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The new NHS Long Term Plan encourages us to work together in integrated care systems. This is good news for us in Communities of Practice as, rather than having to consider a change of focus, we can continue strengthening the valuable work we already do whilst knowing it is being recognised and promoted as current best practice.
I am new to Communities of Practice (or CoP) in North West Sussex, having joined at the end of 2018 after two years with Time to Talk Health, SCFT’s IAPT service for people living with long term health conditions. CoP is a collaborative integrated provider model involving SCFT, SPFT, West Sussex county council, Age UK and Crawley, Horsham and mid-Sussex CCGs. For a psychologist working in physical health, CoP really does offer the ideal environment for delivering genuine biopsychosocial support. CoP teams are made up of social workers, mental health practitioners, occupational therapists, community nurses, physiotherapists, psychological therapists, care coordinators, pharmacists and Community Link workers. Together we provide “wraparound” support, within a single service, to adults with complex health and social care needs, interfacing with IAPT and secondary mental health care where appropriate.
What does this actually mean in practice? Well, for me, as a psychologist, I have the benefit of working alongside practitioners with the skills to navigate universal credit, put together care packages and fit equipment to support independent living, to name just a few. There is no need to access separate services or refer patients on to lengthy waiting lists. We aim to work across service, provider and disciplinary boundaries rather than up against them. So, I can address the anxiety of falling with an older adult, whilst the occupational therapist explores how she is managing physically and provides equipment and strategies to better manage everyday tasks more safely. The physiotherapist can suggest appropriate exercises to manage the pain that can exacerbate the falls and the mental health practitioner is able to organise a memory assessment. I can work with someone else experiencing depression with the support of Age UK’s community links practitioner, who can engage him in appropriate local activities and link him in with a befriending service. Meanwhile, his housing and care needs are being looked at by the social worker.
As psychologists in the teams we are taking on the challenge of strengthening the role of psychology across the service. Not only do we provide direct 1:1 psychological therapy to patients, but we aim to contribute indirectly to patients and the overall service by improving the psychological understanding, skills and confidence of all practitioners in the teams. We are doing this through joint visits, shared formulation sessions, consultancy, interdisciplinary supervision and lunch and learn sessions. Together we are taking on the challenge of creating a service with the capacity to consider and respond to the psychological aspects of long term conditions as a standard part of care.
Dr. Marianne Seabrook, Senior Therapist Team Lead/Counselling Psychologist