Multi- age with a heroin, cannabis and cocaine

Multi- agency is about providing a seamless
response to individuals who have multiple and complex needs, foremost working
across boundaries are critical to the well -being of the service users.

   In this assignment I will be explaining why
working across boundaries are critical to the well -being of service users. I
will also be discussing the importance of collaboration in a team environment, and
supporting my essay with examples of how good practice could contribute to the
effectiveness of a multi- agency team.

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   Interdisciplinary teamwork is a vital model
for delivering quality care to service users Hashbeck (2011).

    In all disciplines there are policies and
procedures that needs to be followed; therefore all disciplines have different
approach and protocols to how quality care is given NHS (2017). On the other
hand working across boundaries bring forth some of the greatest achievements in
medicine and health according to Brandon (1990) When we talk about complex and
multiple needs I understand this as and individual whom has multiple different
issues in their lives, this may include an addiction, mental health conditions
or a chronic disease.

example, 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 being
struggling to keep a roof over his head because of his addiction. He is hearing
voices in his head telling him to harm himself and others around him. He has
just being diagnosed with severe depression and schizophrenia. On the other
hand he had a positive result for HIV and Hepatitis B and C, therefore this
makes John socially vulnerable. In this case John needs a dual specialist to
help John with his addiction, a housing officer because he is homeless and
vulnerable to society, a probation officer because of his criminal involvement,
a councillor for his depression, a mental health consultant for his mental
disorder, a sexual health visitor to help minimise the risk of John’s
communicable diseases from spreading. No one can help John in so may ways;
therefore this was how partnership working started; sharing the work load
amongst disciplines ensuring the service user is protected and given the right
support that is needed 

can cause complexity. This was how partnership working      developed, complex needs require more than
one discipline collaborating together to ensure that the service user is
satisfied, safe and secured (PHE, 2017) If John showed up to me in a GP surgery
and I had all these aspect of his health to take on board I will not know where
to start, therefore this was one of the reason partnership working developed;
sharing the work load and collaborating to ensure the best solution for service
users (NHS, 2017).

    As professions
when collaboration occurs, important information are shared, this piece of
information that are shared may get misplaced and wrong care and medication can
be administered.  This can lead to life
long terminal illnesses and even death. However, legislations such as Data
Protection Act 1998 are in place to ensure that these collaborations are
remained confidential GOV (1998).

   One of
the biggest factors that contribute to the success of a team is whether or not
the members are able to work collaboratively for the ultimate goal Stein

Bruce Tuckman theory was created around 1965; consists of 4 stages titled:
forming, storming, norming and performing. This theory is commonly linked to
the success of team building and how the healthcare agencies work,
collaborating to provide effective and quality care for service users.

to Tuckman (1976), who suggested that for a team to work effectively and to
come to a sustainable decision it goes through stages. The first stage forming
would involve all the staffs’ communicating to each other sharing information
among each other.  The next stage Tuckman
concluded that storming is when everyone gets allocated to their role in
service users life and how best they can help that individual. The third stage
norming; Tuckman suggested that this is when collaboration occurs; disagreeing
and agreeing to other ideas that the other team members have generated. The
final stage is when professionals have come to a sustainable decision for the
service user best interest keeping in mind patients dignity and choices for
example service users culture, the food they like to eat and their religious
practice. Tuckman named this stage performing HSC (2011). One thing I like
about Tuckman’s theory is that the team came to a sustainable decision for the
service user despite the difficulties that arose, however I did not like the
fact 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 effective
collaboration. For example, team analysis theory concluded that eventually your
team could fall apart, so re- evaluate the situation and analyse what went
wrong can bring forth better collaboration minimising any mistakes as least as
possible Belbin (1970) Another thing I did not like about Tuckman’s theory is
that 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 also
how that message was sent, the facial expressions and your body postures and
how was that message interpreted; stage 5 of the communication cycle theory by
Argle (1972) trying to understand what is being said, reflecting and interpret
to brainstorm what the sender is trying to say.

the healthcare system collaboration is vital and significant. For example if a
17 year old come into your GP surgery, crying looking very distressed with
scars on her body, in this situation as a GP you have to refer this case to a
social worker or the police, because as a healthcare profession we have a duty
of care, however in this case a GP has not got the right training and hand on
experience to give the right support that is needed for the service users. So
the GP will have to collaborate with other agency so that the service user will
receive the quality care. This is an example of collaboration in multi- agency
working. On the other hand, this is Domain 2 of the Nursing and Midwifery
Council ( NMC); prioritising people, putting the service users first.

    Within every organisations and bodies there
are advantages and disadvantages to take into consideration.  Even though vital information are shared,
this information has to remain confidential between face workers who are involved
in 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 3
of the Nursing and Midwifery Council state that “all nurses must understand the
roles and responsibilities of other health and social care professionals and
seek to work with them collaboratively for the benefit of all people in need of
care” NMC (2016) I interpret this as understanding the roles of other
disciplines and collaboratively work with them for solutions. However, as
healthcare professions we need to individualise others keeping in mind that
everyone is unique in their own way. As professionals we all have our own values,
morals and culture. However, organisations has their polices and procedures additionally
codes of conducts that needs to be taken in account.  The use of terminology, jargons or slangs that
may be use in your disciplines may be different from another discipline this is
also a communication barrier that needs to be overcome to ensure collaborative
practice among multi agency. To overcome this barrier disciplines should use
alternatives form of communication such as emails and telemedicine HSC (2011).

    If this barrier is not overcome this can
have major impact on service users and stakeholders, because there can be
misunderstanding of information and this could lead to giving the wrong
diagnosis. Learning about patient current complaints and past relevant medical
history also having a consultant to check before you diagnosis can overcome
this barrier to communication.

Collaboration cannot occur without a team working effectively to achieve
the same goal.

   As a healthcare staff, everyone you work with
wants what is best for patients using the person centred approach. This is one
of the importance of working in a team, because staffs are working to the same
goal, you are more likely to do all you can to reach it, additionally the work
load reduces because it is now spilt among the team.  

you ever being to a netball or football game? Throughout the whole match
players are shouting, cheering and in constant communication to each other. This
constant communication throughout the game makes everyone aware of what they
are supposed to be and what they should be doing. Teamwork within the
healthcare system uses that sort of that constant communication; for patients
to 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 the
quality care for example: handovers.

in a team also offers the chance for members to support each other to be
flexible and adaptable to changes within the professional environment.     Within the healthcare sector, there are
always rapid changes on going. New codes of conducts, new practices, new way of
how to collaborate among other multi agency bodies, therefore you will always
be growing both professionally and personally. In my own opinion this is a
benefit of multi agency collaborating; adapting to changes within the team and
be flexible and adjustable to learning new ideas and innovations.

and collaborative practice between multi agency collaborating allow staffs to
combine ideas and encourage innovation within the hospitals, schools, day
centres, rehabilitation centres, nursery anywhere in the health sector; because
healthcare is very broad.

up as a child my grandma always uses a phrase ” show me your company and I will
tell you whom you are” this simply means the company you keep is what you will
become. Linking this to teamwork and collaboration other professionals will
gain exposure to other ways of thinking and doing.  Two brains are better than one so when a team
collaborate effective together they can achieve anything.

   When I
think about communication the first thing that comes to mind is sending a
message to get a response; however this concept changed when I got my first job
interview in a care home. I realised that my interpersonal communication skills
are much more effective than the explicit meaning of my words. When I had my
interview my non- verbal signs gives and additional piece of information and
meaning over and above everything I wanted to say in the interview. After my
interview the interviewer did not commented on what I said about myself and the
skills I can contribute to the organisation. She gave me feedback mostly on my
smile (facial expression), my body posture and my gesture. I concluded that verbal
and non- verbal communication are important.

   While I was doing my research Dr. Albert
Mehrabian, author of Silent Messages (1971) conducted numerous researches on
nonverbal communication. This research led him to conclude that 7% of message
is through spoken words, 38% through certain voice elements for example how
high or low your tone is and 55% through unspoken words but through facial
expression and body posture Mehrabian (1987). Our world and our society are
constantly changing; new technologies are becoming part of our everyday lives;
one of the most significant aspects of interpersonal relationships in the
workplace and learning to work effectively in a team takes time NHS (2016) In
my own opinion good interpersonal skills start with you without these tools
health professional will have difficulty collaborating among team members, also
will be hard for them to keep up with the constant changes within the
healthcare; while being flexible an adaptable for example if you are always
shouting at the top of your voice, not listening to others opinion this will
cause others to view you as being unfair and undiplomatic/ unprofessional. I
interpret this as if individual does not establish a clear foundation in their
profession it will be very difficult to communicate and work with others, for
example a Muslim man thinks that a woman should not give orders, however in a
profession like this we have to respect gender differences regard less of your
cultural practices. Your self-awareness is an essential part of working
sensitively with patients/clients and colleagues.

example: having a clearer perception of yourself, personalities, strengths and
weaknesses, motivation and attributes. This then allows you to interpret others
and how they perceive you (self- image) your attitude and response to them at
that time NHS (2016).

Discrimination Act 1998, ensures that individuals who has impairments/
disability has to receive the same treatment same as anyone. The social model
of health suggests that we all have impairments however, its society who
disables us GOV (2011). Therefore, different forms of communication have to be
in place to ensure that their needs have being met. Different form of
communication such as: sign language, ABC charts, pictures and interpreters. Take
for instance a patient comes to a GP practice but the receptionist cannot
understand what the individual is trying to say. We have a duty of care as
health professionals, therefore the receptionist has to use different ways; to
try and understand the patient and how best they can help. In this case an
interpreter is needed. This is an example of collaboration; interpreter
interpreting what the patient is saying, then pass this information to the
receptionist; so they can give the patient an appointment if the patient
requires one, or if it is an emergency they will guide the patient on what to
do and how to do it. None of this information would have being decoded
according to Argle (1976) stage four of the communication cycle; without the interception
of the interpreter; overcoming a major barrier in communication language

researching about my essay the way professions view each other was concluded by
Slooper (2004). However, in my opinion tensions between different professions
can arise because of feelings of marginalisation by other professions. Cultural
differences among professions and agencies have codes of conducts that are
slightly different in some context Leeds (2017) for example: the police working
towards law enforcement and a social worker working towards protecting others
from abuse. Therefore, mutual respect for the roles of other professions was
highlighted by Hymans (2006) and Watson (2006), although personally tensions
caused by training provided within individual and a multi- agency teams can be
problematic. Overcoming this barrier; providing refreshers coarse and spot
checks to ensure that everyone is treated equal and minimise the risk of
discrimination and bullying among multi- agency working and collaboration. In
my own opinion biasness will always be an issues within collaboration of
agencies, however putting these services in action will be the best
satisfaction for both the staffs and patients.



























Reference list

1. (2018). Healthcare UK:
working in partnership – GOV.UK. online Available at:–2
Accessed 19 Jan. 2018.

2. (2018). Healthcare UK:
working in partnership – GOV.UK. online Available at:–2
Accessed 1 Jan. 2018.

3. (2018). Healthcare UK:
working in partnership – GOV.UK. online Available at:–2
Accessed 12 December 2018.

Accessed 19 Jan. 2018.

5.    ICHARDSON A. & STORR J. (2010) Patient safety: a
literative review on the impact of nursing empowerment, leadership and
collaboration. International Nursing Review57, 12–21




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