Planning and Managing Interprofessional Working and Teams

Abstract

The 1980s were a boom-time for teams in the Nordic countries, the UK and in New Zealand. But in the mid-1990s many working in health and social services began to question the cost-effectiveness of multidisciplinary teams. Service managers in both health and social services had to increase productivity and reduce costs. They looked more closely at the costs and results achieved by the different services they managed. Some felt that single-profession services such as a community nursing service were easily understood by referrers, purchasers and funders and easier to sell than a team service. Pressure on costs and competition led agencies to be more protective of their resources, and reluctant to assign staff to a team. Paradoxically, in some places the effects of reforms, rather than the intentions, was a pulling-back into agency- and profession-specific services and an increasing fragmentation of services. In others, purchasing agencies and joint health and social service commissioning groups continued to emphasise teamwork, but called for more information about activity, costs and effectiveness.