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Front‐line perspectives on ‘joined‐up’ working relationships: a qualitative study of social prescribing in the west of S cotland
Author(s) -
White Jane M.,
Cornish Flora,
Kerr Susan
Publication year - 2017
Publication title -
health and social care in the community
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.984
H-Index - 68
eISSN - 1365-2524
pISSN - 0966-0410
DOI - 10.1111/hsc.12290
Subject(s) - front line , stakeholder , public relations , government (linguistics) , health care , qualitative research , line management , accountability , nursing , political science , sociology , medicine , social science , philosophy , linguistics , law
Cross‐sector collaboration has been promoted by government policies in the United Kingdom and many western welfare states for decades. Literature on joint working has focused predominantly on the strategic level, neglecting the role of individual practitioners in putting ‘joined‐up working’ into practice. This paper takes the case of ‘social prescribing’ in the west of Scotland as an instance of joined‐up working, in which primary healthcare professionals are encouraged to refer patients to non‐medical sources of support in the third sector. This study draws on social capital theory to analyse the quality of the relationships between primary healthcare professionals and third sector practitioners. Eighteen health professionals and 15 representatives of third sector organisations participated in a qualitative interview study. Significant barriers to collaborative working were evident. The two stakeholder groups expressed different understandings of health, with few primary healthcare professionals considering non‐medical sources of support to be useful or relevant. Health professionals were mistrustful of unknown third sector organisations, and concerned about their accountability for referrals that were not successful or positive for the patient. Third sector practitioners sought to build trust through face‐to‐face interactions with health professionals. However, primary healthcare professionals and third sector practitioners were not connected in effective networks. We highlight the ongoing imbalance of power between primary healthcare professionals and third sector organisations. Strategic collaborations should be complemented by efforts to build shared understandings, trust and connections between the diverse front‐line workers whose mutual co‐operation is necessary to achieve effective joined‐up working.