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Abstract
Professionals from many different organisations can be involved in the care of a child, especially a child with special/complex needs. A literature review was undertaken to explore some of the barriers and facilitators of joint working with the aim of informing local practices.
Different models of joint working and the barriers and facilitators to effective multidisciplinary team working were identified. Four of the most prominent themes for effective working were: co-location; key workers; appreciation for other agencies; communication and information sharing.
A multi-faceted approach incorporating a variety of strategies such as meetings, improving working relationships, and developing communication networks may prove successful in facilitating more effective multidisciplinary working than one single strategy.
Key words
* Children: complex needs
* Community children's nursing
* Multidisciplinary teams
* Communication
Multi-professional, community-based services are seen as an effective means of delivering a high standard of care to children and families (Youngson-Reilly et al 1995, Borrill 2002, Tait et al 2002). This means that many professionals from many different organisations can be involved in the care of a child, especially a child with special/ complex needs. The numbers of people involved highlight the need for agencies to communicate and work together to ensure that services are not missed or duplicated (Cass et al 1999). The concept of joint or team working is central to Every Child Matters (DfES 2003), The Children Act (2004) and me National Service Frameworks in England and Wales (Department of Health 2004, Welsh Assembly Government 2005).
If it is effectively implemented, team working improves service provision and leads to better standards of care, lower levels of stress for parents, job satisfaction for staff, better communication, pooling of skills and resources and mutual support for agencies as well as for the child and family (Borrill 2002, Cameron et al 2000, Watson et al 2002, 2004).
Joint working brings many benefits but the differences between agencies mat follow different disciplines, have different training, different methods of working, goals and priorities, and often work in different buildings, can prevent the realisation of these benefits (Cameron et al 2000). As a community children's nurse (CCN) and a specialist school health nurse, I have seen many good examples of multidisciplinary team working but I have also seen,...