Collaborative working in health and social care: a review of the literature

Abstract

The move towards collaborative working in Health and Social Care can be situated within a wider policy shift associated with de-institutionalisation and de-segregation (Payne, 1995). The change from institutional to community-based care (Barr et al, 1999; Sibbald, 2000) meant that the demarcations and hierarchical relations between professions were neither sustainable not appropriate. New ways of working that crossed professional boundaries had to be created, in order to allow a more flexible approach to care delivery (Malin et al, 2002). Collaboration in health and social care is a relatively new field of study, with the first major studies being undertaken in the 1980s (Roy, 2001). The term collaboration has hitherto lacked a clear definition and has been used synonymously with terms such as co-operation, co-ordination, participation and integration. Since the implementation of the 1990 NHS and Community Care Act (Department of Health, 1990), the concept has featured prominently in government policy documents to promote joint working, partnership and the creation of a ‘seamless service’ between health and social care (Maxwell, 1998; Payne, 1995). More recently, the term ‘communities of practice’ (CoPs) has permeated professional agendas (Lave and Wenger, 1991; Anning 2001). At its simplest the concept of collaboration infers that people from different professional and academic backgrounds form a working relationship for the purpose of enhanced service provision. However, the exact nature of the partnership is likely to be contested, whilst fully integrated ‘joined-up’ collaborative practice has so far proved elusive.