Inter-Professional Working in Social Work - Literature review Example

Inter-Professional Working in Social Work Introduction Any organized human activity will require effective “interlinking” or collaboration between the individuals involved, to accomplish the set task. This is aptly applicable to professionals working in different organized service sectors like social service, health, education and so on, with the concept of “inter-professional working” playing the crucial role. Inter professional working refers to how those professionals from different sectors collaborate and even “intertwine” their perspectives to reach their common objectives. Professionals working in social service sector or Social workers, with their knowledge as well as training in organized human activity or group-work, can play key part in facilitating inter-professional working. Thus, inter-professional working in social service involves actualizing an environment where the different social service professionals can work together, collaborating and cooperating among themselves, and also harnessing their respective professional contributions, so all of which can optimize the quality of service to the needy people. Thus, focusing on the social voluntary agency G.U.M, in which I have undertaken my final placement, the discussion will be on how an environment for inter-professional working was actualized there, the opportunities, benefits as well as the challenges it created, by case-studying a 16 year-old individual named Kev. G.U.M is a voluntary agency that works with service users subject to immigration control, and so I can ‘locate’ my placement agency within the mixed sector of health and social care thereby creating apt environment for inter-professional working. I will start off by evaluating the competing perspectives and the approaches relating to inter-professional working with service users, and the relevant legislations. Then the report will provide the organisational structure of the placement agency as well as its’ working. After that, I will show how I have actualized as well as contributed to inter-professional working in this placement setting by sharing, cooperating and collaborating with other professionals for settling Kev, and also to provide him with social and health benefits. That is, by case studying Kev, I will providing the opportunities as well as the positive outcomes, we got it, as well as the challenges we faced. In addition, the theoretical and research material will be applied throughout the essay. Literature Review It is stated by NOS, Key Role 5, Unit 17 that, “Social workers must work in inter-professional team work.” Due to this key relation between social workers and the concept of inter-professional working, the focus will be first on providing an apt definition or even definitions of inter-professional working. Inter-Professionalism in this context may be defined as follows: “Inter-Professional working involves collaborative practice whereby, members of different professions and/or agencies work together to provide integrated health and/or social care for the benefit of service users.” (Barrett, Sellman and Thomas 2005). In this case, needy people can receive a more multiparty service, with joint health and social care teams interlinking and collaborating to support needy people who might have the complex needs. Whilst Ovretveit, Mathias and Thompson (1997, p.2) refers to inter-professional working as, how two or more people from different professionals communicate and cooperate to achieve a common goal. In my opinion, Barrett, Sellman and Thomas (2005) definition seems to apt and relevant, because I worked with the service users in G.U.M who had immigration issues, whereby, I reviewed their cases, co-operated with each service user and also collaborated with other professionals. One of the aims of inter-professional working is to provide a continuous service through an integrated collaborative approach from professionals. This requires the agencies and local authorities to work together and develop a complete and coordinated approach to service delivery by sharing information and using good communication skills. (Ovretveit, Mathias and Thompson 1997). Apart from the term, inter-professional working, I will also use the term multi-agency working to refer to my agency’s collaboration with other agencies to meet the individual needs of the service users. Multi-Agency working is defined as, use of coordinated supports from more than one agency to help an individual to obtain and maintain a livelihood through job, apt education, health, etc. (Payne 2000). Ovretveit, Mathias and Thompson (1986, p. 9) provides an additional perspective by providing definition for multi-disciplinary team, “A group of practitioners with different professionals training, employed by more than one agency, who meet regularly to co-ordinate their work providing services to one or more clients in a defined area.” On those lines, the organisation I did my placement with (G.U.M Agency) also operated within a multi-agency set up or as multi-disciplinary team. However, the bottom line is, irrespective of the terms used, the central theme to inter-professional working or multi-agency working is, the collaboration between the involved people or agencies and the quality of services rendered to the people have to be optimal. In addition, there are number of international as well as national laws and legislations, which facilitate both government as well as non-governmental agencies (NGOs) to support children and young adults who are in a threatened state, that too using the concept of inter-professional or multi-agency working. At a national level, statutes such as the 1999/2006 Health Act, the 2004 Children Act, the 2007 Local Government and Public Involvement in Health Act, and the 2012 Health and Social Care Act set out various strong guidelines on how agencies as well as professionals can cooperate and also work in partnership to promote more integrated care to the needy children or service users. (Glasby and Dickinson 2014). In this case, I was working specifically with an immigrant child in need (Kev) and within an agency (G.U.M). The other key perspective is there can be joint working between agencies and professionals, although they may have different roles and expertise. (HM Government 2010, p.31, 1.12). That is, it takes the view that “everyone shares responsibility for safeguarding and promoting the welfare of children and young people” and so although professionals or agencies may have different roles and expertise, even if there is minimal “common ground” between them and the needy, inter-professional working can be actualized. (HM Government 2010:40, 2.1). Inter-professional working sets out how organisations and individuals should work together to safeguard and promote the welfare of children and young people in accordance with the various laws. Therefore, at G.U.M, all the practitioners working to safeguard children and young people have understood fully their responsibilities and duties as set out in primary legislations as well as associated regulations and guidance. G.U.M works in accordance with the main legislations such as Children Act 1989; Equality Act 2010 with key legislation covering equal opportunities and discrimination; Rehabilitation of Offenders Act 1974, Protection from Harassment Act 1997; Human Rights Act 1998; Sex Discrimination Regulations Act 1999, Racial and Religious Hatred Act 2006 and Code of Practice issued by the Equality and Human Rights Commission. In addition, the Children Act 1989 places responsibility on all staff members to take action in relation to child abuse. Local authorities are also required to work closely with all agencies including private and volunteer services for protecting and promoting the welfare of children. These legislations guide G.U.M on fair treatment of all involved parties from workers, volunteers, students, clients and anyone who they deal with. (Crawley 2012). Organisational structure The charitable sector has countless experiences of how the needy people are not only identified but also not managed aptly. In that direction the organization, in which I undertaken placement, attempts to improve the standard of life of the immigrants by planning and implementing many social services related activities that may be of help to them. My placement was with an immigration aid unit (G.U.M). The aid unit is a registered charity that provides free legal advice and representation in matters of immigration, asylum and nationality. G.U.M was set up in the late 1980s, as a result of campaigns in the greater Manchester area as well as nationally against immigration controls. The aim and the philosophy of the agency are to advise and represent clients in issues of immigration, asylum and national law. I would like to introduce the operational structure of this organization through the “lens” of my personal working experience there, during my placement. The organisational structure is best described as a ‘fully managed team’ (Ovretveit cited in Anning et al. 2010, p.27). The Director is accountable to the Board of Trustees regarding the management work and also for the performance of all team members. The senior Caseworkers, Solicitors, Receptionists, Finance and Admin personnel all report to the Director. Social as well as care cases are always referred to me by the Legal Team Case-workers, and I then collaborate with the service users and the other agencies or professionals to find effective solutions for the service users. The primary role of the professionals in G.U.M is to empower the service user and help them settle into a better life in the United Kingdom regardless of their immigration status. This is where inter-professional working comes into the picture, as empowering and also settling the service user involves collaboration between G.U.M and number of external agencies. G.U.M agency collaborates with other organisations in health and social care sectors, with the UK border agency, refugee and asylum seeker partnership bodies, as well as voluntary and charitable organisations that provide services for individuals with immigration problems. The agency aims to challenge what it believes are racist and oppressive immigration controls, and support people who are most affected by the strict or even harsh boundaries of the immigration and asylum system in UK. Often the service users are people living in the local community, who are survivors of human rights abuses such as torture, trafficking, abuse, children out of divided families, and others who are in need and affected by immigration control. The nature of the work at G.U.M involves its professionals or staffs coming in contact with service users from different backgrounds. This means that the agency has to aptly manage diversity, and also has to be mindful to the possibility of anti-discrimination. Thompson (2006, p. 41) points out this key fact by stating, when organizations take diversity approach, they can tackle discrimination by presenting difference as a positive to be benefited from, rather than the basis of negative, unfair discrimination. Thus, G.U.M works as part of inter-professional or multi-agency working by providing continuous and also effective services to the people from different backgrounds with different immigration needs. Case Study As outlined above, the delivery of social services in G.U.M is through collaboration and mutual efforts of different professionals and agencies, and that is evident through the case of Kev. During my placement, I was assigned to the task of settling Kev, a teenager who was discriminated against due to his bi-sexual orientation and was deprived of his rights in his home county, where bi-sexuality can lead to death sentence. This 16-year-old was rescued by someone from his country who did not consider bi-sexuality as an offence. When Kev was referred to me, he was living in a church store-room in a pitiable condition. The store-room had no heating system, electricity or gas. In order to safeguard him and also settle him in better living condition, I had to initiate a two-pronged process. First of which is to collect adequate details about Kev, and then I had to collaborate with agencies such as social services, hospitals, other charities and children care homes. Basically, Kev as a teenager under duress was entitled to international protection under the UN Convention on the Rights of a Child (UN 1989 cited in Crawley 2012). I was able to initiate the process to find effective solutions for Kev by laying the foundation for inter-professional working with other professionals and agencies. In that direction, we first compiled Kev’s case history, with contributions from others, as we wanted to know his past life in Africa and all the difficulties he faced while travelling to the United Kingdom. (KR 6, 21: 21.3). Then as part of the main task of providing him with social and health benefits along with stable living environment, I shared information and collaborated with colleagues at work and importantly professionals of other agencies. To compile the case history of Kev, I identified a social worker in my agency, who had worked with Kev before and knew about Kev’s life and the events that led to his current predicament. Importantly, according to Barrett, Sellman and Thomas (2005), it is important to identify the individuals, professionals as well as the agencies with whom, one is likely to work with the most, based on their roles, services, likely priorities and also models of practice. On those lines, the social worker who collaborated with me played a key supporting role for Kev, and had a good intention or motivation to settle him. So, with this social worker, I collected and analysed all the information, gathered from the enquiry stage of Kev’s assessment. That information not only helped me to compile the case-history of Kev but also aided in deciding the nature and level of Kev’s needs and also the level of risk, if any, he may be facing. According to Children Act 1989, a child in need is a child who is unlikely to achieve or maintain a satisfactory level of health or development, without the provision of services. With Kev falling under the category of needy child or service used based on the above Act as well as the assessment, the plan of action was initiated. Opportunities and positive outcomes Culture is defined by Morgan (1998 p.122) as the pattern of interaction, the language that is used, the images and themes explored in conversation and the various rituals of daily routine in an organization. At G.U.M, the organizational culture got manifested through rituals, stories, humour, jargon, physical arrangements, formal structures and policies, informal norms and practices including personal rapport with the service users. Every individual or staffs like me is given a specific task. However, the manner in which that task can be completed is the prerogative of the assigned person. This way, the culture at G.U.M provides autonomy to the employee for choosing the strategy that best fits their task. (Munro 2011). In case of Kev, I chose the organizational cultural aspect of personal contacts, personal centred approach and personal involvement as a key to build a stronger relationship with Kev, and also to have Kev’s trust to understand as well as resolve his issues. (KR 4, 12: 12.1). Due to this aspect of personal rapport, Kev became comfortable with me and importantly contacted me whenever he needed my help. Because of which, I was able to collect more information about Kev’s needs and share it with other relevant professionals, thereby leading to inter-professional working. In addition, to practice empowerment, I shared information with other staff, and also focused on working with Kev in a personal centred way by letting him understand reality of how we were supporting him to find his strength, to hold on to it, to express his choices, to take reasonable risks, and also to engage him in the problem solving process (Thompson 2003). Empowerment is linked with anti-oppressive practice because by empowering and enabling Kev, we wanted him to overcome barriers he faced regarding place and food. When following the organizational cultural pattern of personal-centred approach for empowerment of Kev, I had to share information with other staffs, and this clearly showcases how the organizational culture also contributed to the facilitation of inter-professional working. In addition, organisational culture is classified into four major types: the power culture, the role culture, the task culture and the person or support culture. (Handy 1993). On those lines, I would describe my placement organisation’s culture as a combination of task culture and person culture. It is such a combination because in G.U.M, the emphasis was on getting the job done by bringing together appropriate resources for service users, and also because the principal focus was on the service users and the formulation of strategies to support and assist them to have a better life. When the task of supporting the service users was done by bringing together resources including other professionals or agencies, the role of inter-professional working is evident. As a task culture team, we depended on the unifying power of each member to improve efficiency and service delivery (Brooks 2009). In addition, by working as a team to accomplish task and also support people, our professional group worked developed a culture whereby, staff regarded themselves as members of the organisation first and then only as the members of their respective professions. Thus, the inter-professional way of working was carried out as part of organizational culture at G.U.M with the intention to provide integrated health and social care for the benefit of Kev, which was positive and successful. During my placement at G.U.M, I was in contact with a number of professionals as well as agencies particularly in relation to Kev’s situation, all of whom had basic to high level awareness about the need for professionals to work together more effectively under inter-professional working. The Pastor of a Church for instance was the person who gave a temporary residence to Kev by accommodating him in a church store. However, the Pastor understood the fact that the church store was not the right place for Kev to stay for a longer period, and so became concerned. So, when I made contact with the Pastor to have a better insight of Kev’s wretched situation, in line with inter-professional working he provided good support. Then, in order to find a better living place than the church store for Kev, I further interacted and worked with the Pastor’s wife, who accommodated Kev in the church, which was better than the store. Then, as part of multi-agency working, I contacted HH Children’s social services, who understanding the concept of inter-professional working dealt with Kev’s social issues such as food, clothing, etc. Importantly, on the same lines, I approached the hospital, who looked into Kev’s ill health and took the necessary steps. Then, importantly, as part of inter-professional working, I liaised and worked with the Children Care Home who provided Kev with a stable, long-term residential option. From this, it is clear that collaborative practice of teamwork as part of inter-professional working helped us in providing integrated health and social benefit for Kev. In this case, the work involved liaising with relevant professionals and agencies, explaining Kev’s situation to them, further increasing their awareness about inter-professional working and thereby utilizing them to provide Kev with the basic human rights or necessity of right to a home and food. I realised that the good awareness about inter-professional working among the relevant professionals and the agencies helped all of us to understand, that we have key things in common and that we can each contribute distinctively, thereby working in a complimentary manner. (Whittington, 2003). Therefore, resolving Kev’s case demonstrated that through teamwork and sharing all the important information as part of inter-professional working can produce better outcomes for service users, staff members and the organisation itself. Another key part of inter-professional working is strong partnership between the involved professionals or parties. Much of the theoretical work on strong partnerships emphasises on the aspects of trust, shared vision and ability to adapt, and all that was visible in the inter-professional working of us. (Salmon 2004). For example, when I first referred Kev to HA social services with the intention to find him a place to live in, I was informed by a social worker working there that their organization have a defined timescale of at least three days to assess Kev’s case and provide him with appropriate social care services. Although, the social worker expressed his inability to rush Kev’s case due to organizational policies, in line with inter-professional working, he worked with me to find a temporary residence. That is, I and the social worker by working in partnership contacted the pastor, with whom Kev was previously staying. We asked him whether Kev could stay at his house for three more days till the assessment was finalised, for which the pastor readily accepted. From this, it is clear that inter-professional working can lead to strong partnership between professionals, and that can lead to positive outcomes. Challenges Organizations like G.U.M could face structural oppression, when the organization as a whole or certain individuals within it, could act detrimentally against others. To counter those structural oppression scenarios, apt anti-discriminatory practices have to be carried out for enabling all the individuals of the organizations to work in an unbiased and free-handed manner. This oppression on the part of the organizations or groups within it comes on the sociological theory of social oppression theory. According to Jarrett (2000), when institutions or groups in the institutions “conspire” to deprive any individual or group of the needed resources, which are necessary for personal and social development and the ability to make a valuable contribution, such institutions are said to be engaging in structural oppression. This structural oppression could mainly happen, when one group has divergence with other group or individuals, while working as part of inter-professional approach. Basically, it is clear that working as part of inter-professional approach apart from providing positive outcomes could also lead to difficult challenges. This is because multi-disciplinary or multi-agency working could bring in multiple perspectives, all of which could lead to more divergences instead of congruency. When the divergences are on the majority side, then it could reflect as structural oppression. Ovretveit, Mathias and Thompson (1986) explain that the point of inter-professional approach is to bring together the different skills that service users need. However, differences or structural oppression can degenerate into disputes and also unsettling conflicts, with the service user being the worst affected as they would not receive the expected service and also their position could be weakened further. Weakening the position in the sense, the service user or the needy individual’s personal issues including confidential information about them could be threatened. I faced similar predicament during my placement at G.U.M. At my placement agency, confidentiality and equality was given greatest importance. Importantly, disclosing confidential information was a violation of G.U.M’s policies and can lead to various disciplinary actions including termination of access to the organisation’s information system as well as facilities, and even termination of employment. So, we were instructed to make sure that each case was kept confidential, and the case details of the involved individuals were not leaked out. On the same lines, I was given clear guidelines to maintain confidentiality in the case of Kev as well. In that direction, we made sure that the original identity was kept secret and not even the smallest hint about who he was and what is his problem were given out. Despite these strict guidelines and strong measures from our side, due to certain limitation in the physical environment at G.U.M, we faced problems. That is, I found it difficult to work as a part of a multi-disciplinary team at G.U.M because our teams were co-located meaning that we shared the same premises. Due to this co-location, issues concerning client’s confidentiality were compromised as conversations between the team members were conducted in the presence of other team members. If these members are in the majority and could have dubious intentions, then structural oppression was possible. However, despite such a “detrimental” environment, in line with the anti-discriminatory practices we made sure that the confidentiality of all the service users including that of Kev was protected to the maximum of our ability and knowledge. The key facet of anti-discriminatory practice is managing people including service users in an ethical manner without any biases. That is, they have to be managed and treated without bringing in their “perceived” or stereotypical weaknesses or inferior aspects. Although, focusing on the service users’ ethnicity, race, gender, sexual orientation and so on is vital for managing as well as for giving customized care to the service users as part of social work, those aspects could be sidelined if those aspects are perceived to be discriminatory in nature. On those lines, as part of anti-discriminatory practice, we made sure that all the key and confidential details of the Kev from his original name or complete name to his problems are not brought out during casual conversations at the common location. We gave alias to the original name so that the service user’s original identity is protected. In addition, we also kept most of the case details in secured paper as well as other digital file format. With confidentiality being considered as a major tenet of G.U.M’s functioning, all these anti-discriminatory practices had a strong backing. Importantly, with co-location providing certain advantages, and with the confidentiality having to be secured, anti-discriminatory practices was very helpful. That is, the advantage with co-location is, it helped in the optimum use of time and resources, and also it aided communication and information sharing between the members, improved relationships between the professionals and the service users to produce better outcomes, thereby strongly facilitating inter-professional working. Thus, considering how co-location facilitated inter-professional working, confidentiality issue was aptly managed through anti-discriminatory practices. The other challenge with inter-professional working in G.U.M is local authorities or professionals from local bodies may not complement our work in the right manner. On those lines, Lord Laming pointed out that there was a pervasive culture among local authorities, who have the responsibility of protecting children, to delay intervention. (House of Commons’ Health Committee 2003). This delayed intervention on the part of local authorities was also visible in the case of Kev. Many of the failures on the part of the local authorities are related to lack of collaboration among all the local bodies, problems with information sharing, low accountability protocols and field workers having to deal with large caseloads, understaffing, poor management and inefficient training. (HM Government 2010). I also faced the similar issue of delayed intervention on the part of the local authorities in the case of Kev. That is, I not only compiled a case history of Kev’s deplorable condition but also the came up with key options for the perusal of the local authorities. Despite my efforts to ensure that information was shared between the agencies including the local bodies, the problem was, it was not shared in quick time. With the local authorities delaying the relevant procedures, the care as well as the benefits which were meant to Kev, also got delayed. This delay deeply impacted Kev as well as me. Kev expectantly waited that we could find some apt accommodation for him, and so gave all the details about him with a lot of hope. However, when he came to know that the local authorities are delaying, it made him depressive and feared that his hope of getting a good accommodation could be delayed further. Personally, this delay made me restless as a whole and also anxious whether Kev’s case can be processed without any hitch. Despite the anxiety, I was willing to push the limits and try all the things in my control to get the necessary clearances from the local authorities. In addition, the delay was also because of the distrust that was prevailing among certain professionals in the local bodies. Although, we facilitated inter-professional working, certain professionals were reluctant to share information fearing that the shared information could be potentially misused. As they wanted to protect their professional standing, they took time to analyze the case of Kev before coming up with their decisions. Thus, it is evident that inter-professional working faced challenges when local authorities were involved, mainly in the aspect of delayed intervention. Apart from the above discussed challenges within the internal environment, inter-professional working in G.U.M faced a key challenge in the external environment. Despite the obvious need to work collaboratively, there are noticeable hindrances from the current coalition government’s policy of wide scale cutbacks. Multi agency work is being used as a way of reducing state intervention but at the same time, statutory and non-statutory agencies (who require this funding to operate properly) are facing large-scale cutbacks on funding (Unite the Union 2010). This step has negative impact on G.U.M as well, with the government stopping all free immigration advice and judicial help on cases in Magistrate Court. Therefore, service users who came to G.U.M were referred to other agencies such as solicitors as it became difficult to pay for their legal help. This affected the way G.U.M could support its service users with very low income. Therefore, due to these legislations and policies, inter-professional working was negatively impacted. Even then, with the involvement of other commercial parties, inter-professional working was carried out in a different manner. Conclusion In this case, by working together in line with the inter-professional approach, we the professionals from different agencies played a constructive role in finding a place for Kev to live in and also referred him to hospital to treat his ill health. When professionals come together to collaborate, we bring together our skills, knowledge, experience, perspectives and so on, thereby contributing to a positive outcome. At G.U.M, where I undertook my placement, I came across a service user by the name of Kev. By understanding his pitiable condition, I first prepared a case history and then initiated the main task of providing him with a better place to live and also other social as well as health benefits. For the main task, as part of inter-professional working, I collaborated and stuck joint partnership with number of professionals from the pastor to the social workers and other professionals at other agencies, colleagues at G.U.M and many more. With the organizational culture at G.U.M also playing a facilitating role for inter-professional working, I used personal centred approach and personal involvement to deal with Kev, and also followed task and person culture for the effective handling of him. In addition, as I worked with professionals with basic to good knowledge of inter-professional working, positive outcomes were evident. As we developed strong joint partnership, it led to benefits for Kev in the short run as well as in the long run. Even then, we faced challenges regarding co-location as it led to confidentiality issues. Also, we faced the problem of delayed intervention from the local authorities. The issue of cutting off of government funds also was a major concern for us. Despite these challenges, the opportunities and positive outcomes clearly superseded or dominated those challenges. With Kev successfully placed in a home, where he is happily living with other children of his age while waiting for his asylum decisions from the Home Office, it strongly validates the fact that inter-professional working is an effective practice and is a necessity for providing quality service to the service users like Kev. References Anning, A, Cottrell, D, Frost, N, Green, J and Robinson, M., 2010. Developing Multi- professional Teamwork for Integrated Children’s Services. Open University Press. Barret, G, Sellman, D and Thomas, J., 2005. Inter-professional Working in Health and Social Care: Professional Perspectives. Basingstoke: Palgrave MacMillan. Brooks, I., 2009. Organisational Behaviour. Edinburgh Gate, U. K.: British Library Catalogue-in Publication Data. Crawley, A., 2012.The United Nations Convention on the Rights of the Child. 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