Around the world, care and support in all its forms is becoming increasingly challenging. At the 2023 6th Transforming Care Conference which was organised at the University of Sheffield, England, research evidence and ways of thinking were presented on how contemporary developments and policy changes affect (informal) care workers, and those in need of care. Vilans CEO Mirella Minkman and Senior Advisor, Bellis van den Berg attended the conference and shared their learnings.
Vilans, as a centre of excellence for long-term care and support, bridges policy, (scientific) knowledge, education and practice to take steps forward when it comes to large scale issues in healthcare settings and abroad. Mirella Minkman: “Internationally, this way of working is quite unique. Most of the time, organisations focus on research or on practical support, and others host for instance national knowledge platforms. As Vilans, we have chosen to combine all approaches because we believe it can increase impact. All activities support the cycle of knowledge; practice informs us what questions are important for research, and lived experience or science feeds practice for solutions.”
Vilans expanded on their role in a joint session together with two other well-known centres of excellence – the UK Impact Centre for Implementing Science and the Swedish Family Competence Centre (Nka).
Unique role of centers of excellence
In their presentation, van den Berg and Minkman talked about the different ways Vilans collects questions form practice, enriches or develops knowledge for practice and disseminates it by means of knowledge platforms, learning networks, meetings and conferences. They also explained how they work in the large scale national implementation programmes that Vilans has been implementing in the last ten years, such as the National Dementia Programme (setting up Dutch regional integrated care networks for dementia care), The innovation Impulse (making technology a logical choice in the care for people living with disabilities), and Dignity and Pride (supporting the implementation of the Dutch Quality framework for nursing home care).
How do societal developments and policy decisions impact practice?
During the conference, the different sessions focused on how societal developments, policy decisions and the way healthcare services and support are arranged affect the experience of care workers and those receiving care. Several societal developments such as labour market shortages, ageing population, but also transnational lives and changing family relationships were discussed. Similarly, the concepts and directions that are introduced by policy makers, such as personalised care, informal care and integrated care. Several of these concepts are ambiguous since it is not completely clear what is meant or how these developments work out in practice. Practical implementation was the subject of many of the studies presented. In this case, context matters.
Minkman: “You can look at ‘problems’ from a single scope; for example, frame the shortage of staff as a capacity issue. However, other underlying dimensions like a low recognition of female work (or jobs where females are overrepresented) are societal issues and a cultural or gender inequality issue. How you frame it, matters for options for solutions.”
Collaboration and negotiation
An important theme in various sessions, was collaborating with clients and families when it comes to personalised care, informal care and care provided across professional boundaries. In this context, the purpose of care and the responsibilities become less defined. In addition, the relational and situational character of care makes collaboration subject to a continuous process of negotiation about who should do what – mobilising actors, distributing responsibilities and weighing (different) values. This kind of micropolitics asks for additional competencies of the various stakeholders.
Caring for carers and mutual relationships
Retaining and attracting care professionals is important to meet current and future care needs. In several studies the high stress rates and mental and physical burden of care workers were studied. But also interventions to reduce these burdens by introducing higher wages, increasing autonomy and improving working conditions. In addition, some studies focused on the mutual relationship between the caregiver and receiver of care, studying how clients can contribute to care and ease the burden on care professionals (reablement) or providing emotional support to care workers.
van den Berg: “Also in our Vilans programmes, we see relational preconditions within organisations, such as team collaboration, opportunities for voice behaviour and management support contribute to job satisfaction and employee retention.”
Equality and equity
The themes equality and equity were reflected in several forums. For example, this was related to the question how and if we can create a more equal contribution by involving more male carers? But also by acknowledging and valuing often unpaid and invisible carers. There was also the observation that welfare states are based on principles of universality and equality. However, among more heterogeneous populations, for instance with increased migration, universality may cause inequality because of the different backgrounds and situations of citizens. Since these demographic challenges can create unintentional inequity, the question arises whether welfare states should adjust other principles to cover unmet needs.
Knowledge and insight with regards to the issues described above will be derived from scientific studies. In addition, there is a need for knowledge from practice as well as lived experience. The centres of excellence, including Vilans, are aimed at supporting the use of evidence resulting from scientific research, practical knowledge and lived experiences. Vilans in particular, bridges practice with scientific knowledge, research and policy by means of large scale implementation and innovation programmes. As a result, these programmes serve as a policy instrument to take steps forward when it comes to large scale issues in healthcare settings.