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.