberdeen City Health & Social Care Partnership in February 2018. In Scotland, the Public Bodies (Joint Working) Act 2014 was passed to task NHS boards and local authorities to integrate health and social care provision toimprove both effectiveness and efficiencies in care delivery. In Aberdeen, INCA consisted of two teams, each with three support workers and three nurses. The new INCA recruits worked alongside existing community nursing teams and were based across two sites: one in a corporate office setting and the second in a general practice surgery setting. Teams were self-managing and had autonomy over all aspects of service delivery, such as accepting referrals (patients without previous receipt of care and living within local postcode areas were referred to the service), care provision and staff rostering. A coach was provided for staff to access for issues regarding team working. Before this service, community nursing and community care teams would deliver care to patients separately, even if the patient required both health and social care input.
Study design:
In this qualitative case study, nine staff members volunteered to participate in individual, semi-structured interviews. Demographic information collected included the following: age, sex and years of experience working in a healthcare/social care setting.
Study findings:
This study has provided several important considerations when attempting to implement a new model of integrated care working in a self-managing way. Recommendations would include the colocation of staff, developing frameworks to support clear delineation of tasks and embedded, accessible support structures. Elements of self-management that appeared acceptable included staff rostering, autonomy to adjust care provision and the ability to provide care continuity to patients.
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