‘Only Connect … ’: tightrope walking and joint working in the care of the elderly

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Abstract
Repeated calls for improved joint working between agencies and professionals providing social care have had limited success. Following a brief review of possible reasons for this, it is argued that joint working cannot truly succeed unless it does so at street level at the professional/user interface. Yet this level has received little attention. Taking the example of a mechanism created to ease communications and negotiate transitions between a range of services for the elderly, the paper demonstrates that there exists an important but neglected role for brokers or mediators (so-called ‘reticulists’) who display an awareness of the political realities and power dimension of organisational life and who operate on the margins and in the interstices of services. Of the lessons to be learned from this initiative in joint working the most important is that a direct transplant is likely to suffer rejection. The mechanism reported on is a product of its environment—a ‘bottom-up’ response to a perceived problem—and tailored accordingly.

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