7: Core and Specific Partnership Work

Core and Specific Partnership Work requires extended core clinical skills in Core Partnership sup- ported by Advanced skills in Specific Partnership. The majority of clinical work is carried out in Core Partnership pathway with the general principle of Core Partnership work first with Specific Partner- ship work added if required.

To smooth flow though our service, as well as to be as effective as we can, we need to offer a range of intensities and complexities of intervention.

Why separate into Core and Specific clinical work?

Well the gains are:

Clinicians in Core work have extended clinical skills and are of equal value to single advanced skills clinicians. The majority of clinical work is carried out in Core work and there is a general principle of Core work first with Specific work added, if required. Finally, most clinicians will do both in their job plan.

This is such an important area that we devote a whole of Chapter 6 to it. But here is a summary:

Core Partnership Work

Core work is the majority of what services do. Most clients can and should be seen in Core Partnership work and most staff should be able to deliver this work. It generally has more high volume - lower duration work than Specific Partnership. As such it should be the first priority of our service. If there is not enough then waiting times for Core Partnership will grow. Even if there is enough total clinical capacity, too much may be being used in Specific work.

Core Partnership clinicians need a wide range of extended, core level clinical skills. See the Alpha- bet skills later on.

Specific Partnership Work

Specific work means using a advanced clinical assessment, technique or therapy skill. Staff delivering advanced skills are likely to have higher training, perhaps to diploma level, and are often capable of supervising others in this skill. Examples include using a structured assessment tool for Autism e.g. the ADI, psychometric assessment, and individual psychodynamic psychotherapy.

What happens if you don’t define Core and Specific Partnership Work?

If you only offered Core Partnership work in your service then clients needing more intensive / advanced skills or longer-term interventions could not access them. On the other hand, if everyone worked delivering high-intensity, advanced interventions then some service users would receive a level of help that they did not really need, and that did not give attention to the whole system. Waiting lists to each step would develop (and this may vary from clinician to clinician). The client experience is likely to be poor as their problem needs to fit the intervention, (a ‘Push’ system) no matter what their preferred style or co-morbidities are.