Study the hoops, but care about the thresholds

When you are on a course you really have - quite rightly - to do things by-the-book. That is the way - they say - you learn which corners of the pages you can turnover. Students learn early on that you have to jump through various hoops in order to complete the course and earn the stripes. The art and science of caring presents its own hoops, but in addition it is thresholds that present a barrier, thresholds that need to be negotiated in order to meet need.

Suddenly this is not about one person (you) it is about a partnership. A partnership of professionals allied and directly collaborating with a 'patient' and their carers.

One of the hoops is the paper or electronic referral form. Are you still sure this referral of yours is necessary? Are those two assessments really necessary?

There are a host of thresholds that may (or may not?) shift like a tide around the local and increasingly extended health and social care community, or 'economy' if you prefer, for example:

The threshold at which a nursing home will contact a GP surgery; or mental health services?
Just exactly what is residential care's capacity to cope internally and manage with a given range of health and social care challenges? What exactly should that capacity be? Should the public have access to referral data from care homes - to accident and emergency, mental health services, primary care? What proportion of 'referral problems' are dealt with at the nursing - social work level? What is the mental health service's threshold in terms of responding to a referral? What is the threshold for relatives believing that sufficient is being done for their loved one?

As lifelong learners of course we are all perennial hoop jumpers, learning the art of scaling and re-framing the thresholds that cross our way.

Image sources:

Seed-and-threshold segmentation

hula hoop (no longer available)