Putting the ‘I’ back into multi-disciplinary teams

Featured article - 13 December 2017
Dr Robin Miller, deputy director of the Health Services Management Centre

It’s an old cliché that there are no ‘I’s in team. This well-worn phrase evokes despondent sports coaches rallying their troops, exasperated guide leaders inspiring teenagers, and hopeful facilitators setting construction challenges involving straws, sticks and / or marshmallows. Beyond its familiarity the saying does have a point. Good teams work on the basis of reciprocity and trust enabling members to go beyond their own interests to achieve a common good. Simply requiring people to meet on a regular basis or denote themselves as being part of the same team is unlikely to change behaviour. Conscious commitment to a collective endeavour is required.

• Delivering integrated care: the role of the multidisciplinary team

MDTs are made of ‘I’s

But it’s also fundamentally flawed. On a pragmatic basis, we all know that teams are a collection of ‘I’s so pretending that it’s something different is not a helpful start. Indeed the point of a team is that it connects and co-ordinates the unique contribution of individuals into something more than their separate offers. This is especially the case in multi-disciplinary teams (MDTs) in which we need a diversity of professional and practice backgrounds to respond to the diversity of the people concerned. For example, I recently spent a morning in Thurrock on research fieldwork and heard from a GP practice about the benefits of having a ‘local area co-ordinator’ as part of their MDT. Without this alternative ‘I’, this primary care team would be much less aware of community resources available to their patients.

• SCIE: developing an integration scorecard
• SCIE's integration resources
• Stronger together Thurrock

Understanding our ‘I’

Beyond being the basic component, we know that being aware of ourselves as an ‘I’ and how we participate in a team is central to teams functioning successfully. MDTs stand or fall on their internal dynamics and the ability of individual members to support, challenge and inspire their colleagues. It is therefore surprising how little investment we make in our ability to practice as responsible team members, and in particular with those from different backgrounds. At a recent Better Care Fund event in Birmingham there were very few examples of explicit team development. Participants who did report such activities highlighted the major benefits gained from relatively little time investment.

Putting the ‘I’ back

In conclusion then there most definitely needs to be ‘I’s in MDTs. ‘I’s are what brings the potential synergies and ‘I’s can keep teams focussed on the people who require support. The economic case for MDTs is currently being evaluated. You can guarantee that any benefits will not be realised without the right ‘I’s for the population concerned, individual and team development, and data for team improvement.

So let’s hear it for MDTI’s – multi-disciplinary teams of individuals.

• Dr Robin Miller is co-author of Working in Teams
• Robin Tweets @RobinHSMC
• Health Services Management Centre on Twitter