Many aspects of healthcare have changed rapidly since the beginning of this year as the NHS faced the biggest challenge of its existence – the Covid-19 pandemic. Several of these changes are long overdue and ‘necessity (being) the mother of invention’ – or more correctly the mother of implementation in most cases – rings true in a system under pressure where new ways of delivering care have long been recognised but were only being carried out in a limited capacity due to the accepted and inevitable, inertia of organisational inability to enact pathway and service redesign. COVID-19 has transformed all that and remote consultations, fewer 1-1 interactions and well received recommendations for self-care have become the adopted norm.
These much needed and accepted modifications have come on a background of a gradual and piecemeal transformation of healthcare delivery over the past few years aimed at meeting the increasing demand and improving patient care and experience. This was being achieved through improved use of resources across all locations, incorporation of IT, improving patient empowerment – but, mostly, via better utilisation of the entire workforce, enabled through broader training and a more flexible approach for the use of all staff. In essence, traditional professional boundaries have been increasingly stretched so that patients can benefit from a broader, more diffuse, skilled team. However, it is not simply doing more to achieve more – this approach has improved job satisfaction, stimulated career development, permitted all professions to work to their maximum potential, promoted inter-personal relationships and enhanced retention of staff. The total benefits amount to considerably more than the sum of the individual parts.
However, the advantages of being the member of a specific profession are also tangible; the sense of belonging and professional identity these bring must not be lost within the multidisciplinary team. Each member contributes from their own particular skill-set which commonly has been optimised and enhanced to deliver within specific clinical settings – providing generic higher level expertise. Individual professional development is exciting and rewarding. The opposite side of that coin is professional protectionism – others delivering activities considered within the domain of a specific professional group being seen as threatening; these can cause conflict if not recognised and addressed properly. The balance between identity and protectionism can be fine but what is vital for success is that each member is encouraged and enabled to contribute as part of a group that fully respects each other’s roles and abilities. This is happening at pace across all healthcare professions at all levels and coupled with the acknowledgement this contributes to staff wellbeing, is helping to support safe and effective patient care and as well as staff performance.
The value of multi-professional work has been fully exemplified in the rapid advances we have seen during the Covid-19 pandemic, assisting in keeping patients safe and out of the hospital environment when not needed and stepping up to address gaps in the service due to demands initiated by coronavirus infection on others. Collaborative working to maintain the, now, open interface across primary, community and secondary care and to holistically deliver comprehensive, effective services has never been so relevant. Several sectors of staff have been energised by undertaking additional responsibilities and this must be harnessed through inter-professional decision support mechanisms and systems alongside more standardised advanced healthcare training programmes.
This week the Academy has published a document, Developing professional identity in multi-professional teams, illustrating how professions can work together to maximise the potential of every member of the healthcare team. This will be invaluable in further developing services to deal with the delays and backlog caused by the current pandemic and to address the new, future world of endemic COVID-19.
© 2020 Academy of Medical Royal Colleges.