Working interprofessionally A real life view Inter-professional Learning

“Working interprofessionally: A real life view”. Inter-professional Learning Symposia School of Health and Education 2017 - 2018 Tutor Mary Clark Role: Senior Lecturer child health E-mail address: m. p. clark@mdx. ac. uk

Learning outcomes • To explore the meaning and the realities of “Interprofessional working” • To investigate through the experience of professionals why interprofessional working consistently features as an area of weakness in research and serious case reviews • To explore how good interprofessional practice can be promoted in future © Middlesex University Inter-professional Learning Symposia | 2

Welcome! • Welcome to this pre session work for the first interprofessional symposia for 2017 entiltled “Working interprofessionally- A real life view”. • For this symposia we have representatives from different professions who will share their experience of interprofessional working and their perspective on why interprofessional working is often raised as an area of weakness e. g in Serious Case Reviews and research. There will then be opportunity to ask questions related to this subject. The session will conclude with a summing up as to the way forward in interprofessional working © Middlesex University

Pre work • The following slides include both activities for you to do and information to read. It is hoped that by completing these activities you will get the most from this exciting learning opportunity • It is suggested that you record your answers using your own preferred style of note taking e. g word document or written notes © Middlesex University

Please refer to the references at the end of this presentation and use these to provide meanings for the definitions given on the left. . Term • Interprofessional working • Multidisciplinary working • Interagency working • Serious case review Definition

Your experience • Think about the definitions you have just given. Which one applies to you? • Think about teams you have worked with and reflect on examples where interprofessional/ multidisciplinary/ multi-professional teams have worked well and examples where they have not • What made the difference between one team working and the other not? © Middlesex University

Interprofessional working • The term we are going to use for this symposia is “interprofessional”. Interprofessional working applies to all aspects of nursing, social work and education. © Middlesex University

Definition of interprofessional working “The process whereby members of different professions and/or agencies work together to provide integrated health and/or social care for the benefit of service users. ” (Pollard et al 2005) i. e Working together to achieve a shared goal ! © Middlesex University Presentation title | 8

Interprofessional working and safeguarding • Children: Working together to safeguard children (2015) outlines legal framework in terms of interprofessional working • Adults: Care Act 2014 gave safeguarding adults a legal framework for the first time. • Overarching objective for both is to enable children and adults to live a life free from abuse or neglect. This cannot be achieved by any single agency. That is why it is essential for all the organisations that come into contact with children and adults to work in partnership to help protect them from abuse and neglect (CQC 2015) © Middlesex University Presentation title | 9

Interprofessional working and safeguarding: The Law • Section 10 of the Children Act 2004 places a duty on the local authority and its partners to cooperate with the aim of improving the well being of the child • Section 11 of the Act places duties on a range of organisations and individuals to ensure their functions, and any services that they contract out to others, are discharged having regard to the need to safeguard and promote the welfare of children. © Middlesex University

Interprofessional working: The guidance Everyone who works with children including teachers, GPs, nurses, midwives, health visitors, early years professionals, youth workers, police, Accident and Emergency staff, paediatricians, voluntary and community workers and social workers has a responsibility for keeping them safe In order that organisations and practitioners collaborate effectively, it is vital that every individual working with children and families is aware of the role that they have to play and the role of other professionals. In addition, effective safeguarding requires clear local arrangements for collaboration between professionals and agencies. © Middlesex University No single professional can have a full picture of a child’s needs and circumstances and, if children and families are to receive the right help at the right time, everyone who comes into contact with them has a role to play in identifying concerns, sharing information and taking prompt action. Working together (2015) p 8&9

Interprofessional working: historical difficulties • Promotion of effective Interprofessional/interagency working has long been a feature of government safeguarding policy, however difficulties in interprofessional working continue to be a highlighted in child death inquiries. • Reder et al (1993) review of 35 child abuse inquiries states flawed inter agency communication as most common feature. © Middlesex University

Findings of Climbie inquiry and interprofessional working • Lord Laming’s inquiry into the death of Victoria Climbie detailed the numerous failings in coordinated working across the key agencies, (Mc. Innes, 2007) • Laming (2003 p 6): “I am in no doubt that effective support for children and families cannot be achieved by a single agency acting alone. It depends on a number of agencies working well together. It is a multi-disciplinary task. ” • Out of all Laming’s 108 recommendations the only one highlighted as key was “challenging the views of others” (Keys 2009) © Middlesex University

Interprofessional working and high profile cases continue • Death of baby P and child deaths in Doncaster have given rise to further examination of interprofessional child protection working practices (Bell, Allain 2010) • Second Laming report stressed that although progress had been made ‘there is a clear need for a determined focus on improvement of practice in child protection across all the agencies. . . ’ (Laming, 2009, p. 61) Further reform to interprofessional practice is suggested: © Middlesex University

Serious Case Reviews (SCR) • Failures in interprofessional/multi agency working are a feature of many of the SCRs • http: //www. nspcc. org. uk/preventing-abuse/child-protectionsystem/england/serious-case-reviews/ • Hamzah Khan’s SCR (2013) highlights the practical difficulties that can lead to interprofessional practice not protecting the child “Workload pressure and contractual or commissioning arrangements can influence the capacity and focus of professional’s ability to respond to information or lack of engagement” (SCR Hamzah Khan Executive Summary 2013) © Middlesex University

Interprofessional working-Assertiveness and communication • Failure to challenge colleagues can leave children at risk • Studies looking at interprofessional working with families where there are mental health and childcare needs indicate that when groups have a different focus then communication breaks down (Keys 2009) © Middlesex University

Complexities of interprofessional working • In their review of the literature. Bell and Allain (2011) suggest that stereotyping appears to be a key issue in terms of developing an individual’s own professional identity and that of those with whom they collaborate • In addition to professional stereotyping, studies identify lack of recognition of expertise, insularity and lack of trust as barriers to collation of information and assessment (Watkin et al 2009) © Middlesex University

Interprofessional working-a complex set of skills • Keys (2009) suggests that key skills involved in effective interprofessional communication related to safeguarding/child protection are: Challenging others Able to see the perspective of others • How easy is this really in practice? © Middlesex University Being clear about own role

Compiling a glossary: before the symposia please prepare a piece of paper with the headings given below Term Definition

Compiling a glossary • During the symposium please list terms you hear in the discussion that you are not familiar with on the pre-prepared sheet. © Middlesex University

Post session Work Interprofessional symposium 4/10/16

Completing the glossary • After you have attended the session please look the definitions for any terms you have written on you glossary • Think of how you can incorporate these terms in your future academic work and in your professional communication © Middlesex University

Post session work: contd • Information sharing is often cited by practitioners as an area they are unclear over when working with other agencies. Please access the following HM Government guidance (2015) on information sharing https: //www. gov. uk/government/uploads/system/uploads/attachment_dat a/file/419628/Information_sharing_advice_safeguarding_practitioners. pdf • From the reading above and using what was discussed in the session, please complete a reflection (using the model of your choice) to demonstrate what you have learnt and how this may influence your work in the future as part of a interprofessional/multiagency work force • Please keep this pre and post work and your reflection for evidence as part of your professional development portfolio • Thank you for taking part! © Middlesex University

References Bell, L and Allain, L (2011): ‘Exploring Professional Stereotypes and Learning for Inter-professional Practice: An Example from UK Qualifying Level Social Work Education’, Social Work Education: The International Journal, 30: 03, 266 -280 CQC (2015). Statement on CQC’s roles and responsibilities for safeguarding children and adults. https: //www. cqc. org. uk/sites/default/files/20150710_CQC_New_Safeguarding_Statement. pdf (Accessed Oct 2017) HM Government (2015) Working together to safeguard children A guide to inter-agency working to safeguard and promote the welfare of children HM Government Keys, M. (2009). ‘Determining the skills for child protection practice: Emerging from the Quagmire!’ Child Abuse Review. Vol 18: 316 -332 Lord Laming. 2003. The Victoria Climbié Inquiry. Report of an Inquiry by Lord Laming. Cmnd 5730. The Stationery Office: London. Lord Laming 2009. The protection of children in England: a progress report. Norwich: TSO Mc. Innes, K. (2007) A practitioner guide to interagency working in children’s centres: a literature review. Barnado’s Policy and Research Unit Available from : http: //www. barnardos. org. uk/a-practitioners-guide-to-interagency-working-in-childrenscentres/publication-view. jsp? pid=PUB-1302 [Accessed Oct 2017] NSPCC: Breakdown or breakthrough involves some short films on supporting vulnerable children and families http: //www. nspcc. org. uk/services-and-resources/research-and-resources/breakdown-or-breakthrough/ Pollard K et al (2005) in Barrett G et al (eds) Interprofessional Working in Health and Social Care. Basingstoke: Palgrave Macmillan Reder P, Duncan S, Gray M. (1993). Inter-professional communication. In Beyond Blame Child Abuse Tragedies Revisited. Routledge: London. WHO (2010) Framework for Action on Interprofessional Education& Collaborative Practice. WHO Zeiss et al (1996). Team healthcare models available from http: //ccnmtl. columbia. edu/projects/sl 2/pdf/glossary. pdf (accessed Sept 15) © Middlesex University

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