Collaboration: “easy to say, difficult to do”

The purpose of this paper is to recount 12 months of a pioneering collaboration between the Aneurin Bevan University Health Board, five local authorities and nine registered social landlords in South East Wales. It will aim to share the understanding that has emerged, demonstrating how a large number of agencies, many of which have different purposes or which have traditionally been in competition with each other, have been able to work collaboratively, to meet the interests of some very vulnerable people.

This reflective approach draws on the views of a large number of staff from each of the three constituent public sector service areas and their experience of collaborative working using action research principles. The study will use people’s own words to highlight real experiences, but analysed against similar collaborative activity elsewhere reflected in the literature. As there has been no established pathway for the collaboration to follow, we have adopted a Plan-Do-Study-Act cycle to capture the evolving “In One Place” (IOP) process.

This paper highlights the inherent systemic barriers that have to be identified and overcome if the authors are to move from wishful thinking to pragmatic realism, both within and between organisations. The sense of public sector agencies being able to work together, simply because it makes good sense, is challenged and the paper identifies both cultural and professional factors that made a difference in this collaboration, which could be harnessed elsewhere.

From the outset, a key driver for the IOP has been to align health, social care and housing processes by bringing together practitioners and senior managers to identify need and to plan and deliver services locally, offering a real benefit to individuals with complex needs. This is set within the context of increasing demand on public services, financial austerity and the history of “housing” being on the margins of discussion when considering the integration of health and social care services. The authors are able to demonstrate the benefit of housing being at the centre of such discussions.

Mae’r astudiaeth hon yn adrodd hanes deuddeg mis cyntaf cydweithrediad arloesol rhwng Bwrdd Iechyd Prifysgol Aneurin Bevan (ABMUHB), pum Awdurdod Lleol a naw Landlord Cymdeithasol Cofrestredig (RSL) yn Ne Ddwyrain Cymru. Nod yr astudiaeth hon fydd rhannu’r ddealltwriaeth sydd wedi dod i’r amlwg yn dangos sut mae nifer fawr o asiantaethau, llawer ohonynt â dibenion gwahanol neu sydd wedi bod mewn cystadleuaeth â’i gilydd yn draddodiadol, wedi gallu gweithio’n gydweithredol, i fodloni budd rhai pobl agored iawn i niwed.

Mae’r dull adlewyrchol hwn yn defnyddio safbwynt nifer fawr o staff o bob un o 3 maes gwasanaeth sector cyhoeddus yr etholaeth a’u profiad o weithio’n gydweithredol gan ddefnyddio egwyddorion ymchwil weithredol. Bydd yr astudiaeth yn defnyddio geiriau pobl i amlygu profiadau gwirioneddol, ond wedi ei ddadansoddi yn erbyn gweithgaredd cydweithredol tebyg sydd wedi ei adlewyrchu rhywle arall yn y llenyddiaeth. Gan nad oes unrhyw lwybr wedi ei sefydlu i’r gydweithrediaeth ei ddilyn, rydym wedi mabwysiadu cylch Cynllunio-Gwneud-Astudio-Gweithredu (CGAG) i gyfleu’r broses ‘Mewn Un Lle’ sy’n esblygu.

Mae’r erthygl hon yn amlygu’r rhwystrau systemig cynhenid y mae’n rhaid eu nodi a’u goresgyn er mwyn symud o ddymuno i realaeth ymarferol, o fewn a rhwng sefydliadau. Mae’r syniad bod asiantaethau’r sector cyhoeddus yn gallu cydweithio, dim ond am fod hynny’n gwneud synnwyr, yn cael ei herio ac mae’r papur yn nodi ffactorau diwylliannol a phroffesiynol a wnaeth wahaniaeth yn y cydweithrediad hwn, y gellid eu defnyddio rhywle arall.

O’r cychwyn, ysgogwr allweddol ar gyfer y rhaglen ‘Mewn Un Lle’ oedd alinio prosesau iechyd, gofal cymdeithasol a thai trwy ddod ag ymarferwyr ac uwch reolwyr o’r sectorau gwahanol hyn ynghyd i nodi angen ac i gynllunio a chyflenwi gwasanaethau yn lleol, pan fo hynny o fudd gwirioneddol i unigolion ag anghenion cymhleth. Mae hyn wedi ei nodi o fewn cyd-destun cynyddu’r galw am wasanaethau cyhoeddus, cynildeb ariannol a hanes ‘tai’ ar ymylon trafodaeth wrth ystyried integreiddio gwasanaethau iechyd a gofal cymdeithasol. Yn yr enghraifft hon rydym yn gallu dangos buddion gwneud tai yn ganolog i drafodaethau o’r fath.