Transdisciplinary working: Evaluating the development of health and social care provision in mental health

Abstract

The NHS Plan (DoH, 2000), consistent with earlier policy documents, emphasises the need for integrated working between health and social care. However, the path to achieving integration appears to be littered with as many failures of teamworking as successes. This paper reports on an evaluation of the development of a team of practitioners working with clients with severe enduring mental health problems. Soft systems methodology enabled the researchers to inform service development rather than merely describing its process and outcomes. Care management was proactive rather than crisis orientated, with prompt response to subtle changes in clients' needs, facilitated by the employment of Community Support Workers. New care processes and structures enabled client and professional knowledge to be used as a resource to inform decisions about care. The practitioners managed this knowledge through informal trans-disciplinary exchange, promoting access to the fine detail of the relationship between user need and service provision.

Is the co-location of GPs in primary care centres associated with a higher patient satisfaction? Evidence from a population survey in Italy

“…This study shows a strong association between the co-location of GPs in PCCs and the experience of a co-located multidisciplinary team, confirming the findings from previous studies according to which co-location improves joint working [33, 34] and then facilitates multi-professional teamwork [20, 21]. …”

Co-Leadership – A Management Solution for Integrated Health and Social Care

“…Another important precondition, seen as essential to achieving efficient joint governance of an integrated health and social care service, was co-location. The results of this study are in line with previous findings [162454] showing that co-location enables informal discussions, sharing of knowledge and experience as well as smooth information transfer. Additional essential preconditions for exertion of co-leadership were related to understanding the value of managing care jointly and to viewing management as a collective activity.…”

What have we learnt about joint working between health and social care?

“…Similar problems were identified in the second review with Gibb et al, (2002) noting that staff working for the NHS or social services differed in terms of the type and level of decisions they could make, additionally Burch and Borland (2001) found that different understandings of concepts such as 'risk' led to divergent practice in relation to the discharge of older people. Such differences led to the emergence of distrust, professional rivalries and professional defensiveness (Hudson and Willis 1995, Scragg 2006).…”

“…When effective communication and information sharing processes were established studies reported improvements, including speedier and timelier assessments (Brown et al, 2003, Brooks 2002, Rutter et al, 2004. In both reviews the co-location of staff was regarded as facilitating improvements in understanding (Rutter et al, 2004) and communication (Gibb et al, 2002).…”

“…While the existence of different funding mechanisms could frustrate attempts to develop joint assessment mechanisms (Gibb et al, 2002), the use of unified or pooled budgets, introduced under the Health Act, were thought to have made the process of strategic resource allocation more transparent and equitable (Drennan et al, 2005).…”