Multi Agency approaches on the ground to Health & Social Care

One of the areas that concerns me greatly is the number of organisations that are trying to do the same or similar things. They often say or talk about doing the same things but just by different organisational structures or bodies. The number of similar reports done by organisations is astounding. 

There is a quote that I like and try to follow ‘there is no limit to what a man can do so long as he does not care a straw who gets credit for it’ Charles Edward and quoted by President Henry Truman, President Reagan had a plaque of it on his desk too.

Luckily quite early on in my career, I had some great mentors that I worked with. These people truly helped me to develop. One such person when asked what is the most important thing that I need to know about this job? (a question I have asked often). The answer I was given has stood as the best piece of advice and it was to develop a network of like minded people in the area you work in. 

In my career, I often come up with issues, where the exercise, knowledge or plan required more resources than I had available to me. The above line moto time after time worked for me in achieving tasks which people told me that it was not possible. As long as i had a shared approach the job always got done.

One such exercise in my early days resulted in five different government agencies coming together with a total of seventy personnel involved to tackle a large scale problem. The issues were solved and almost a million pounds were saved or protected from the public funds. 

After this we developed a multi-agency group, where we could talk and share resources, equipment & personnel to do the job. Is this any different to the requirements to do joined up work as required by various legislation under health and care. Even the  set up of the ICS is a way which supposed to help in this area. The difference in our approach was that there were no managers. We did not want to talk, we just wanted to do our work efficiently. So within legal parameters we did just that.

I see many areas in the work that I am involved in have many branches doing the same job. Personalisation under the NHS is one such area. There are about five to six strains under this piece of work. They all do a great job, but there seems to be little interaction or a multi-faceted approach to this. For example, peer leaders, a brilliant resource but they are not integrated within personal budgets or social prescribing or information and advice. By integrating and sharing the work, you end up expanding your reach and giving support to each strand. 

It is really simple, and I do not know why people do not use the approach more often; especially in local government and health. You are not the only person dealing with this issue or problem in your area, region or country. If you reach out you will find others. The amount of time I have seen people write process and spend weeks doing it, or on projects that from the outside look the same and seem to have the same purpose. Or reports that are all published within weeks. when every authority is doing the same thing. Just ask if you can borrow the framework or process document, acknowledge them and use it. Most people are more than happy to share. Adaption may be necessary to tailor for your local needs. Or talk more, earlier work together it'll be cheaper and you'll have a bigger impact.

The same applies when working with members of the public. Often I see talented, skilled and very knowledgeable people being sidelined to shake tins, or sit at tables for the services. Often these people who often want to participate just are not given the opportunity to fully utilise their skills, which are often offered voluntarily. It is like stand there, do this and that is it.

In equalities, I have seen many local authorities and health departments talk about meeting the needs of minorities by disabled or other members of protected characteristics engaging with them, yet they will not think to ask people from the same characteristics who may be sat opposite them in an office. Or think about developing staff groups from these Equality strains. 

The word coproduction is often bandied around in health and care, without any real understanding of what it is, or what it takes to achieve it. For me it's always been just another form of using multi agency approaches. It's in the word co (togher) production (making it happen).

Utilising a multi-agency approach, whether from the same agency or external, to help in the work you are doing can make the job or issues substantially easier. Even when there are legal restrictions these can be easily overcome via a memorandum of understanding, make it clear what can or cannot be accessed or shared. In these times when every department seems to be underfunded and has a lack of resources it just makes sence.