Community feedback about Multi-Disciplinary working
As part of their own review of Multi-Disciplinary working, Islington Clinical Commissioning Group asked Healthwatch to interview some patients, family carers and support workers. 12 gave consent and seven people eventually took part. Five of these were family carers, one was a patient, and one a support worker. We've shared our findings with commissioners. Here is what we learnt.
Are outcomes improved?
Understandably, it was difficult for respondents to know whether being discussed in the Multi-Disciplinary team meeting had made services more co-ordinated. It was not possible to show better outcomes except in one case where a respondent had been supported around hoarding. However, despite not being completely clear what the interventions had been, five respondents did feel that having a co-ordinator had made things easier. ‘I can phone her and discuss things quite easily. It’s easier to deal with one person that 5,000 doctors’ (Respondent 4). ‘[The MDT Social Worker] was supportive of him and me… she was brilliant at co-ordinating… she could tell me the best options and then leave me to it’. (Respondent 7)
Are people given greater control and support to manage their needs?
Respondents generally talked about helpful staff, although some cited delays because of a turnover of (non-MDT) staff dealing with some of the queries that had been raised through the co-ordinator. There was generally a feeling that mental and physical health needs were considered. ‘She’s got time for mum and she cares...Not sure what her job is but she listens and chases up’ (Respondent 1). ‘There’s a good rapport. You don’t mind her coming in your home’ (Respondent 4). ‘I’ve not met an unpleasant person yet’ (Respondent 6).
However in some cases it was felt that social workers ‘don’t really listen to mum’s needs’ or not having ‘a clue who to talk to’. In one case, the family carer had not felt heard in the decisions social workers made about their loved one, and another respondent felt that social workers didn’t understand their loved ones real needs. This related to the general social workers rather than specific MDT input.
Respondents recognised the support of the MDT Social Worker in chasing up other staff or information and had found this helpful in managing needs.
Are people seen by a range of professionals at home?
Yes, respondents made it clear that they were being seen by a range of people at home, including matrons, district nurses, navigators (a support service provided by Age UK Islington) and social workers. Two respondents noted that it was useful to have a co-ordinator to offer assurance when the GP or other professionals could not be contacted.
Is information and support provided to carers? Are carers supported and heard?
There wasn’t strong evidence of direct support to carers, though one respondent remembered being asked about a carer’s assessment. However, there was a sense that having one designated person to talk to and to co-ordinate on their behalf was a really positive thing. ‘It’s another perspective and can reassure…From the minute she came on to the phone it was different…Where there are loose ends she ties them all up…Whatever it is, I think it’s a really good idea. You need that continuity.’ (Respondent 1 referring to input from MDT Social Worker).
Two respondents felt that their views as family carers weren’t really heard (by the general social workers) and that this had been stressful.
Did services work together?
Responses suggest that the MDT worker had been able to co-ordinate and chase things up, rather than that services had worked together.
‘It was my first time working with a network…They were all trying to do their best. How they communicated and the authority they had to speak was unclear… She directed us’ (Respondent 7).