This blog has been kindly shared with us by Rachel Wright, Director and Founder of Born at the Right Time.
We encourage you to read this blog. The Allied Health and Therapy Network was set up primarily as a platform for increasing the opportunities of true multi-disciplinary practice between our professional members. We think Rachel really makes some poignant points in this article, even if they may be slightly uncomfortable for us as health professionals to read in places.
From my observations as a healthcare practitioner and the parent of someone with complex disabilities, too often underneath the rhetoric of collaborative working and MDTs, practitioners can end up working like a group of children in a pre-school.
That isn’t to suggest professionals aren’t fully toilet trained or have tantrums (although that isn’t entirely unheard of) but rather that their social interactions aren’t fully developed.
Young children can think they have played with their friend because they have stood side by side while playing with their own toy in the same sandpit. It could even be that they are so engrossed in their own game, they don’t even look up to see what their friend is doing. Yet, both children can leave the interaction convinced they played together. Their sweaty little hand will grab their parents on the walk home and they’ll regale their parents with the tales of playing in the sandpit with their BFF.
What really happened is that neither child has progressed to actually playing together. They haven’t come to the point where they have the same aims, share their resources (toys) and invent a creative, fun activity using each other’s imagination and skills. They aren’t playing in a way which they couldn’t do alone. That level of play and interaction comes later in their development.
MDTs can also function like pre-schoolers around a sandpit
Professionals might believe they are part of a wider team, working effectively together because they do their work in close proximity with other practitioners. They might even sit around the same table from time to time. But like the children by the sand pit, the sharing resources, mutual avenues of communication, the systems and structural collaboration required for real participation in co-productive working is not in place to nurture true integration.
I know as a parent of a child with close to 100 practitioners in our network of support, the rhetoric of Multidisciplinary working isn’t our reality as a family. Parents are still living in a world/sandpit where people are working in parallel rather than collaboration. Communication works more like wheel and spoke model with all the information disseminating into the hub - so the parent is the only person with whom everyone communicates. There simply aren’t the connective systems in place for information to be disseminated like a web of MDT working.
Steps still need to be made to transition from pre-schooler to true integrated working. The success of the new Intergrated Care Boards (ICBs) and Integrated Care Systems within the UK requires maturity, structural change and cultural shift to get us from pre-schoolers around a sandpit to a game of Dungeons and Dragons in Stranger Things.
Such a big change in the cultural narrative needs to be supported by systems of communication across departments and fundamentally, a shift to collective responsibility rather than simply linear reporting. At the minute the system is accountable upward to line managers. Despite the language of collaboration being hailed as gold standard for decades, this hasn’t been matched with collective accountability to the person or family being supported. Too often measurements of success are output focused rather than outcome focused – looking at what it meant for the family or individual being supported.
It seems the longevity of the MDT hasn’t always translated to maturity and sometimes we are still pre-schoolers, playing our own games around the same sandpit.
#MultidisciplinaryTeams #MDTs #IntegratedCareSystems #ICS #IntegratedCareBoards #ICB #TransformativeCare #CoProduction #Collaboration #LivedExperience #ParentPerspective #PersonCentred #BornAtTheRightTimeTraining #EffectiveCommunication
Original blog July 2022 Written by Rachel Wright, qualified nurse and unqualified parent of 3, one with complex disabilities. She’s the author of The Skies I’m Under, host of The Skies We’re Under Podcast, an award-winning blogger and founder of Born at the Right Time. Passionate about effective communication and collaborative working, she uses her skills and lived experience to educate practitioners with CPD-certified courses. Find out about the highly commended, on-line, international courses https://www.bornattherighttime.com/disability-training/