Multi- agency is about providing a seamlessresponse to individuals who have multiple and complex needs, foremost workingacross boundaries are critical to the well -being of the service users.   In this assignment I will be explaining whyworking across boundaries are critical to the well -being of service users. Iwill also be discussing the importance of collaboration in a team environment, andsupporting my essay with examples of how good practice could contribute to theeffectiveness of a multi- agency team.   Interdisciplinary teamwork is a vital modelfor delivering quality care to service users Hashbeck (2011).     In all disciplines there are policies andprocedures that needs to be followed; therefore all disciplines have differentapproach and protocols to how quality care is given NHS (2017). On the otherhand working across boundaries bring forth some of the greatest achievements inmedicine and health according to Brandon (1990) When we talk about complex andmultiple needs I understand this as and individual whom has multiple differentissues in their lives, this may include an addiction, mental health conditionsor a chronic disease.

   Forexample, John is 23 years of age with a heroin, cannabis and cocaine addiction,for the past 3 years since John left his parents’ house, John has beingstruggling to keep a roof over his head because of his addiction. He is hearingvoices in his head telling him to harm himself and others around him. He hasjust being diagnosed with severe depression and schizophrenia. On the otherhand he had a positive result for HIV and Hepatitis B and C, therefore thismakes John socially vulnerable. In this case John needs a dual specialist tohelp John with his addiction, a housing officer because he is homeless andvulnerable to society, a probation officer because of his criminal involvement,a councillor for his depression, a mental health consultant for his mentaldisorder, a sexual health visitor to help minimise the risk of John’scommunicable diseases from spreading. No one can help John in so may ways;therefore this was how partnership working started; sharing the work loadamongst disciplines ensuring the service user is protected and given the rightsupport that is needed      Interdependencecan cause complexity.

This was how partnership working      developed, complex needs require more thanone discipline collaborating together to ensure that the service user issatisfied, safe and secured (PHE, 2017) If John showed up to me in a GP surgeryand I had all these aspect of his health to take on board I will not know whereto start, therefore this was one of the reason partnership working developed;sharing the work load and collaborating to ensure the best solution for serviceusers (NHS, 2017).     As professionswhen collaboration occurs, important information are shared, this piece ofinformation that are shared may get misplaced and wrong care and medication canbe administered.  This can lead to lifelong terminal illnesses and even death. However, legislations such as DataProtection Act 1998 are in place to ensure that these collaborations areremained confidential GOV (1998).    One ofthe biggest factors that contribute to the success of a team is whether or notthe members are able to work collaboratively for the ultimate goal Stein(2006).

  TheBruce Tuckman theory was created around 1965; consists of 4 stages titled:forming, storming, norming and performing. This theory is commonly linked tothe success of team building and how the healthcare agencies work,collaborating to provide effective and quality care for service users.    Accordingto Tuckman (1976), who suggested that for a team to work effectively and tocome to a sustainable decision it goes through stages. The first stage formingwould involve all the staffs’ communicating to each other sharing informationamong each other.  The next stage Tuckmanconcluded that storming is when everyone gets allocated to their role inservice users life and how best they can help that individual.

The third stagenorming; Tuckman suggested that this is when collaboration occurs; disagreeingand agreeing to other ideas that the other team members have generated. Thefinal stage is when professionals have come to a sustainable decision for theservice user best interest keeping in mind patients dignity and choices forexample service users culture, the food they like to eat and their religiouspractice. Tuckman named this stage performing HSC (2011).

One thing I likeabout Tuckman’s theory is that the team came to a sustainable decision for theservice user despite the difficulties that arose, however I did not like thefact it did not suggested any type of reflection at the end of this theory;ensuring that the same mistake that occur is stage 3 does not happen again;therefore their will always be mistakes without any improvements of effectivecollaboration. For example, team analysis theory concluded that eventually yourteam could fall apart, so re- evaluate the situation and analyse what wentwrong can bring forth better collaboration minimising any mistakes as least aspossible Belbin (1970) Another thing I did not like about Tuckman’s theory isthat Tuckman did not look on the different aspect of how communication occurs.Communication is not only about the message you want to send across, but alsohow that message was sent, the facial expressions and your body postures andhow was that message interpreted; stage 5 of the communication cycle theory byArgle (1972) trying to understand what is being said, reflecting and interpretto brainstorm what the sender is trying to say.    Withinthe healthcare system collaboration is vital and significant. For example if a17 year old come into your GP surgery, crying looking very distressed withscars on her body, in this situation as a GP you have to refer this case to asocial worker or the police, because as a healthcare profession we have a dutyof care, however in this case a GP has not got the right training and hand onexperience to give the right support that is needed for the service users. Sothe GP will have to collaborate with other agency so that the service user willreceive the quality care. This is an example of collaboration in multi- agencyworking. On the other hand, this is Domain 2 of the Nursing and MidwiferyCouncil ( NMC); prioritising people, putting the service users first.

    Within every organisations and bodies thereare advantages and disadvantages to take into consideration.  Even though vital information are shared,this information has to remain confidential between face workers who are involvedin the service users care, however if the service user is at risk of abuse or danger,this information has to be disclose to ensure the safety of patients.  Domain 3of the Nursing and Midwifery Council state that “all nurses must understand theroles and responsibilities of other health and social care professionals andseek to work with them collaboratively for the benefit of all people in need ofcare” NMC (2016) I interpret this as understanding the roles of otherdisciplines and collaboratively work with them for solutions. However, ashealthcare professions we need to individualise others keeping in mind thateveryone is unique in their own way. As professionals we all have our own values,morals and culture.

However, organisations has their polices and procedures additionallycodes of conducts that needs to be taken in account.  The use of terminology, jargons or slangs thatmay be use in your disciplines may be different from another discipline this isalso a communication barrier that needs to be overcome to ensure collaborativepractice among multi agency. To overcome this barrier disciplines should usealternatives form of communication such as emails and telemedicine HSC (2011).     If this barrier is not overcome this canhave major impact on service users and stakeholders, because there can bemisunderstanding of information and this could lead to giving the wrongdiagnosis. Learning about patient current complaints and past relevant medicalhistory also having a consultant to check before you diagnosis can overcomethis barrier to communication.  Collaboration cannot occur without a team working effectively to achievethe same goal.    As a healthcare staff, everyone you work withwants what is best for patients using the person centred approach.

This is oneof the importance of working in a team, because staffs are working to the samegoal, you are more likely to do all you can to reach it, additionally the workload reduces because it is now spilt among the team.     Haveyou ever being to a netball or football game? Throughout the whole matchplayers are shouting, cheering and in constant communication to each other. Thisconstant communication throughout the game makes everyone aware of what theyare supposed to be and what they should be doing. Teamwork within thehealthcare system uses that sort of that constant communication; for patientsto receive the best care every face workers that are involve in the patients’care has to have the most significant piece of information to deliver thequality care for example: handovers.    Workingin a team also offers the chance for members to support each other to beflexible and adaptable to changes within the professional environment.

    Within the healthcare sector, there arealways rapid changes on going. New codes of conducts, new practices, new way ofhow to collaborate among other multi agency bodies, therefore you will alwaysbe growing both professionally and personally. In my own opinion this is abenefit of multi agency collaborating; adapting to changes within the team andbe flexible and adjustable to learning new ideas and innovations.    Teamworkand collaborative practice between multi agency collaborating allow staffs tocombine ideas and encourage innovation within the hospitals, schools, daycentres, rehabilitation centres, nursery anywhere in the health sector; becausehealthcare is very broad.    Growingup as a child my grandma always uses a phrase ” show me your company and I willtell you whom you are” this simply means the company you keep is what you willbecome.

Linking this to teamwork and collaboration other professionals willgain exposure to other ways of thinking and doing.  Two brains are better than one so when a teamcollaborate effective together they can achieve anything.    When Ithink about communication the first thing that comes to mind is sending amessage to get a response; however this concept changed when I got my first jobinterview in a care home. I realised that my interpersonal communication skillsare much more effective than the explicit meaning of my words. When I had myinterview my non- verbal signs gives and additional piece of information andmeaning over and above everything I wanted to say in the interview.

After myinterview the interviewer did not commented on what I said about myself and theskills I can contribute to the organisation. She gave me feedback mostly on mysmile (facial expression), my body posture and my gesture. I concluded that verbaland non- verbal communication are important.

   While I was doing my research Dr. AlbertMehrabian, author of Silent Messages (1971) conducted numerous researches onnonverbal communication. This research led him to conclude that 7% of messageis through spoken words, 38% through certain voice elements for example howhigh or low your tone is and 55% through unspoken words but through facialexpression and body posture Mehrabian (1987). Our world and our society areconstantly changing; new technologies are becoming part of our everyday lives;one of the most significant aspects of interpersonal relationships in theworkplace and learning to work effectively in a team takes time NHS (2016) Inmy own opinion good interpersonal skills start with you without these toolshealth professional will have difficulty collaborating among team members, alsowill be hard for them to keep up with the constant changes within thehealthcare; while being flexible an adaptable for example if you are alwaysshouting at the top of your voice, not listening to others opinion this willcause others to view you as being unfair and undiplomatic/ unprofessional. Iinterpret this as if individual does not establish a clear foundation in theirprofession it will be very difficult to communicate and work with others, forexample a Muslim man thinks that a woman should not give orders, however in aprofession like this we have to respect gender differences regard less of yourcultural practices. Your self-awareness is an essential part of workingsensitively with patients/clients and colleagues.

  Forexample: having a clearer perception of yourself, personalities, strengths andweaknesses, motivation and attributes. This then allows you to interpret othersand how they perceive you (self- image) your attitude and response to them atthat time NHS (2016).  Discrimination Act 1998, ensures that individuals who has impairments/disability has to receive the same treatment same as anyone. The social modelof health suggests that we all have impairments however, its society whodisables us GOV (2011). Therefore, different forms of communication have to bein place to ensure that their needs have being met. Different form ofcommunication such as: sign language, ABC charts, pictures and interpreters. Takefor instance a patient comes to a GP practice but the receptionist cannotunderstand what the individual is trying to say.

We have a duty of care ashealth professionals, therefore the receptionist has to use different ways; totry and understand the patient and how best they can help. In this case aninterpreter is needed. This is an example of collaboration; interpreterinterpreting what the patient is saying, then pass this information to thereceptionist; so they can give the patient an appointment if the patientrequires one, or if it is an emergency they will guide the patient on what todo and how to do it. None of this information would have being decodedaccording to Argle (1976) stage four of the communication cycle; without the interceptionof the interpreter; overcoming a major barrier in communication languagedifferences.   Whileresearching about my essay the way professions view each other was concluded bySlooper (2004). However, in my opinion tensions between different professionscan arise because of feelings of marginalisation by other professions.

Culturaldifferences among professions and agencies have codes of conducts that areslightly different in some context Leeds (2017) for example: the police workingtowards law enforcement and a social worker working towards protecting othersfrom abuse. Therefore, mutual respect for the roles of other professions washighlighted by Hymans (2006) and Watson (2006), although personally tensionscaused by training provided within individual and a multi- agency teams can beproblematic. Overcoming this barrier; providing refreshers coarse and spotchecks to ensure that everyone is treated equal and minimise the risk ofdiscrimination and bullying among multi- agency working and collaboration. Inmy own opinion biasness will always be an issues within collaboration ofagencies, however putting these services in action will be the bestsatisfaction for both the staffs and patients.                           Reference list 1.    Gov.

uk. (2018). Healthcare UK:working in partnership – GOV.UK. online Available at:https://www.gov.

uk/government/publications/overview-working-in-partnership/healthcare-uk-working-in-partnership–2Accessed 19 Jan. 2018.2.    Gov.uk. (2018). Healthcare UK:working in partnership – GOV.

UK. online Available at:https://www.gov.uk/government/publications/overview-working-in-partnership/healthcare-uk-working-in-partnership–2Accessed 1 Jan. 2018.

3.    Gov.uk. (2018). Healthcare UK:working in partnership – GOV.UK.

online Available at:https://www.gov.uk/government/publications/overview-working-in-partnership/healthcare-uk-working-in-partnership–2Accessed 12 December 2018.4.    https://moodle.une.edu.

au/pluginfile.php/454891/mod_data/intro/User-Manual-Reflective-Practice-FINAL.pdfAccessed 19 Jan. 2018.5.

    ICHARDSON A. & STORR J. (2010) Patient safety: aliterative review on the impact of nursing empowerment, leadership andcollaboration. International Nursing Review57, 12–216.      

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