Enhancing Interagency and Interprofessional Working in Adult Nursing


The field of the study is adult nursing which involves providing nursing care to elderly and people above 18 years of age in variety of settings who expresses wide range of dependency for support to gain good health and well-being. In this assignment, initially the chosen case study that is case of Winterbourne View Hospital is to be briefly introduced. Thereafter, the main principles and importance of interagency and interprofessional working in adult nursing in relation to the case study is to be discussed. Further, the barriers and enablers of interagency and interprofessional working in adult nursing in relation to the case study is to be explained. The recommendations to be followed and its importance in relation to the case study in adult nursing is to be discussed.

Case Study

The Winterbourne View Hospital was subjected to be executing systematic abuse of the patients who are mostly detained in the hospital under Mental Health Act 1983 by the staffs and professionals. The undercover footage regarding the hospital showed that staffs were repeatedly assaulting and harshly restraining service users under their chairs. The patients who were victims of abuse were seen to be shaking and screaming and one of the patients was seen to jump from second floor to the first floor in an attempt to escape from the torture and abuse (communitycare.co.uk, 2012). The case study chosen to be discussed is relevant to my field of study because it explains regarding the harmful actions that are faced by adult patients in lack of protective care and provides idea regarding the actions to be established in the adult nursing field as a nurse to ensure safeguarding and well-being of adult patients. Moreover, the case study is relevant to my field as it assists in explaining the concerns regarding health faced by adults and nature of care services required to be present and provided as an adult nurse to deliver care with quality.


Key interprofessional and interagency working principles

One of the key principles of interagency and interprofessional working in adult nursing is determining and sharing responsibilities and accountability of care between professionals and carers. This is important to allow professionals and agencies according to their expertise to care for specific needs of the patients to be fulfilled to ensure safe and effective quality care (Campeau et al., 2021). However, in Winterbourne View Hospital, even after involvement of multiple agencies no alarms regarding the abuses were raised at the authority level to take actions indicating they expressed ineffective accountability and execution of responsibilities at work. It is evident as nearly 150 separate incidents were reported during the entire phase before the footage uncovered the abuse. In the phase, police attendance was seen in the hospital along with safeguarding concerns being reported to the local council irrespective if which no alarms were raised against the hospital until the footage were released (assets.publishing.service.gov.uk, 2021).

The other principle of interprofessional and interagency working is maintaining effective collaboration and communication between professionals of different expertise and agency. This is because collaboration and communication between different professionals would assist in creating sharing of their knowledge and extend support for delivering care to one other to develop effective care plan for the patient (Kaasbøll et al., 2020). However, in Winterbourne View Hospital, lack of communication was seen between professionals to ensure sharing of ideas and data to deliver quality care to patients. It is evident as staff reported of communication breakdown between general practitioners in surgery for prescribing medication. The change of medication though was mentioned by the psychiatrist but not updated by the GP surgery and not informed to the nurses that led to medication error (assets.publishing.service.gov.uk, 2021).

The key principle of interprofessional and interagency working is delivering seamless care services and increased specialised care. This is because interagency and interprofessional working leads different professionals with varied expertise to work collaboratively in specialising care delivery for the unique needs of the patients. Moreover, it helps in resolving barriers in care for seamless care services through supporting one another by using ideas in overcoming the problem which may led to error in care delivery (Schot et al., 2020). However, in Winterbourne Hospital, it was seen that there was lack of interprofessional collaboration as the psychiatrist and the nurses were found to avoid working together that led to raise confusion and difficulty in delivering seamless care (assets.publishing.service.gov.uk, 2021).

The importance of interprofessional and interagency working is that it minimises work pressure on the professionals and empowers team members to provide quality person-centred care that assist in lowering readmission rate and avoid worsening of health of the patients (Anjara et al., 2020). This is because in interprofessional and interagency working, the professionals work as a team by sharing expertise with one another along with assist in collaborating to share care responsibilities to specifically meet different needs of the patient (McKinlay et al., 2017). However. in Winterbourne View Hospital, the interprofessional and interagency care was found to be total failure as each of nurses were responsible to take care of many patients on their own which they were unable to control (assets.publishing.service.gov.uk, 2021). It led the nurses to stay for long to deliver forceful care, punishment in care and others towards the patients to control them in care support.

Barriers to interprofessional and interagency working

In adult nursing, one of the barriers of interprofessional and interagency working is lack of shared and stated measurable purpose among the professionals. This is because without the idea of the key care purpose to be fulfilled, the professional from different field and agencies becomes confused regarding the way they are to act in delivering care to ensure well-being of the patient (Auschra, 2018). In the Winterbourne View Hospital, the care purpose was found to remain ill-informed to the professionals due to which the nurses and other staffs faced difficulty to act inter-professionally and collaboratively to delivery unhindered and non-abusive care to the patients. As argued by Nooteboom et al. (2021), lack of effective hierarchical framework and structures discouragers and create obstacles to interagency and interprofessional working. This is because enhanced leadership and management required to direct the collaboration between agencies and professionals are not present. In Winterbourne View Hospital, it is seen that there was no Registered manager in the pace and substandard recruitment process was maintained that led to create limited human resources to support enhanced interprofessional working (assets.publishing.service.gov.uk, 2021).

In interprofessional and interagency working, the lack of enhanced amount of resources and funding create barriers towards effective collaboration between agencies and professionals. This is because without resources the agencies and professionals feel crippled to perform their actions with collaboration along with hindered funds made the agencies and professional unable to have the money needed to arrange care for the patients (Goldsberry, 2018). In case of Winterbourne View Hospital, it was seen that rigorous cost cutting to arrange care resources and trying to save profits made the create lack of funding and resources needed to support effective interagency and interprofessional working.

Enablers to interprofessional and interagency working

The enabler for effective interprofessional and interagency working is that an appropriate mechanism is to be used for timely sharing of vital information of the patients and effective communication between professionals is to be made to develop enhanced care support for service users (Macvean et al., 2018). This is because it would help in strategic care planning for the patients and lower work pressure on nurses along with limit their confusion raised in care due to sharing of the way care is to be delivered by active communicative involvement of different professionals. Similar action is to be followed by Winterbourne View Hospital to establish effective interprofessional and interagency working. In contrast, the study by Henderson et al., (2019) mentions that interprofessional working can be effectively established through team building exercise and training. This is because the exercise and training would provide skills and knowledge to professionals making them understand the way they are to work for ensuring collaborating working. In Winterbourne View Hospital, no interprofessional working training is been provided and therefore it is to be arranged immediately to enhance their interprofessional working. The other enabler for interagency working is development of trust and interdependence between professionals in sharing facts and information to perform care of the patients. This is because lack of trust and interdependence makes the professionals try to work interpedently and avoid collaboration with others to deliver care (Reeves et al., 2017). Thus, Winterbourne View Hospital is to create an interdependent working environment and support development of trust between professionals to establish effective inter-professional working.


The most important recommendation emerged from the case study of Winterbourne View Hospital is establishment of effective staff training and better leadership to direct inter-professional and interagency working (assets.publishing.service.gov.uk, 2021). This is important because training would lead the professionals trying to work inter-professionally understand the specific roles and responsibilities they are to play in ensuring collaborative care delivery to patients. Moreover, effective leadership in interprofessional working assist in creating direction to be followed by professionals for initiating and maintaining collaboration. It also helps to create rewarding of professionals and way of delivering seamless care through their effort which makes them show increased zeal to work (Wei et al., 2020). Therefore, use of current recommendation would help Winterbourne Hospital to deliver seamless and collaborative care to patients with enhanced institutional support indicating following of effective principle of interprofessional and interagency care.

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The above discussion concludes that in Winterbourne View Hospital many adult patients are abused by the staff and nurses which led to hinder their quality of care as well as lowered their dignity along with respect. The key principle of interprofessional and interagency working includes establishment of effective communication, collaboration, seamless care, institutional support and others. The importance of following of interprofessional and interagency working for Winterbourne View in adult nursing care is that it helps in delivering person-centered care with involvement of multidisciplinary team. The barrier faced in of interprofessional and interagency working in Winterbourne View include lack of communication, collaboration and coordination of staffs, lack of training and support and others. The enablers to be focused in improving the of interprofessional and interagency working in Winterbourne View include effective team working, training, trust and interdependence and others.


  • Anjara, S.G., Shé, É.N., O'Shea, M., O'Donoghue, G., Donnelly, S., Brennan, J., Whitty, H., Maloney, P., Claffey, A., Quinn, S. and McMahon, N., 2020. Embedding collective leadership to foster collaborative inter-professional working in the care of older people.pp.45-67.
  • assets.publishing.service.gov.uk 2021, Winterbourne View Summary of the Government Response, Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/213221/4-page-summary.pdf [Accessed on: 25 December 2021]
  • Auschra, C., 2018. Barriers to the integration of care in inter-organisational settings: a literature review. International journal of integrated care, 18(1).pp.45-60.
  • Campeau, A., Huiskamp, M., Sykes, N., Kriening, S., Bourn, S. and VanAarsen, K., 2021. An inter-agency expert panel’s prioritisation of clinical quality improvement topics in a paramedic system. Australasian Journal of Paramedicine, 18.
  • communitycare.co.uk 2012, Winterbourne View ‘a case study in institutional abuse’, Accessed on: https://www.communitycare.co.uk/2012/08/07/winterbourne-view-a-case-study-in-institutional-abuse/ [Accessed on: 28 August 2021]
  • Goldsberry, J.W., 2018. Advanced practice nurses leading the way: Interprofessional collaboration. Nurse education today, 65, pp.1-3.
  • Henderson, J., Javanparast, S., Baum, F., Freeman, T., Fuller, J., Ziersch, A. and Mackean, T., 2019. Interagency collaboration in primary mental health care: lessons from the Partners in Recovery program. International journal of mental health systems, 13(1), pp.1-10.
  • Kaasbøll, J., Ådnanes, M., Paulsen, V. and Melby, L., 2020. Interagency collaboration for early identification and follow-up of mental health problems in residential youth care: evaluation of a collaboration model. Nordic Social Work Research, pp.1-16.
  • Macvean, M.L., Humphreys, C. and Healey, L., 2018. Facilitating the collaborative interface between child protection and specialist domestic violence services: A scoping review. Australian social work, 71(2), pp.148-161.
  • McKinlay, E.M., Morgan, S.J., Gray, B.V., Macdonald, L.M. and Pullon, S.R., 2017. Exploring interprofessional, interagency multimorbidity care: case study based observational research. Journal of Comorbidity, 7(1), pp.64-78.
  • Nooteboom, L.A., Mulder, E.A., Kuiper, C.H., Colins, O.F. and Vermeiren, R.R., 2021. Towards Integrated Youth Care: a systematic review of facilitators and barriers for professionals. Administration and policy in mental health and mental health services research, 48, pp.88-105.
  • Reeves, S., Pelone, F., Harrison, R., Goldman, J. and Zwarenstein, M., 2017. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6).pp.45-78.
  • Schot, E., Tummers, L. and Noordegraaf, M., 2020. Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration. Journal of interprofessional care, 34(3), pp.332-342.
  • Wei, H., Corbett, R.W., Ray, J. and Wei, T.L., 2020. A culture of caring: the essence of healthcare interprofessional collaboration. Journal of interprofessional care, 34(3), pp.324-331.

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