In introducing this essay the student aims to explain the importance of inter professional practice and examine key factors and the consequences involved. It is essential for them to break down the aspects of collaborative inter professional practice so understandable to all. Along with this, they will define the meaning of inter professional working as well as the individual meaning of ‘collaboration’. The writer will look to identify how inter professional collaboration came about in society and the imperative effect it had on us all.
They will then look to identify crucial differences when comparing inter professional practice throughout the 1900’s to modern day society and the ways in which inter professional collaborative practice has flourished. They will strive to outline the positive aspects as well as critique it, along with consequences resulting from bad collaborative workings. The student will also detect factors that help and hinder the effectiveness of inter professional collaborative practice. Finally they will present a real life practice example from their IPL (Inter Professional Learning) week experience, then link this back to items that helped or constrained the learning outcome.
There is a key difference between the two terms; inter professional and collaborative. Inter professional working requires practitioners from alternative professions and agencies to work together. However, ‘This does not necessarily imply collaboration.’ (Ovreteit 1997, Payne 2000.) Collaboration describes the act of working together; united labour and ‘refers to knowledge, skills and values utilised when putting this partnership into practice’ (Whittington et al 2003.) Inter professional collaborative practice is described by Dr. Tabitha Rogers as ‘seeing ourselves through the eyes of others.’
There was no consistency before WW1 in the standards or organisation of health and social care. Most services either charged for the services they provided or were made available by a number of different charitable boards. However, the services all did have one thing in common; their unpredictable level of inter professional working. Cost effective services were provided but along with these benefits there were dire consequences such as increased fragmentation in the organisation of service delivery (Allsop 1995, Payne 2000.) A change was prompted by Margaret Thatcher as the need for inter professionalism along with coherence, accountability and transparency from service users rose. (Barrett, Selman and Thomas, p8 2005.) The student observes the importance of communication with the varying health professionals. Standards were set for providers to meet for certain aspects of health care delivery.
This gave the public control and choice about the care they receive (Allsop 1995, Ovretveit 1997.) However, the concept of inter professional collaboration is not a new one; Henderson makes reference to inter professional workings in the USA in medical literature of the 1960’s. ‘One hospital is reported to have weekly inter professional ward conferences attended by all members of the clinical team.’ (Henderson, 1966.) Social care literature included such matters of inter professional learning’s almost a decade later, but nonetheless the emergence of these ideas did not mean that inter professionalism was existent at this time.
It was not until 1989 that the Conservative government set out principles of collaboration that health and social services authorities were required to follow (DoH 1989.) The author also notes that in looking at the last 15 years reveals enhancement of collaborative practice and improvement of quality of service delivery. However, a document was published in 2000 stating that some professionals were not being ‘holistic in their approach’ to Social Work (DoH 2000) and expectations for inter professional practice to become standard were anticipated. Overall, the writer believes it is a fair assessment to make, that inter professionalism and collaborative workings has improved throughout the era bringing increased benefits to society.
It is paramount that ‘Social Workers are open to a range of interpretations, critical approaches, theories and debates in relation to life development in order to understand their use in practice.’ (Crawford and Walker, p12.) For example, in the case of Victoria Climbie, January 2001, this provided a major area of significance when referring to inter professional practice. If all professionals had joined together from different backgrounds to collaborate their knowledge and skills and they had communicated efficiently between them, this tragic outcome could have been prevented. In addition to this, the author makes references to the speech by Laming (2003). He appears to agree with the argument and seems to take an inter professional approach and ‘make recommendations as to how the safeguards for children should be strengthened so that as far as possible, events of this kind can be avoided in the future.’ This example stresses the importance of inter professional collaborative practice and emphasises the need for more communication and a greater understanding of the service user.
The author feels that having a clear understanding of what each profession brings to the health care team and knowledge of how other professions perceive us can play an important role in enhancing patient care and building stronger teams. The support and encouragement of colleagues would also be vital and can adapt and create new knowledge from experience and continue to improve the individual’s performance. Inter professional working is also thought to be cost effective in streamlining delivery systems and avoiding duplication (Paul and Peterson 2001.) A shared knowledge base is imperative in any line of work but is essential in contemporary Social Work and for other medic professionals. The writer also claims the understanding about all different aspects of a service user’s life is essential in the study of Social Work.
The student recognises the many factors facilitating successful inter professional learning, such as the willingness to learn and partake in activities and the need of high levels of motivation (Molyneux 2001.) The possession of communication skills is primary along with active listening and is an important way of showing you are participating within the group. This is essential as it ‘requires the listener to focus on the speaker’ (Payne 2000.) Also by showing each individual that you are interested in what they are saying encourages further issues to be brought forward, for instance if a point was made and ignored the first time, the person is less likely to make another point and this may constitute as fatal. All issues raised should be treated as important. There are also other benefits such as the knowledge of professional roles. This means that stereotypes of other positions are eliminated and practitioners feel more at ease approaching them each time.
Confidence has been identified by the author as being very important in more ways than one, for example the having to interact with someone you do not know means you have to possess the skill of being confident originally, and also each time you meet you would gain more experience as an individual. Also, confidence is thought to ‘develop through one’s career from interaction and feedback, from mentors and others’ (Hudson 2002.) Trust and mutual respect is the most obvious point to be made but must not be forgotten. Trust is an ‘essential attribute to collaboration’ (Stapleton 1998) along with open and honest communication and the delegation of power. It has also been highlighted that trust ‘facilitates open discussion and successful role negotiation, both important features for inter professional learning’ (Cook 2001.)
The importance of these is essential when working within any team. Moreover, the student can also exemplify several precluding cases. The first item they wish to point out is the collaboration of a group of people who have not necessarily met before, this can sometimes be disadvantageous. There are many social differences, such as the age of the individual. For instance, if they are young or older this may relate to power constraints as would the status of the individual. For example if they were a student they may think their opinion would be less valued in comparison to a manager, this may also affect their willingness to speak up in a group. Their family situation, gender and ethnicity may also have an impact on the way the individual is treated and this should be considered when meeting new people for the first time.
Furthermore the professional differences which ‘can relate to values, priorities, approaches to care and expectations in terms of authority, leadership and what constitutes a successful outcome’ (Irvine 2002.) Both differences, social and professional are related to power issues. However, the ideal of shared power is not necessarily proven the best method and could result in everyone in the group assuming the task is in hand. (Allen et al, 2002) encountered exactly this with services not liaising correctly as they thought somebody else in the department was responsible. Responsibility is another very important issue and should be considered when delegating tasks.
Also, the balance is not always fair and not everyone will always have a say or make a reasonable contribution to the group or task. Payne suggests ‘Unequal power distribution can be oppressive’ (2000) and has been known to limit some individuals partaking in a discussion based activity. This can in turn lead to feelings of uncertainty and even envy; leaving individuals feeling angry at having a bigger workload than another member of the team. It can also lead to the ‘withholding of information or actual sabotage’ (Halton 1994.) As you can see, inter professional practice does not benefit everyone and there are many objects that hinder it. It is essential to get the balance just right so everyone feels they have a say, the writer feels the delegation of a leader is perhaps assumed the best method.
The student identifies a practice example they have been involved in to illustrate good inter professional practice and the varying difficulties they faced. It was evident when the group first met they were just a group of people from different areas of study. They found it difficult to gel at first and some members of the group, the writer recalls, did not contribute to the task at hand as well as others. There was one individual in the group that did have better leadership skills, this benefited the group somewhat but also caused conflict. For example, Loxley refers to conflict as being ‘Interwoven with inter professional collaboration.’ Usually in a group that have just met there are so many social and professional differences and constraints the group face and it is normal for the people in the group to not get on at the beginning.
However, after a few days the group became a team and worked very well together. The writer identifies the benefit of inter professional learning is often the common goal that everybody shares. Like in practice everyone shares a similar goal; the safeguarding and welfare of the individual. One advantage of inter professional practice that the student encountered was the varying opinions of all members of the group, this is extremely imperative in practice as some people may have encountered discomfort from the service user but it may not have been spotted by the Social Worker, for example. Every person was from different areas of study and in being in this environment it made the student more relaxed about approaching the varying practitioners for the future.
In concluding the essay the student evaluates the need for inter professional practice within modern society today. Having looked back to past WW1 times to the present day, it is noticeable that the need for inter professional collaborative practice has become greater and as a result has differentiated the way people perceive health and social care today. The implementation of successful inter professional collaboration can change the lives of individuals, such as Victoria Climbie, as mentioned above.
If her key workers had collaborated all their findings it may not have resulted in this fatal outcome. However, there are many adverse effects when considering inter professional collaboration as well as benefits to assess but it is generally thought the pros outweigh the cons. The student finally concludes that the IPL experience was an extremely important time where the students got to understand the reason for collaborative practice in Social Work and inter professionalism. Also all professions were highlighted and the unknown became clear so as to prevent uncertainty in the future when working with other health professionals.
* Inter professional Working in Health and Social Care by Gillian Barrett, Derek Sellman and Judith Thomas – (Obtained on the 27th November 2008)
(Ovreteit 1997, Payne 2000 p9)
(Allsop 1995, Payne 2000 p10)
(Ovreteit 1997, Allsop 1995 p10)
(Henderson 1966 p11)
(DoH 1989 p11)
(Molyneux, 2001 p19)
(Hudson, 2002 p20)
(Stapleton 1998 p22)
(Cook, 2001 p21)
(Irvine, 2002 p19)
(Payne, 2000 p21)
(Allen et al, 2002 p22)
(Loxley, 1997 p23)
* Social Work and Human Development by Karin Crawford and Janet Walker – (Obtained on the 29th November 2008)
(Lord Laming, 2003 p13)
* Collaboration in Social Work Practice by Jessica Kingsley Publishers- (Obtained on the 29th November 2008)
(Whittington et al 2003, p1)
Web links visited –
(Obtained on the 27th November 2008)
(Obtained on the 27th November 2008)
(Obtained on the 27th November 2008)