Working in Health and Social Care: An Introduction for Allied Health Professionals

216 Pages·2005·21.82 MB·English

by  Teena Clouston MBA PGDip(Research) DipCOT DipCouns ILTM

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Contributors
Martin Booy MAHA DipCOTTDipCOTIU'M
Dean ofHealthcareStudies and DirectorofOccupationalTherapy
Education, Wales College ofMedicine, Biology, Lifeand Health Sciences,
CardiffUniversity, Cardiff
TeenaClouston MHAPCDip(Rese.lrch) DipCOTDipColinsIlTM
Senior Lecturer, Wales CollegeofMedicine, Biology, Lifeand Ilealth Sciences,
CardiffUniversity, Cardiff
Deb Hearle MScDipCOTCertEd(IIE) DIPISM IlTM
Deputy Director, OccupationalTherapy, Wales College ofMedicine, Biology,
Lifeand Health Sciences, CardiffUniversity, Cardiff
Helen Hortop DipCOTDBA
Honorary Fellow, CardiffUniversity, Head ofOccupational TherapyServices,
Cardiffand ValeTrust, Cardiff
Ritchard Ledgerd HScOT(lions)
International Manager, Reed Health Group, London
Linda Lovelock HA(lIons) PhD DipCOT
Senior Lecturer, School ofHealth Professions, UniversityofBrighton
Tracey PoiglaseMScDipCOTPCCE(IIE) PCDipIlTM
Deputy Programme Manager, Wales College ofMedicine, Biology, Lifeand
Health Sciences, CardiffUniversity, Cardiff
GwilymWyn Roberts MADipCOTPCDip(Psych) FlCP
Deputy DirectorofOccupationalTherapy, Wales College ofMedicine, Biology,
Lifeand Ilealth Sciences, CardiffUniversity, Cardiff
Robin Sasaru
Clinical Audit Manager, WalsallTeaching PrimaryCareTrust, Walsall
SomaSasaru
Clinical Audit Assistant, Walsall Teaching PrimaryCareTrust, Walsall
Yvette Sheward
DirectorofClinical Governance andTraining, WalsallTeaching PrimaryCare
Trust, Walsall
Elizabeth Stallard BA(lIons)l.aw
SeniorSolicitorat Welsh Health LegalServices
viii Contributors
LynWestcott MScBScDipCOTRegC)T
Senior Lecturer and Programme Manager, Wales CollegeofMedicine, Biology,
Lifeand Health Sciences, CardiffUniversity, Cardiff
StevenW.Whitcombe MSc BA(lIol1s) 8Sc(1I0I1s)OTPGCE(PCEJ') fUM
Lecturer in OccupationalTherapy, Wales College ofMedicine, Biology, Life
and Health Sciences, CardiffUniversity, Cardiff
Paul K.Wilby MEd BEd(SpEd) MCSP DipTPCertEd(FE)
DirectorofInterprofessional Education, Wales CollegeofMedicine, Biology,
Lifeand Health Sciences, CardiffUniversity, Cardiff
Foreword
Allallied health professionalswho work within healthand social care inthe UK
should be advised to reflecton the words ofJohann Wolfgang von Goethe, the
18thcenturyGermandramatist, whowiselywrote 'Whatwedo notunderstand
we do not possess.'
The health and social care organisations within the UK are amongst the
biggest employers in the world. To practise within them, therefore, is both a
unique and common experience. Because of their size, their relationship to
central and local government and their place in the national consciousness,
health and social care in the UK have developed their own cultures, systems
and philosophies, and these impact in a very real way on the day-to-day
practice ofthe peoplewho work in them.
Topractise effectivelyin any situation it isvital to have not only knowledge,
but also an understandingofthe context in which that practice takes place.To
practise in ignoranceofthepressures, powers and drivers ofthe organisation in
whichyou work isto denybothyourselfand thosewhoaccessyourservice,full
use of your knowledge and skills. Ifwe concentrate only on the issues ofthe
peoplewe servethen as practitioners wewill be at the whim and behest ofthe
organisationwhichemploysus.Tounderstandboththe macro and micro drives
and cultures within health and social care, to understand its politics, policies,
changes and philosophy, is not only essential for effective practice but also
enables us to have some control and influence over that section of the
system in which we practise. Therapists who can positively use and influence
the context in which they practise are those who will best servethe public for
whom they work.
Tobean effectivepractitionerwithin health andsocial carerequiresaknowl
edge and understanding of how the system sees, and what it requires of
its practitioners. The culture that exists within both the organisation and the
country has high expectations of its practitioners. Its expectations of autono
mous, ethical, effective, evidence-based, professional practice stem from its
understandingofprofessional working. Tobeeffective,therefore, requires prac
titioners to have a level of understanding and commitment to these prin
ciples in order to develop and deliver a service that will best serve the public
who own it.
Choosing to enter health and social care within the UKrequires not only a
commitmentto becomingapublicservantbutalso an understandingofhow to
developacareer pathwaythatbest servesthetalentsand aspirationsofthe indi
vidual. Practitioners who successfully develop their career are those who will
continuously develop and use their talents to the full. Career development
within a large organisation offers many and varied opportunities. However it
also requires individual professionals to have a knowledge and understanding
ofthe organisation in orderto ensure theirbest pathwaythrough it.
A text such as this, therefore, that helps allied health professionals to
understand the context of health and social care in the UKand their unique
x Foreword
positionwithin it,will bean invaluablesourceof reference.Tobe able to access
a text that helps build a clear and dynamic view of the culture and systems in
which they are working is one that will help each practitioner towards more
effective and efficient practice. As Francis Bacon famously wrote in 1597
'Knowledge itselfispower.' To best serve the public from within a large organi
sation practitioners need to have aclear understandingof their place within it,
and this timelytextwill certainlyhelpthe process of makingsense ofand there
fore practising most effectivelywithin the ever-changing health and social care
organisations.
AnnieTurnerTDipCOTMAFCOT
Head of Division ofOccupationalTherapy
Centrefor Health Care and Education
UniversityCollege, Northampton
Foreword
The title of this book explains very accurately what it contains, and the
content must be ofinterest to a whole range ofprofessional groups. It will be
particularlyrelevantto newlyqualified practitionersandfinalyearstudentswho
have,or are preparingto, embarkontheircareer in oneofthe allied health pro
fessions. Unfortunately the term allied health professions (AHPs) can hide the
fact that there are some strong professional 'tribes' and it is my hope that this
book isseen astruly multi-professional asthe content isrelevant to many, and
the profession oftheauthors isof little relevance.
Teena Clouston and Lyn Westcott have assembled a range of experts who
have all made a significant contribution to this text. As editors, Lyn and
Teenahavemanagedto keepcontrolofacademicsandpractitioners- which has
beenlikenedto herdingcats- byintroducingandsummarisingeach ofthe four
sections of the book themselves. From my own experience of editing multi
authorbooks, establishing consistencyofstyle without takingawaythe unique
nature of the individual contributions is important. I think the editors have
achieved this verydifficult task and the end result iscommendable.
The book is made up offour sections. Part 1 - Settingthe SceneforPractice
is made up ofthree chapters covering contexts, systems and change. Part 2
Development of the Professions and Individual Practitioner has four chapters
and covers sociological perspectives, tearnworking, continuous professional
development and development of the allied health professions. Part 3
Professional Influences on Practice has four chapters covering quality, evidence
basedpractice, auditand legalinfluences. Part4- FirstSteps intoPracticehas two
chapters and appropriately covers preparing and developing your work and
securinga postfor employment.
Fromthesesection headings itcan be seen that the authors have managed to
cover most areas that surround practice. I think this isthe real strength ofthe
book as it appreciates the context within which the reader will operate,
butdoesnotgethungup on the intricacies ofindividual professions.Thisisnot
an occupational therapy book written for occupational therapists and should
not be seen as such. Asa physiotherapist by profession but currently having
responsibility for a wide range of medical and socially related professions, I
would encourage the reader to considerthe content in the waythe editors and
contributors intended, as a text aimed at helping the health professional. The
editorsand individual authorsshouldbepleasedwithwhatthey have produced
and Icommendthis book asaveryrelevant textforthoseaboutto qualifyor in
the early part of theircareer. More experienced health professionals might also
find it illuminating.
Professor Nigel PalastangaMA BAFCSP OMS OipTP
ProViceChancellor
Learning andTeaching
CardiffUniversity
Acknowledgements
Ourthanks are extended to all the contributorswithoutwhom this textwould
not have been possible.
Toall ourcolleagueswhosesupportover the last year has been invaluable in
maintaining the momentum.
Toall ourstudents forgiving us the ideas and necessary experience.
ToMichael, William and George, a patient and supportive family.
To Daniel for encouragement and support.
Introduction to the contexts
of health and social care
Lyn Westcott and Teena]. Clouston
This book has emerged from our experience in the education of allied health
professionals (AHPs), particularlystudentoccupational therapists. Astutorswe
were aware that students, especially as they neared qualification, struggled to
find asuitabletextbookexaminingthe keyareas thatcontextualised theirstudy
ofprofession-specific skills. Although there were a range ofveryuseful sources
examining profession-specific practice, philosophy and theory, thereseemedto
be little available coveringthe breadth ofsubjects needed to help AHPsunder
stand and prepare for practice in the contemporaryclimate of health andsocial
care.These were issues pertinent beyond our own profession and ofcommon
interest to all the professions in the AHPgroup.
This book has been designed to address this gap drawing on a wide range
of areas that need to be understood, in addition to the practice skills that each
AHPcan offer. Recognisingthat many readers are likelyto be using the bookto
find outabout topicsfor thefirsttimeor wantingto know why the information
held in the textisrelevant to them, wehave designed the structureofthe publi
cation so that itcan be used in differentways.
The text groups what might be seen as disparate areas into parts, each
containing linked themes. An introduction and conclusion are used to help
readers think through the relevance ofthese parts, highlighting how the topics
link together and may be applied to the single practitioner, their profession
and employing organisation and finally the wider context and setting of
British health and social care. Readers may choose to read the bookfrom cover
to cover, but are more likely to look at single parts or chapters in a sequence
relevant to their needs at the time.
Wehave encouraged ourcontributors to enhancetheirtext byensuringtheir
chapters challenge the reader to be interactivewith the material. This has been
undertaken in slightly different ways throughout the book, but you will find
some interesting illustrative examples across professions, be challenged with
reflectivequestions and posed with exercises that will help bring the text alive
and make it relevant to your particularworkingcircumstances.
We hope the book will help readers develop a general understanding of
issues across a range of areas and stimulate further interest to examine the
topics contained in greater detail and depth. With this in mind, many con
tributors have recommended further readingor websitesthat readers can use to
develop their knowledge.
It is important to remember that this is an introductory text written about
topical issues that are subject to continuous review,development and change.
xvi Introductiontothecontextsofhealthandsocialcare
Assuch, readers are advised to think through how issues contained here may
have been further developed and impacted upon by political drivers, policy
changes and professional developments since the date of publication. This
should help to ensure that the text retains its relevance and usefulness as a
resource to support practice.