TY - JOUR
AU - L. Thana
AU - G. Wistow
AU - M. A. Durand
AU - A. Pacho
AU - L. Rehackova
AU - N. Douglas
AU - M. Al-Haboubi
AU - N. Mays
A1 - 
AB - ObjectivesHorizontal integration of health and social care in England is frequently supported by multi-disciplinary (MDT) case management focused on high-risk older people with multiple chronic conditions living in the community. This paper analyses MDT working in two of the 25 areas participating in the Integrated Care and Support Pioneer Programme in England. The analysis aims to understand the experience of frontline staff in such MDTs of working with professionals and staff from multiple sectors, and their perceptions of their roles and the benefits of integrated working.MethodsWe conducted semi-structured interviews with a purposive sample of 54 frontline staff from a range of professional backgrounds working in 11 community-based MDTs in two Integrated Care and Support Pioneers. A largely inductively developed coding frame was used to thematically code and guide analysis of verbatim interview transcripts from audio recordings.FindingsStaff conceptualised the team as a cohesive yet 'porous' entity, able to evolve a shared sense of purpose to deliver holistic care that helped to level traditional professional hierarchies, enable collective problem-solving and share responsibility for patient care. MDT working was seen as benefiting staff and patients. Despite strong similarities between the MDTs in members' understandings of the role and purpose of a MDT, each MDT was adapted to its context and the needs of the population served. The process of working through inter-professional tensions seemed to strengthen relationships within the team and enhance its ability to work effectively in the local health and care system. However, without performance or outcome measures, these perceptions were driven by 'soft' intelligence alone.ConclusionsFrontline staff accounts of MDT working demonstrate their strong commitment to this way of working, as a mechanism enabling them to deliver more holistic care with perceived benefits to patients.
AD - Research Fellow, Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.; Professor in Social Policy and Honorary Professor, Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.; Professor in Social Policy and Honorary Professor, Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK. RINGGOLD: 4905; Associate Professor, Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.; Professor of Health Policy and Director, Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
AN - 40682520
BT - J Health Serv Res Policy
C5 - Healthcare Disparities; Education & Workforce
CP - 1_suppl
DA - Jul
DO - 10.1177/13558196251349388
DP - NLM
ET - 20250719
IS - 1_suppl
JF - J Health Serv Res Policy
LA - eng
N2 - ObjectivesHorizontal integration of health and social care in England is frequently supported by multi-disciplinary (MDT) case management focused on high-risk older people with multiple chronic conditions living in the community. This paper analyses MDT working in two of the 25 areas participating in the Integrated Care and Support Pioneer Programme in England. The analysis aims to understand the experience of frontline staff in such MDTs of working with professionals and staff from multiple sectors, and their perceptions of their roles and the benefits of integrated working.MethodsWe conducted semi-structured interviews with a purposive sample of 54 frontline staff from a range of professional backgrounds working in 11 community-based MDTs in two Integrated Care and Support Pioneers. A largely inductively developed coding frame was used to thematically code and guide analysis of verbatim interview transcripts from audio recordings.FindingsStaff conceptualised the team as a cohesive yet 'porous' entity, able to evolve a shared sense of purpose to deliver holistic care that helped to level traditional professional hierarchies, enable collective problem-solving and share responsibility for patient care. MDT working was seen as benefiting staff and patients. Despite strong similarities between the MDTs in members' understandings of the role and purpose of a MDT, each MDT was adapted to its context and the needs of the population served. The process of working through inter-professional tensions seemed to strengthen relationships within the team and enhance its ability to work effectively in the local health and care system. However, without performance or outcome measures, these perceptions were driven by 'soft' intelligence alone.ConclusionsFrontline staff accounts of MDT working demonstrate their strong commitment to this way of working, as a mechanism enabling them to deliver more holistic care with perceived benefits to patients.
PY - 2025
SN - 1355-8196 (Print); 1355-8196
SP - 36s
EP - 47s+
ST - Frontline staff perspectives on multi-disciplinary team working and the effectiveness of integrated service delivery: Findings from the evaluation of the Integrated Care and Support Pioneers in England
T1 - Frontline staff perspectives on multi-disciplinary team working and the effectiveness of integrated service delivery: Findings from the evaluation of the Integrated Care and Support Pioneers in England
T2 - J Health Serv Res Policy
TI - Frontline staff perspectives on multi-disciplinary team working and the effectiveness of integrated service delivery: Findings from the evaluation of the Integrated Care and Support Pioneers in England
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.1177/13558196251349388
VL - 30
VO - 1355-8196 (Print); 1355-8196
Y1 - 2025
ER -