Sharing Assessment in Health and Social Care

A Practical Handbook for Interprofessional Working

Carolyn Wallace, Michelle Davies

• Publisher: SAGE Publications Ltd
• Year: 2009
• Print ISBN: 9781412945745, 9781412945738
• eBook ISBN: 9781446244968
• Edition: 1
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

"This is an accessible and important text. It is to be commended for bringing together policy and practice on assessment and information sharing across England, Scotland and Wales." -

Professor Michael Preston-Shoot, University of Bedfordshire

"This new text is a welcome addition to the literature relating to inter-professional working. It offers students from a range of professions a comprehensive guide to current social policy and authoritative guidance on how to conduct a safe and effective assessment." -

Soo Moore, City University, London

Shared assessment is the standardised approach to assessment and the sharing of information and documentation within and between health and social care. This book offers students and practitioners a step-by-step guide to the process, helping them to overcome some of the anxieties of change and providing realistic guidance on the process.

Key features of the book include:

- Comprehensive coverage - follows a logical structure looking at context, policy, and practice

- A focus on the practitioner?s understanding of an individual?s experience and the roles of staff within the process

- Discussion of confidentiality and anti-discriminatory practice

- Four chapter-long case studies that take the reader through the stages of assessment and subsequent roles and responsibilities.

The book includes pedagogical features such as a glossary of terms, a Comparative Grid for Standardised Assessment Frameworks, examples of carers? assessments, reflective questions and further reading.

It is essential reading for students and practitioners working across health and social care, particularly in social work, nursing and mental health.

PART I

WHERE IT ALL BEGAN

1	THE UK POLICY CONTEXT

INTRODUCTION

The UK policy context has changed considerably over the years since the inception of the National Health Service and Social Services. In the last ten years devolution has influenced health and social care policy through devolved governments’ need to provide tailor-made services that satisfy the needs of their citizens or customers. For example, in Wales the focus is on inequalities in health and the understanding that health is not just health service business but also the responsibility of individual lifestyle and economics. The Welsh Assembly Government (WAG) solutions to these problems are increasingly influenced by European welfare policy. Policy diversity across the UK is therefore inevitable and it’s important that practitioners and students are aware of these differences in practice.

This chapter outlines the UK policy development and context for Sharing Assessment information within and across agencies throughout the UK. It also includes reference to the devolved health and social care policies of the Scottish Government and the National Assembly for Wales. These tailored policies – in addition to those published by the Department of Health (DoH) – serve to meet the needs of differing populations and cultures within the UK today.

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Chapter Aims

The aims of this chapter are:

• To introduce the reader to the idea of sharing assessment information and its principles, for example person-centred care.
• To introduce the reader to the concept of assessment.
• To introduce the reader to the role of the carer within these standardised frameworks for assessment.
• To introduce the reader to drivers such as demography, legislation and evidenced policy. Diversity is acknowledged through reference to some of the many policy documents that are found within the devolved public services in Wales and Scotland.

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WHAT IS ASSESSMENT?

Before we can discuss sharing assessment information we need to clarify what we understand by assessment itself. Assessment is a set of complex tasks that requires us as either individual health or social care professionals to acquire, develop and maintain our needs for specific knowledge and skills throughout our professional careers. The knowledge and skills required are those which are both profession specific (e.g., models, theory, physical examination, measurement) and generic (e.g., communication skills, listening and observing). These are essential parts of the assessment experience, which are dictated by the service user’s context and needs (Armstrong and Mitchell, 2008).

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Activity

What is assessment? Think about the many times that you’ve been assessed in a health or social care context, when were they?

You may have thought of … The time when you’ve visited the GP, the midwife when you were born or having your own children, the health visitor when you were a baby or young child, the school nurse when having a vaccination, the occupational health team when you gained employment, etc. The truth is that we experience assessment many times throughout our lives and each one of those professional groups, in addition to others, such as the social worker, the physiotherapist and occupational therapist. They assess in different ways, gathering and using both subjective and objective information and guided by theories and models taught specifically within their undergraduate and postgraduate professional curricula and the speciality within which they practice.

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Adams (2007: 283) states that the

aim of assessment is to make a judgement about a person’s situation and needs.

Coulshed and Orme (1998: 21) some time ago defined assessment as

an ongoing process, in which the client participates, who’s purpose is to understand people in relation to their environment; it is a basis for planning what needs to be done to maintain, improve or bring about change in the person, the environment, or both.

Grossman and Lange (2006: 77) more recently saw that

a decision for nursing care evolves from the nursing assessment, which includes not only what the nurse observes but also the nurse’s ability to perceive what might be actually ‘going on’ in a person’s life. If the nurse had more knowledge regarding the person’s circumstances and potential challenges, he or she would be able to ask questions that would be most valuable in performing a holistic assessment.

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Activity

For many of us assessment is a condition of our registration but what’s the purpose of assessment? Think about those times that you were engaged in an assessment either as a service user or the assessor. Why did you participate in the act of assessment?

You may have thought of … To solve a problem (e.g., difficulty breathing or inability to prepare a meal), to meet a need (e.g., to breathe with ease or to ensure adequate nutritional intake), to ensure that a person received a service to meet a need or a number of needs, to avoid a risk(s) to independence, to manage risk(s), to gain a nursing or medical diagnosis, to gain a whole picture of an individual’s behaviour.

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The quality of the judgement made by the professional is dependent on the quality of the assessment and whether or not the information gained within it is reliable. Likewise the quality of the subsequent care plan and the ability of the care plan to meet the agreed service user outcomes are dependent upon the quality of the knowledge gained and whether the right questions are asked within the assessment. Hence the assessment, the ‘How’, ‘Why’, ‘What’ and ‘When’ type of questions professionals ask within it, are important aspects in ensuring that the right information is gained to build an accurate picture of need, an appropriate care plan, treatment or care package with achievable outcomes.

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Activity

What sources of information do we use to build an accurate and reliable assessment?

You may have thought of … The service user, the carer, other key people in the service user’s life, current and previous records, assessments from other professionals past or present and, depending on where you work, information from other agencies such as the police, ambulance personnel and of course witnesses, e.g., of an accident or a fall.

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Assessment involves key people such as a service user and/or a professional in the process of gathering reliable information in order to make judgements as to a person’s needs, in respect of their health and wellbeing, situation or environment. These judgements then facilitate action that may make change possible or maintain the desired status quo.

SHARING ASSESSMENT INFORMATION

Sharing assessment information is a fundamental part of the UK modernisation strategy and will enable public services to deliver individual assessment in the twenty-first century.

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Activity

Why do we need to share assessment information? Think about the times when you’ve participated in an assessment with a person.

You may have thought of … The service user has a lot of problems and a lot of needs, which require the skills from different professionals and at times different agencies. Therefore, working closer together may mean that we can solve more problems through utilising each other’s knowledge and skills. This could mean shorter hospital stays, more timely treatment and care, and increased satisfaction for the service user and staff.

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There are many good reasons for professionals to share assessment information but the most fundamental is the need for service users to feel that they are not repeatedly asked the same questions. The act of dovetailing the assessments to avoid repetition and duplication will in time lead to a seamless, effective, efficiently delivered, accurate and timely assessment. This should then lead to the planned treatment and care, which meet identified and agreed outcomes for an increasing number of people who have complex needs.

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Activity

What do we mean by an increasing number of people who have complex needs? Think about your practice, whether in hospital or in the community. What is significant about the population of patients or service users you encounter on a day to day basis?

You may have thought of … The population is getting older, there are an increasing number of people who, dealing with one long term condition may as they get older, have several. In addition to that a person may experience frailty. This may lead to an individual requiring more than one need to be met at the same time – which can’t be satisfied by the skills of one professional – and so it demands a different approach to care. For definitions of ‘need’ see Chapter 2.

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DRIVERS FOR SHARING INFORMATION

The UK population is growing quickly at an annual growth of 0.7 per cent. It is projected to reach 71 million by 2031 due to more births than deaths and an inflow of immigrants. In addition, our population is growing older with those over the age of 65 years increasing to 22 per cent of the population by 2031 (Office of National Statistics (ONS), 2007). Children born in the UK in 2006 would expect (on average) to live to 76.9 years (boys) and 81.9 (girls) years. As a result, the chances of a child born in the UK in 2006 reaching 65 years is projected at 91 per cent for boys and 94 per cent for girls compared with 74 per cent for boys and 84 per cent for girls born in 1980–82.

However, while women live longer they can also expect to spend more years in poor health and with a disability. Chronic diseases such as diabetes, heart disease, stroke and back problems are common in older age but arthritis and rheumatism are the most common. As we get older, we experience increasing numbers of chronic diseases which then impact on our ability to live our lives as we would wish (ONS, 2006).

So it’s inevitable that in the future, individuals will need to access primary, acute and community care services (in proportion to need) in order to be as independent as possible. In accordance with the UK Census in 2001, the proportion of the population reporting a long term illness or disability increased with age, especially those over 90 years of age (ONS, 2001). Many (85 per cent), who reported their health as not so good also reported having a limiting long termillness or disability. Of those people consulting their GP in 2001–02, 40 per cent were over the age of 65 years (ONS, 2004).

Therefore, staff will need to engage with one another within and across agencies to fulfil the needs of those most vulnerable people. Unfortunately, staff working across health and social care services often feel confused about the policy, law and guidance available that should enable them to comfortably share information with colleagues when working in the service user’s best interests.

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Activity

Can you think of the policies, law and guidance which influence your everyday practice when sharing assessment information?

You may have thought of … The National Service Frameworks, NHS and Social Service strategy documents, the Data Protec...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• Acknowledgements
• Introduction
• PART 1: WHERE IT ALL BEGAN
• PART 2: APPLYING THEORY TO PRACTICE
• PART 3: OPPORTUNITIES AND CHALLENGES FOR INDIVIDUALS, STAFF AND ORGANISATIONS
• Appendix 1: Comparative Grid for Standardised Assessment Frameworks
• Appendix 2: Mrs Pam Griffiths’ Carer’s Assessment
• Appendix 3: Mrs Betty Mitchell’s CPA Assessment
• Appendix 4: Glossary of Terms
• Appendix 5: Resources
• References
• Index