Partnership Working Fiona Couper and Debbie Spain Department of Mental Health Florence Nightingale...
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Transcript of Partnership Working Fiona Couper and Debbie Spain Department of Mental Health Florence Nightingale...
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Partnership Working
Fiona Couper and Debbie Spain Department of Mental Health
Florence Nightingale School of Nursing & Midwifery
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Learning Outcomes
By the end of this session, you will be able to • Discuss the meaning of ‘partnership working’ in
mental health services• Critically examine factors that may prevent and
promote partnership working• Identify implications for clinical practice• Have opportunities for reflection
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Background
• Individuals in contact with mental health services typically benefit from involvement with more than one health professional and more than one agency
• Partnership working: “any situation in which people are working across organisational boundaries towards some positive end’ (Huxham and Vangen, 2005, p.4 in Tait and Shah, 2007)
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Shared Knowledge, Skills and Values
• Pulling Together (SCMH, 1997) promoted collaborative teamwork while retaining separate professions
• Ten Essential Shared Capabilities (DH, 2004): broad domains of competency for all workers
• Clinicians may not have full awareness of other disciplines in terms of scope of practice, values, codes of conduct and organisation
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Group work
In small groups identify the :-
1.Benefits of team working
2. Barriers to team working
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Ten Essential Shared Capabilities (DH, 2004)
1. Working in partnership2. Respecting diversity3. Practising ethically4. Challenging inequality5. Promoting recovery6. Identifying people’s needs and strengths7. Providing service-user centred care8. Making a difference9. Promoting safety and positive risk taking10. Personal development and learning
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Shared Knowledge, Skills and Values
How do members ofyour team conceptualisepresenting difficulties ?
Do all professionalsshare ideas about thetreatment plan ?
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Some benefits of team working
• holistic approach to care and support • reflects the need to offer Recovery-focused interventions • increases efficiency, reduces duplication • shared knowledge and expertise• better use of resources, value for money• improved communication and engagement• stimulates creativity • combined influence• distinct conceptualisations of symptoms / treatment• anything else ?
(e.g. DH, 2006; SCMH, 2000; Tait and Shah, 2007)
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Factors affecting partnership working with service-users
• attitudes / perceptions• nature / severity of mental health symptoms• MHA status• withholding information• relationship dynamic• unclear expectations• inconsistency • resistance • staffing levels / retention• resource constraints(e.g. McCloughen et al, 2011; Simpson and Brennan, 2009)
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Barriers to working with professionals
• perceptions and attitudes• no common shared
language• inequalities in relationship• accountability and
responsibility not clear• conflict of interests /
agenda • power struggles• resistance • ‘a blame culture’
• end points / outcomes not clearly identified
• different organisational policies, priorities, IT structures
• disagreements re cost• bureaucracy • reluctance to share• team dynamics• poor support mechanisms
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Triangle of care
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The Triangle of Care. National Mental Health Unit(2010)
This document provides a guide to the views of users, cares and professionals about best practice. Their view about what constitutes a mental health crisis can differ. Consider some one you have cared for recently and note how:- •The user described the crisis•The carer described the crisis•The Professional described the crisis
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Barriers to inter-agency working
Five significant obstacles to inter-agency working between health and social services:
1.Structural 2.Procedural 3.Financial 4.Professional 5.Status and legitimacy (Wistow and Hardy, 1991 in Holton, 2001, p.431)
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Group work
• Consider one of the five Barriers and find examples in practice.
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Improving partnership working with service-users and their families
• recognising need• being prepared to work together • listening • acknowledging service-user expertise • adopting a collaborative, goal-orientated approach• promoting open and reciprocal conversation• developing a shared understanding • facilitating self-management skills and self-efficacy • providing information in accessible formats
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Improving partnership working with service-users and families contd.
• encouraging service-user feedback• named / designated nurse / team• providing choice• evidence-based decision making• signposting to PALS and advocacy service as needed• emphasising relapse prevention techniques • using advance directives / crisis planning when appropriate
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Working in partnership in day-to-day clinical practice
Strategies include:
• clear communication: a shared language• effective leadership• making time• meetings ! (need to specify when, where, how often)• inter-agency training
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Working in partnership in day-to-day clinical practice contd.
Strategies also include:
• identification of individual strengths and resources• joint assessments• sharing of information / ideas / experience• mechanisms for providing feedback• willingness to manage change
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Enhancing partnership working
• leadership skills • negotiation skills• assertiveness• flexibility / creativity • feedback• responsiveness• trust
• motivation • skills-based intervention• familiarity with policies • shared resources• clarity in aims • clinical supervision
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Is there one thing that you could change in yourself to encourage more cohesive partnership working with others ?
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Summary and some considerations
• A need to consider a whole-systems approach to care
• Service-user involvement in design, delivery and evaluation of services
• Increasing emphasis on evidence-based practice – we need to develop broad systems for evaluating inter-agency interventions
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ReferencesAudit Commission (1998). A Fruitful Partnership: Effective Partnership Working. Audit Commission.Department of Health: NHS Modernisation Agency, NATPACT. Working separately together: A guidebook for successful partnering between organisations within the NHS. Leeds: HM Government. Department of Health (2006). From Values to Action: The Chief Nursing Officer’s Review of Mental Health Nursing. London: HM Government.Department of Health (2009). Putting People First. Working together with user-led organisations. London: HM Government.Department of Health (2011). No Health Without Mental Health. London: HM Government.National Mental Health Unit(NMHDU)(2010) The Triangle of Care. London. NMHDUHolton, M. (2001). The partnership imperative. Joint working between social services and health. Journal of Management in Medicine, 15(6), pp.430-445.Involve: www.invo.org.uk
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ReferencesMcCloughen, A., Gillies, D. and O’Brien, L. (2011). Collaboration between mental consumers and nurses: Shared understandings, dissimilar experiences. International Journal of Mental Health Nursing, 20, pp.47-55.Rethink. www.rethink.org Sainsbury Centre for Mental Health (2000). Using opportunities for inter-agency partnership in Mental Health. Taking Your Partners. London: SCMH.Sainsbury Centre for Mental Health. (2004). The Ten Essential Shared Capabilities. London: Sainsbury Centre for Mental Health.Simpson, A. and Brennan, G. (2009). Working in partnership. In P Callaghan, J Playle and L Cooper (eds). Mental Health Nursing Skills. Oxford : Oxford University Press.Tait, L. and Lester, H. (2005). Encouraging user involvement in mental health services. Advances in Psychiatric Treatment, 11, pp.168-175.Tait, L. and Shah, S. (2007). Partnership working: a policy with promise for mental healthcare. Advances in Psychiatric Treatment, 13, pp.261-271.