As you can see, my experience of working in an action learning set was not a happy one, and this disappointed me as I had been looking forward to working with new people and I had quite high hopes for our group.
From the beginning I seemed to take on the role of leader of the group, mainly because I am quite authoritative, as well as being very organized, and nobody objected to this. When we were set group tasks we all met up and decided amongst ourselves which area each person was going to do to ensure that all aspects were covered and we could give a good presentation. We also agreed a day and time to meet up and collate our information in time to give the presentation to the rest of the class. Unfortunately, only I and another member of the group turned up punctually, and the other three members had to be chased to get them to our meeting. When everybody had finally arrived it came to light that only I and one other member of the group had done what we had agreed upon, the other members offered no input whatsoever. When it came to putting the presentation together it was again done by only two of us, and when we got applauded for our presentation it made me very angry that the other members of the group were getting the credit for our hard work.
Although my experience of working in an action learning set was not a good one, I do feel that inter-professional collaboration can only a positive concept when it is working effectively; our team produced good results with only two functioning members, it would have been far better if the other team members had contributed as much. This experience has shown me that although the concept of inter-professional collaboration sounds wonderful, in reality it is much more difficult to achieve.
Inter-professional Observations
The first observation that I attended was at the combined courts in Burnley. We went as a full group to observe the inter-agency working in the court. Although all the parties in the courtroom worked together, and have a resounding semblance of order it soon became apparent that the majority of the collaboration happens ‘behind the scenes’ at the Crown Prosecution Service. The CPS put together all the evidence for the case and they also ensure that all the relevant people will be in attendance at the hearing. We tried to follow up this visit with a visit to the CPS but unfortunately they were unable to accommodate us.
The second observation that I attended was at the Pendleview Blakewater Mental Health Unit at Queens Park Hospital in Blackburn. The person who we met and showed us around was Anne Gillespie, a social worker within the unit, who was very helpful and informative.
The team in which Anne works was set up 7 years ago, and has been collaborating with other agencies since it began. Anne is a social worker within a multi-disciplinary team, and although Anne works for Social Services, she told us that she collaborates with mainly health services, including nurses, doctors, the psychiatric doctor, and the community support worker. Freeth (2001) informs us that ‘to provide a genuinely user-centred service requires inter-professional collaboration and effective teamwork’ (p38). As well as this she also liaises with other social workers, GP’s, occupational therapists and community support workers outside the hospital. The team as a unit collaborates with as many voluntary organisations as possible to try and take the focus away from the mental issues and try and resolve the problems in their lives, such as alcohol or substance abuse. They use organisations such as relate, age concern and other agencies that deal with drugs and alcohol abuse, and many more besides.
The overall impression that Anne gave was that inter-professional collaboration was very effective in this unit, although it took time for people to adapt to the roles of others, and feels that one of the most positive things to come from inter-professional collaboration is that it helps achieve a continuity of care. This is achieved mainly from the use of the ECPA (Electronic Care Programme Approach). This is a special system on the computer that many professionals from many agencies have access to. The system allows for good accessibility to patients files. Every service user has their own file on the system in which the details of their case have been logged, either in the hospital or in the community. The consequent visitors to the client after the database has been set up can easily access the records which hold valuable and up to date information about care plans, referrals and safety profiles. The ECPA is a really effective way of collaborating between professionals that has the added bonus of not being very time consuming. The ECPA allows several agencies to update the profile of the service user on the database which any other professional can access. This means that the paper files are no longer necessary as all of the reports can be located easily within minutes. It was found by Molyneux (2001) that ‘common documentation systems are beneficial to good Interprofessional collaboration’ (p344).
Although Anne felt that her team worked very effectively within the hospital as well as with other agencies she did feel that there were some barriers to working effectively. The barriers include the inability to communicate effectively between professionals, the lack of understanding of the roles of the other professionals, as well as uncooperative agencies, and the use of jargon within agencies that sound foreign to other agencies (Sussex, 2004). Another factor that does not facilitate good inter-professional collaboration is the differences in the terms and conditions in the contracts of the professionals involved with the service user; this can lead to a conflict of interests and can mean that the professionals have different goals, and this inevitably means that they will find it difficult to liaise with each other, which ultimately leads to the needs of the service user not being adequately met (Sussex, 2004). Freeth (2001) also echoes the thoughts of Sussex (2004) and believes that structural differences between organisations and conflicting agendas can make sustaining inter-professional collaboration difficult. Anne works for Blackburn with Darwen social services within Queens Park Hospital, and the hospital has patients from Blackburn with Darwen, Hyndburn and Ribble Valley, and because of her contract she can only deal with service users that live within Blackburn with Darwen. This means that the hospital then has to get a different social worker to come and deal with other service users that live outside that area. Anne expressed her concern over how this puts pressure on resources, as well as making inter-professional collaboration more difficult within the hospital. Larkin (2005) tells us that ‘each professional within a team has an individual role to play but it must not be assumed that each understands the role of others (p340), and Hunt (1983) found that if members of a team made assumptions about the roles of others then a breakdown in communication can lead to ineffective inter-professional collaboration. Anne’s overall view of the inter-professional collaboration within the Mental Health Unit was that they all worked together very effectively in order to meet the needs of the service user, and that it is not only the service user that benefits from the collaboration, but the professionals also gain a widened experienced and gain a better knowledge basis, for example Anne know has reasonable knowledge about the health side of Mental Health as well as the Social Work viewpoint.
The third observation that I attended was a Child Protection Case Conference at Burnley General Hospital. Two young girls, aged 7 weeks and 1 year, had been admitted to hospital with several injuries, mainly fractures to their arms and legs, and had been put in temporary foster care. The purpose of the meeting was to try and establish the extent of the injuries as well as the possible causes, and to determine whether or not to put the children on the Child Protection Register, and if so under what category.
Each of the professionals that were invited to the meeting by phone as this was an emergency meeting. The professionals that attended the meeting were the health visitor, the doctor sent his apologies, the doctor from the hospital that attended the girls’ injuries, the police, the social worker that was handling the case, the parents and their support, and a chairman and secretary to conduct the meeting and take the minutes of the meeting.
Each of the professionals took their turn to speak about the girls and their parents, the health visitor expressed her views on how well she thought the parents were managing and whether she thought they were good parents, the doctor from the hospital gave details of the injuries and how they would probably have occurred, the police informed the group about their investigations as well as the social worker giving her own report of the circumstances. Each of these reports were also given to the chairman to be put on file in case they were needed in the future. After they had each given their views they then discussed the care of the children, and the parents gave their consent for the children to stay with foster parents, although they were told that if they did not do this then they would go to court and get an emergency care order to keep the girls in care. As well as this, the group also made the decision to put the girls on the child protection register under the categories of abuse and neglect.
I felt that this particular experience was very worthwhile, and it was very useful to see so many professionals in the same room collaborating together. Vanclay (1996) tells us that in order to maintain good collaboration between agencies it is important to understand the roles of others, as well as the responsibilities of others, and it is important to share information and not see other agencies as threatening. The conference made me aware of just how many agencies are involved with each service user, and the result of the meeting was very conclusive and informative for all the agencies present, which showed me that the professionals involve were all collaborating effectively in order to reach a good outcome for the girls.
After the meeting everyone who attended was sent a copy of the minutes, as the reports were also filed with the rest of the girls’ case file in case they were needed at a later date.
The effectiveness of Inter-professional Collaboration
“The End goal is to provide a high quality of comprehensive services to those who seek assistance from the helping professions” (Thompson, 2006, p2)
From the range of observations that I attended as well as my own experience within the Action Learning Set it is easy to understand why the concept of inter-professional collaboration was introduced. When put in place effectively the use of inter-professional collaboration can make the outcome for the service user much better than if the agencies worked alone, and also makes the individual agencies’ roles much easier as they have much more information to use when assessing the service user’s needs and how the are going to help them.
As I said earlier, the concept of collaboration is one that is seen to be very promising and effective, but in reality it is much more difficult to achieve, and the breakdown of communication and conflict of interests can make the original job much harder than it was before the introduction of collaboration. Sussex (2004) shows us a ladder of collaboration, and shows us 7 points that aid effective collaboration. These points include being aware of the roles of others, as well as being aware that they exist in the first instance; you need to find out who is involved in the case and refer to other agencies (Sussex, 2004). As collaboration becomes more effective you will begin to liaise more with other agencies involved with the service user, and in time conduct regular meetings in order to achieve the best outcome foe the service user, and eventually, when collaboration is at its most effective, you will begin to invite outside agencies to meetings within your own agency (Sussex, 2004). It becomes apparent that if each professional has a strong professional identity then collaboration is good, whereas a weak professional identity can lead to problems as the worker is unsure of their own role (Sussex, 2004).
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BIBLIOGRAPHY
Freeth, D. (2001) Sustaining Inter-professional Collaboration. Journal of Interprofessional Care. Volume 15, No 1
Hunt, M. (1983) Possibilities and problems of interdisciplinary teamwork. London; Churchill Livingstone
Larkin, C. and Callaghan, P. (2005) Professionals’ perceptions of Interprofessional working in community mental health teams. Journal of Interprofessional Care. Volume 19, No 4
Leathard, A. (2003) Interprofessional Collaboration. Hove; Brunner-Routledge
Molyneux, J. (2001) Interprofessional team working: what makes a team work well? Journal of Interprofessional Care. Volume 15, No 1
Quinney, A. (2005) Collaborative Social Work Practice. Exeter; Learning Matters
Sussex, F. and Scourfield, P. (2004) Social Care for Level 4. Oxford; Heinemann
Thompson, A. (2006) Interprofessional Collaboration Process
(Internet Reference www.osu.edu/ico/CD_Files/Pdf_Docs/Interprofessioal_Coll.pdf
Accessed 24/04/2006)
Vanclay, L. (1996) Sustaining Collaboration between general practitioners and social workers. London; CAIPE
Candidate Number 20160036
