Client: A UK Clinical Commissioning Group.
Measuring the effectiveness of a third-party intervention enabled participants to understand its impact and to consider other ways to improve the relationship between frontline service providers.
A group of doctors’ practices undertook an exercise to improve their relationship with social services in order to impact the efficiency and effectiveness of service provision. The chosen intervention was to co-locate dedicated social workers in practices to act as co-ordinators between the healthcare and social care teams. The commissioning organisation wanted to evaluate in what ways the intervention improved the relationship. Renuma was engaged to take a baseline measurement and a follow-up measurement to assess the intervention. The measurement included the ability to distinguish between the social workers co-located with the healthcare teams and wider group of social workers also working with those same healthcare teams.
At baseline, the relationship between the clinical and social work teams was distant. Although there was a good level of mutual respect and a feeling that their objectives were aligned, both parties indicated a lack of understanding of each other’s worlds. A symptom of this was a feeling that the amount of contact between them was very inadequate.
Both parties were encouraged to find ways to build a better level of mutual understanding through the project, but not necessarily through lots of face-to-face contact, which was felt to be impractical.
After 16 weeks, the relationship was re-measured. In every aspect of the relationship, there was some improvement (particularly for the co-located social workers). The biggest impacts of the project were an improvement in the responsiveness of both parties to each other and an understanding that their cultures were much more aligned than previously thought. The different outlooks of the two professional groups were no longer seen to be a barrier.
Of particular interest for the commissioners was that a low level of mutual understanding between the parties persisted throughout the intervention. Also, the improvements measured were confined to members of the dedicated (co-located) social work team rather than having spread wider in the social work system. These insights gave important context to the findings of a simultaneous qualitative evaluation and indicated that the intervention was unlikely to bring sustained change at the scale it was delivered.