Advocates of integrated care are increasingly talking about the need to integrate at the level of the individual rather than the system. What this requires is not just for health and social care staff to get better at working together (although that does need to happen). Often what is crucial to integration is for a single professional to work with the person receiving care as a coordinator and navigator of the complexities of the health and social care system.
The House of Lords report on Ageing cited a research study in which there were, ’22 different health services alone, excluding social care, which could be aimed at a person needing care at home’. The report called for ‘care managers, who know the systems, can help people navigate through them, pull together funding streams, and advise people with personal budgets or help those who are paying for services privately.’
The University of Birmingham Policy Commission on the Future of Local Public Services also identified the need for ‘navigators’, guiding citizens and service users around the range of possibilities that might be available in local public services.
What is lacking in the discussions of integration to date is a convincing account of how you equip public service workers to be good navigators. It seems likely that good navigation would require strong relational skills, good project management, pragmatism and creativity in the face of apparent barriers, and also the tenacity to keep working to dismantle those barriers. Is it enough to assume that health professionals, social workers and care workers will have acquired those skills along the way, even if they are not currently covered in formal training? Considering new ways to meet the need for skills such as navigation is one of the aims of our 21st Century Public Servant project.