THE ANTHROPOLOGY OF INTEGRATED CARE
In this blog, Dr Luci Attala, Senior Lecturer in Anthropology, discusses her current research on integrated care in Wales.
On 21 October 2019, a new integrated care centre (ICC) opened in the seaside town of Aberaeron. It is the first centre in a wider roll out of ICCs starting in Wales. The building has clinics and a surgery downstairs and an open plan, hot desk section with breakout rooms upstairs, away from the public.
The notion of care being integrated is not new.
Integrated care has been promoted internationally for some time as a method that enables care provision to be bespoke, person-centred and responsive to both social and medical needs simultaneously. Click this sideeffects
The new centre in Aberaeron is advertised as doing just that. It is designed to enable care provision to be ‘joined up’ and, therefore, ‘holistic’. This change is expected to benefit service users enormously.
But, how will the changes be experienced by the staff, and will the centre benefit them?
This is where I come in.
As an anthropologist, I do extended fieldwork in different environments to learn from the people I am trying to understand about how they perceive their worlds. Where my previous work has focused on peoples’ relationship with water, I now have a chance to learn about how staff at the centre make sense of their new working environment.
Recognising the importance of staff wellbeing and potential tensions between efficiencies and employee welfare, Susan Griffiths of the local Heath Board (Hywel Dda) approached me to offer an anthropological perspective on the new centre. In particular, Susan wants me to record how the staff manage the move to the ICC.
As a result, I am now in the process of learning how different teams – who previously worked in separate offices, or out of their cars – are finding working in the new facilities. I am keen to discover how staff adapt to a situation where various departments (Community Nurses, Physios, Occupational Therapists, Health Visitors, School Nurses, Public Health, Pain Management etc.) are expected to work alongside each other, without a specific space dedicated to their team.
The theory is that the new environment will foster creativity and connectivity. We will see what happens in practice.
Staff wellbeing is of increased significance in Wales since the Well-being of Future Generations Act came into law in 2015. The Act affirms that employers have a duty to ensure that work conditions do not impact negatively on wellbeing in the widest sense and that all actions or changes are sustainable and aware of future generations.
Hot desks have a lot of bad press and the jury is very much out about their value – besides their economic efficiency, that is. Consequently, knowing how staff react to these changes is of importance if future improvements are to be tailored to human rather than just financial needs.
I have just completed a month in the field, which enabled me to record initial responses and conclusions. I will return in a few months to see how those initial feelings have developed or changed.
After that, a report will be written, presented and published so that the management teams can have some idea of whether the building supports or inhibits people to do their jobs effectively.
Hopefully my research will help
inform good practice moving forward.