Reading

Please read Helen Gilburt's (2016) report entitled Supporting through new roles and working across boundaries, which presents in detail some of the barriers and challenges to integrated care.

One of the challenges that Gilburt (2016) discusses, relates to professional roles and settings. Oliver (2007 cited in Pollard et al. 2010) argued that the introduction of new working roles and responsibilities can be unsettling for people, and can even put them into a crisis state, particularly if there are no guidelines in relation to professional boundaries or communities of practice. Professionals may want to protect their own professional identity, and feel threatened by the prospect of joined-up services which they feel may erode their professional identity.

Each professional role may have its own distinct differences. For example, nurses are seen to have a direct and practical involvement with patients, whereas social workers are interested in patients' social and emotional well-being, and their involvement would be more relationship-based and underpinned by models of social justice (Blewett et al. 2007).

Settings may also operate different models of care, so, for instance, the health service may base its intervention on a medical model of care involving diagnosis and medical treatment, whereas a social care establishment will focus on social relationships and support (Goodman et al. 2013). Other challenges may relate to the concern about the possibility of roles overlapping, for example social workers undertaking nursing roles and vice versa. The Centre for Workforce Intelligence (2011) found that differences such as these could create tensions between health and social care professionals, but, interestingly, this could also be the case for other professionals, too, such as health and housing.

Professional roles is only one area that is highlighted by Gilburt (2016) and, as her report indicates, and as this diagram illustrates, other barriers relate to: