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Partnerships are when individuals work together, meaning that neither individual has full control of every situation. This is extremely important in health and care settings. However, depending on knowledge and everyone’s profession, it must be recognised and accepted that in some situations, one of the partners will be the ‘leader’ from the start. The individual may be able to give more knowledge and understanding on a situation due to past experiences. When working in partnerships, I must always be aware of individually strengths and weaknesses. Also, I find other factors important for effective working partnerships, including:
• Trust
• Honesty
• Good communication skills
• Effective listening skills
• Clear objectives
• Clear policies and procedures
• Empathy
• Realistic expectations
• Respect
• Working to agrees practices
The government has put together a policy to enable individuals to take a participating role in the making of decisions where care is involved. It makes sure the individuals wishes and well-being is the centre of attention from the care team so that the goals can be set and worked towards in a professional manor. The act is named ‘Health Act of 1999’. Health and social care partnerships made easier. The Health Act 1999 came into force in April 2000. It includes the latest attempt to pull down the “Berlin Wall” that divides health services funded and provided by the NHS from social services run by local councils.

Colleagues – Partnership working benefits individual staff members by working together as a team. It helps to share the work load and stresses, which can arise in health and social care settings. When working in partnerships, often responsibilities of the job in hand are shared out with clarity of who’s doing what. This can help the job to be less stressful and to be carried out smoothly.

Other professionals – Partnership working with other professionals can help to improve a situation. For example, in a care home, a doctor has been called out, the patient may not be able to explain to the doctor of what the problem is for the visit. Due to dementia. This is where it is very important for good partnerships with staff members and other professionals to work together and explain what the issue is, what the plan is and what should be the result. Good communication is required throughout.

Others – Partnership working with others is important, for example, others could be family members, the service user. It’s important to work together with both family members and the service users to make sure that all care needs are met. Goals can be made for care needs or even what the service user is aiming to work towards. Partnership working can be make improvements to the lives of the service users through more intensive support. Working with the families, this is also very important, that they feel included in all the care needs if the service user is happy for them to be included. This then helps to build up a positive and non-judgemental relationship between all individuals involved. This helps towards putting a faire care plan together, including input from the service user and their family members. Good communication and listening skills are needed throughout.
Working in a partnership with colleagues, other professionals and others, such as the service users and families is very important to improving the individual outcome. This helps towards achieving the goals, which are set by each person and to share their knowledge and experiences. By sharing information and using good communication, this helps to ensure the best possible service and outcomes to be achieved. I encourage all staff members to use good communication skills between colleagues, other professionals and others. This includes the renal nurses, renal doctors, colleagues may have a different way of partnership working but they are all aware of the goal outcomes and what should be achieved. It is my job and duty to carry out all care plan assessments, personal evacuation plans (PEEP), COSHH, etc. I always pass on all information to my team and ask them to read the care plan, to sign that they have read and understood what’s in place for the service user, family members and other professionals are included. This allows all individuals involved in the service users are to have an input with the patients care needs. Every six months, I carry out care plan reviews for any changes or issues which have arisen. The care plans are all person centred by using personalisation agenda plan.

Sometimes there are barriers to partnership working, which could be due to several issues such as:
• Different values and responsibilities
• Lack of expertise in the area
• Unable to co-ordinate with others
• Unable to work productively as a team
• Lack of communication
• Lack of understanding
This can be overcome quite easily, if the individuals are willing to work as a team. I would invite the individuals to a face to face meeting either separately or both together, I would discuss the problems in hand and work to better the issue and overcome the barriers to partnership working. I would offer my support and guidance to overcome these barriers, for example:

• Help with communication
• Agree priorities
• Delegate roles
• Train together if needed
I would make sure that partnership working goals were clear and the individuals were focused to work together on what needs to be achieved. I would remind them that they are working as part of a team and remind each person that their objective is all about putting the patient and families first continuously.

In my job role, I work as a lead supervisor role managing a team of renal technician’s. I’m also a qualified renal technician. When a patient has been discharged from hospital and in need of assistance or someone who is already receiving treatment and is no longer able to continue to carry out safe therapy, the patient is then referred to myself from the renal nurses and/or doctors from either Morriston hospital or the Heath hospital’s renal department. I will inform the health care professionals if my team are not able or not to carry out care for the patient. The therapy which is needed is peritoneal dialysis. Once its been agreed to take on a new referral, paperwork about the patient, including their prescription, information about the patient is then send by fax to the head office and then uploaded to myself, which is then sent out to the renal team who will be or could be involved with the patient. This paperwork is confidentially sent to my home address, I then contact the patient to arrange a time and date as soon as possible to carry out a care plan including the following:
• The renal unit contact details and referral form
• Patient consent form
• Personal profile
• Key contacts, environment and social history
• Agreement for security in the homes
• Patient prescription
• Record of prescription changes as requested by renal unit
• Any additional therapy information such as blood pressure and their personal exit site care instructions including effective hand washing page to prevent infections
• Ordering supplies and stock check information including a calendar for the renal technicians to follow for stock call in dates and delivery dates
• Risk assessment checklist and risk assessments
• PEEP form (Person Emergency Evacuation Plan)
• Patient allergy form
• COSHH risk assessment (Control of Substances Hazardous to Health Regulations)
• Manual handling risk assessment
• Connecting/disconnecting patient procedure
• Recording information and disposal
• How to change the prescription parameters on the home machine
• What procedure is in place for the patient
• Taking sample from drain bags
• PV and quality assurance contact details
I then inform the renal nurse sister and my manager about how the meeting for the care plan had gone. When at a patient’s home, I introduce myself and carry out all the paperwork which is needed for the care plan making sure its carried out in a person-centred way. I read through the whole care plan with the patient and others involved for consent and agreement. I then take a copy of the completed care plan, once signed by the patient and I then scan a copy and sent over to my manager. I explain that I will be reviewing the care plan often, every six months or when required. I contact the team of renal technicians, whom will be visiting the patient and give a brief handover. I also ask them to all read the care plan and sign a sheet, which I leave in the front of the file for them to sign stating that they agree they are happy and have read it completely. I encourage staff to voice any concerns regarding the care plan or patient.
After the completion of the care plan, if required i.e. a new patient, I will unpack their dialysis machine, which would have been delivered from the hospital alongside their prescription. I would then programme the machine to suit their medical needs. I would discuss a suitable place in their home for the machine and where all the stock could be placed. I ensure that if needed, I can carry out the monthly or fortnightly stock orders by counting stock and then contacting Baxter. I keep the patients and family members informed always including notification of delivery dates and rough times. If for whatever reason, the date of time doesn’t suit the patient, I can get this changed. I then set up the dialysis machine with the medical equipment making sure they have been trained by the hospital renal nurses regarding their job of connecting and disconnecting themselves to and from the dialysis machine. Sometimes a family member takes this responsibility to help the patient, if not then the renal technicians can take this responsibility on board. Once I know whom is to take this lead, I document this in the care plan and inform colleagues. I let the patient know of who will be with them for the rest of the week verbally and from then on, the office will send out to each patient either weekly/monthly rota of whom to expect. I inform my manager, renal nurses, renal sister and renal technicians about how the care plan meeting went. All of which is documented in the daily notes, which I provide paperwork for and collect in weekly and replace documents when care plans are running low.
I believe that it’s very important to work together as a team. I evaluate and manage the skills of each renal technician by looking at their strengths and weaknesses. I have noticed that most of the renal technicians work very well at lone – working, however, some of the team need to be prompted and reminded of small issues they need to work on when working independently. I reassure that there is always someone at the end of the phone, whether its myself, my manager, the renal nurses or doctors if they feel unsure or uncomfortable with the situation in hand. I have noticed that one of the team tries not to be working on the days there’s a stock order to be counted and phoned to order. I questioned this individual in a polite way and concluded they were worried that they would order the wrong equipment or amount of stock required. Every three months I have an appraisal with my manager to see how I’m getting on with my job role, we discuss any concerns from both sides, weaknesses and strengths which I have. I feel that this is very important, which I then use for each team member every three months too. This helps to better the quality of work and improve each person’s role within the company. Everyone, including myself needs to accept all feedback from colleagues and management. Sometimes it helps by setting targets to work towards over the next three months.

Whenever I notice an issue with any documents, which have come from the renal team in the hospital, whether it’s a spelling mistake, I will contact them direct and quire the issue and request an immediate correction of the documents. This can become a very serious issue when it’s the patient’s prescriptions in place. My role when working with other health care professionals is to maintain a professional approach always. I make sure that all conversations and documents remain confidential and only share relevant information to the correct individuals. As a renal technician, it’s all our jobs to keep an eye on the patients and keep on track of their health and wellbeing as we are in daily contact with the patients and the professionals such as the renal nurses and doctors will see the patients between 2 – 10 weeks at a time. We also document all readings and recordings from the dialysis machines daily, including the patients weight and blood pressure readings. This is recorded in a small booklet, which is to be taken into they’re renal appointments for the doctor to read and evaluate how the patient’s therapy has been going.

Whenever I work with other professionals, I will gain consent from the patient firstly to talk about the patient for confidential reasons. Sometimes I will suggest that the other professional is to contact the renal ward at the patients registered at the hospital to liaise with the relevant renal nurses or doctors. This would always be documented in the patients care plan and if needed reported to my manager. It’s always important to listen carefully to what is being asked from other professionals. Good communication skills are important when working with other professionals. Once each side has communicated the reason for the contact from other professionals, it’s important to be clear about the purpose of professional partnerships and to monitor their actions and the reasons they use is crucial for any organisation. Once it’s been recognised of what objectives are and have been agreed on, it is then time for the other professionals and myself to discuss how the partnership actions will be measured and used to work with information on the patients and how it can be collected and calleted.

Working in partnerships creates a strong and good understanding of the roles that each person must do. Clear communication and agreed individual responsibilities will lead to successful partnership working. Working as a partnership, communication can be formed from shared records, from some of the following:
• Written documents such as care plans, daily communication diary
• Emails
• Face to face communication
• Fax
It helps to work effectively together with other professionals, agencies and organisations to improve and develop the health and wellbeing of each patient. These are all in place to help promote partnership working between myself, renal technicians, renal nurses and doctors by using correct and factual information.

Evaluating the procedures when working with others is to ensure the best method is being used always and that communication is being used correctly and reaching the other professionals effectively and clearly. I must ensure that all workers and professionals are happy with the procedures in place also requesting that if they feel the need for any changes to voice their concerns, which will help to make working as a team more effective.

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