Crossing the Cultural and Value Divide Between Health and Social Care

Introduction Collaboration between health and social care services is vital if we are to truly provide integrated care. Whilst structural barriers based on policy frameworks, resource availability and organisational difference contributes to fragmentation between these sectors, it is the clashes in organisational cultures and values that can often be the most divisive. Only by being honest about our own values and the underlying assumptions that they reflect, and by being willing to challenge ourselves and others about unhelpful cultures that have developed can we ensure integration that draws successfully on both sectors. Since qualifying as a social worker I have spent over two decades practicing, managing, purchasing and researching care services. The exact nature of this diverse and evolving sector and indeed the use of the term ‘social care’ itself varies between country and continent. It commonly includes the provision of personal care and domestic support to enable people to maintain their independence or recover from a physical or mental trauma, and services that connect excluded people with wider community resources such as housing, education and employment. Most of my career has been in the context of care services which work closely with those in health, and this has convinced me that neither sector can fulfil its responsibilities or indeed achieve the aspiration of integrated care unless they collaborate successfully. In this perspective I will reflect on my personal experience and the wider evidence regarding health and social care integration, and the central role that culture and values play within this.