Inter-Professional Working in Healthcare

The purpose of this assignment is to examine an event that the author has been exposed to during clinical practice and exploring how inter-professional working (IPW) was utilised and the significance of IPW has in the health and social care sector. The event would have been under the direct supervision of the author, clinical mentor and it has been able to consolidate and engagement in the front line of the individual care. IPW is a fundamental property for health professionals to work collaboratively for achieving the same personalised care goals, by looking carefully at each individual’s health needs with a wide range of professionals (Mosser and Begun, 2013). This assignment will be elaborated through four parts; firstly, it will give a brief overview of IPW and the understanding of why it is essential and useful to maintain in practice. Secondly, it is linking evidence-based practice to the author clinical experience of IPW and critically analysing looking and at the role of the nurse in facilitating personal centred care. Thirdly, exploring the challenges faced relating to IPW and looking at legal, professional and ethical issues. While finally, recapping and concluding the essay. Due to the nature of the essay and exploring into clinical practice, confidentiality and consent will be maintained throughout, with no names or places being disclosed, while following the standards the Nursing and Midwifery Council (2018). Furthermore, the author prior to writing the assignment obtain consent by having a discussion with their clinical mentor on utilising the event for academic purposes and adhering to the Local trust Policy (LTP) (2017) all the way through.

The term IPW can also be known as; integrating care, collaborate working, multi-agency working, partnership working, teamwork, and co-ordinate care (Standing, 2010). There is a variety of terms, for this assignment, IPW will be utilised throughout for simplicity. Subsequently, within health and social care, there are a variety of terms used to refer to a person receiving care, patient, service user, individual, and client. Throughout this essay, they will be referred to as the patient for simplicity.

IPW is a crucial aspect of the healthcare industry, where Day (2013) explain that, IPW has significantly improved since the late 1990’s after the Department of Health (1997) published the white paper on New NHS, Modern, Dependable. The paper saw changes to modernise the NHS to fit with the increasingly complex care provision patients were presenting with to ensure both their health and social needs were being met and to reduce readmission occurring from their needs not being met (O'Carroll et al., 2016). The World Health Organisation (2013) broadly defined IPW as multiple health workers from different professional backgrounds working together to help deliver the highest quality of care to meet their individualised needs. Since this definition, a varies of meanings have been evolved among researchers, The Royal College of Nursing (2016) stated that, IPW is where different healthcare professionals with diverse knowledge, skills and talents collaborate as one to achieve a common goal by creating care pathways and enhance teamwork by encouraging coordination, collaboration, communication and make decision to achieve optimal healthcare outcomes. Burns (2018) highlighted that, IPW is no longer optional and is mandatory to all health professionals and is outlined in each of their regulatory bodies’ codes and must be maintained. These come from the initial IPW being promoted from the Five-Year Forward View (2014) plan, and these have expanded and seen further adaptations being placed in the Long-term Plan (2019a) to meet with the current health and social care demand. Consequently, from the Long-term Plan (2019a) has seen the growth and expansion of specialising roles and healthcare professionals being developed to meet the current need and make sure effective collaboration is being obtained in all clinical areas.

While working in the Intensive care unit, the author was able to care for a middle-aged gentleman who had suffered a head-on collision with a car while on his bicycle. The patient needed a wide range of medical treatment to stabilise the trauma he had obtained from a bleed on the brain and damage to their spinal code. To prevent further deterioration and to stabilise the patient, they were placed under sedation while treatment was carried out and having to be intubated to maintain his airway. During investigation saw the patient obtaining sepsis from the lines inserted from when the paramedic had treated the patient at the scene and had to be maintained on inotropes due to their unstable condition to maintain his physiological systems. After many MDT meetings and involvement of the family, many interventions and treatments saw the decisions to switch off the patient-ventilator from showing no signs of responsiveness to the treatment and the patient life ended and being able to be an organ donor.

According to a definition provided by Bosch and Mansell (2015), any patient can have care delivered by numerous health and social care professionals from a variety of agency to make sure all their needs are being met and reduce the gaps in care. There were many different professionals apart of the patient care from pain specialist nurse, dieticians, palliative care and end of life team, Chaplin, neurosurgeon, consultants, neuro-rehab, physiotherapists, social worker, organ donation retrieval and radiographers. While working within the team making sure effective communication was sustained to enhance the clarity of the roles and responsibilities each member of the team played in the patient care and to prevent duplication of work and information (Thomas et al., 2014). From this will see continuity in care being delivered while in a timely and appropriate provision being utilised to improve and promote recovery devoted to the patient individualised needs (Glasby and Dickinson, 2014).

From the author experience, they saw a variety of different health profession not communicating and witnessed a failure to collaborate simultaneously which entail a negative impact on patient care and a delay in for correct treatments and potentially placing the patient at risk of harm and their safety being compromised (Bowling, 2014). Bowling (2014) state that if IPW is not collaborating accurately could see delayed discharges, referrals and assessments being squandered, being placed in an incompatible environment, receiving unnecessary care and not following the patient agreed care goals. Due to the poor communication could see potential solutions from communication skill training to demonstrate the importance and being continuous throughout all professional’s career to enhance professional development (Department of Health, 2000). By providing inter-professional education and learning the team, it is effective to adapt all IPW approaches to see the team having the ability to communicate to all professionals to help contributor to the patient goals and shared objectives (Day, 2013).

Furthermore, due to the patient having altered levels of consciousness saw the patient next of kin and family being present during at the meetings to act as a critical member and be the voice of the patient as they were unable to express their wishes (Standing, 2010).Barrett et al. (2005) summarise by engaging the family in to care planning can establish long term strategies designed to both promote recovery and creating achievable goals suitable to the individual needs. In contrast, The King’s Fund (2019) express by giving the patient a voice when they are unable to express their own wishes, will see advantages in collaborating their needs and their quality of life being looked at while providing empowerment to the patient. This was achieved throughout the meeting and was able to identify personal choices and seeing the patient next of kin expressing some of the sensitive issues they had discussed throughout their life together and believed they could make those decisions on behalf of the patient and seeing preventative measure being put in place (The King’s Fund, 2019). Alternatively, if these were not obtained in practice could see patients receiving treatment that they would not usually agree to from health professionals just deciding between themselves and not taking any preferences on board (Purnell, 2013).

By providing a personal centred approach saw care planning with professionals and families working together to gain an understanding of the patient and their baseline and see the patient being but in control of their care and delivering services to achieve the best outcome (Martin et al., 2010).However, from the team proving excellent personal centre care and providing care around the highlighted wishes raised from the meetings while making sure that they were feasible and achievable, as well as safe towards they patient continuous needs (Day, 2013). To help health professional work safely by utilising the diverse knowledge, skills and talents, and discovering outcomes through IPW and once agreed, explaining them to the family to collaborate and make a decision on achieving optimal healthcare outcomes (Royal College of Nursing, 2016). Nevertheless, there will be time during IPW where health professionals having different opinions to other members in the team, by making sure all opinions are listened to and explored correctly and having a designated professional to help make the final decision, e.g. doctor, consultant (Burns, 2018).

Furthermore, despite the continuity of IPW that was being upheld throughout, the main barrier that was highlighted was out of area NHS health professional and agencies struggling to gain accesses to the local trust paperlite system. This is seen valuable information not being correctly contributed to the team or the agencies to assess the patient, due to not having access to the patient medical records. Koubel and Bungay (2012) state that as a result of a patient receiving care from different health and social provider can see the services being disjointed, difficult to access and not based around the patient needs. The King’s Fund (2019) expresses hospitals upgrading their documentation to IT systems are seeing health professional struggling to accesses their systems and resulting in lack of information-sharing on their findings needed to feedback to the current area. Due to having to chase down information from the patient assessment, saw potential breakdowns in communication from information not being fresh in the assessor’s mind and unable to document their findings straight away while in the local trust premises (Burns, 2018).

The author witnessed the team’s goals becoming singular and the wards thinking their care was superior and did not need to work collaboratively with other professionals and gaining their skilled opinions (Day, 2013). This outlined a uni-disciplinary approach being used and was not seeking the advice and guidance of specialised areas to help with the care of not only the patient but for his family going through this traumatic time (Powell and Davies, 2012).The NHS long-term plan (2019) set out a vision of joined-up services for health professional to embed with a system built around collaboration rather than competition. From this, saw the expert opinions to help maintain the patient current medical needs being overlooked and saw unsafe practice and professionals not following their regulatory body’s code of practice and could see them being placed in fitness to practice consultations.

In additions, it is essential to look at the legal obligations that IPW entails and all health professional need to be aware of their statutory regulatory bodies that implement a code of practice for them to uphold in the clinical area. However, each health professional has a different regulatory body to adhere to, but they all state the importance of maintaining IPW to enhance patient care and meet their health goals. One of the current legislations that empower IPW is the Care Act (2014) which states at all the different care providers to promote the integration of care and support with all health services. There are also current drivers as professional practice changes continually and to promote the best practice for all professionals to adhere to.

To achieve IPW in clinical practice can be dependent on the leaders involved in the team. Leadership is essential to uphold while collaborating within different teams by utilising a collective and distributed approach while influencing them to achieve commons goals and motivating them to accomplish great things (Gopee and Galloway, 2017).From the author experience, it outlined that all health profession could of utilising their leadership skills in adapting to a situational leadership style that can be used in contrasting situations by using the four supportive behaviours: supporting, coaching, delegating and directing (Barr and Dowding, 2012). This approach is effective to evaluate how much input is needed in making IPW effective throughout the team by using the four domains and help they goals be more achievable from using all networks that are available to be used (Day, 2013).

Finally, the ever-changing and the variety of different cultures and ethnically diverse world within the healthcare need efficient health professional for obtaining a transcultural approach. Transcultural nursing is an essential aspect of healthcare today with the ever-increasing multicultural population and adapting care needs around the beliefs and wishes of the individuals. IPW can see different professionals already having gained experience in certain religions and can bring their knowledge to help educate others in making their care plans flexible around these. Also, recognising and appreciating cultural differences in healthcare values, beliefs, and customs can see health professionals providing individualised and holistic care to their patients. Nurses must acquire the necessary knowledge and skills in cultural competency. Culturally competent nursing care helps ensure patient satisfaction and positive outcomes.

In conclusion, it can be seen how vital IPW is to uphold in the clinical area. By highlighting the evidence-based practice of the importance of IPW and the effects, it can have on patient care and delivery in the clinical area. From looking at the experience, the author apart off has contributed in several ways in an understanding of how to maintain and promote IPW going forward in practice. By ensuring appropriate systems, services and support for in place and looking at providing training to areas that are not maintained, IPW should be a priority for local trust to see improvement in patients care. The concept of IPW is based on the premise that excellent patient care relies on the expertise of several care providers working subsequently (Green and Johnson, 2015). The local trust needs to make sure that communication and accessibility need to be improved for IPW to work more smoothly. As if they do not fix these current issues will see ineffective IPW and continue to affect the quality of care provided by health and social care professions as they are not working simultaneously.

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