……”we”……. not “me”…..
Decision Making & Co-ordination
in a
Multidisciplinary Team
Monica McTurk
Clinical Co-ordinator
Community Child Health /
Head SLT for Special Needs, Dumfries & Galloway
February 2010
The Multidisciplinary Feeding Team
 Paediatric Gastroenterologist
 Speech & Language Therapist
 Paediatric Surgeon
 Physiotherapist
 Community Paediatrician
 Occupational Therapist
 Family GP
 Psychologist
 Paediatric Radiologist
 Social Worker
 Clinical Nurse Specialist
 Community Nurse
 Dietician
 Health Visitor
 Educational Staff
Vital Features of Intervention in Enteral
Feeding must be to:
 Ensure
feeding is safe
 Maximise nutrition
 Support the family – whatever the feeding difficulties
 Consistency of advice
 Timely communication
 Co-ordination
 Support
during diagnosis
 Communication
 Respect for parents
 Respect for expert knowledge
 Attitudes and values
 Organisational issues
A Key Worker is both a source of support for
disabled children and young people and their
families and a link by which other services are
accessed and used effectively. Key workers
have responsibility for working together with the
family and with professionals from services and
for ensuring delivery of an inter-agency care
plan for the child and family.
Practice Standards
The role of the key worker should include:
 Providing information
 Identifying and addressing the needs of all family members.
 Providing emotional and practical support as required.
 Assisting families in their dealings with agencies and acting
as an advocate if required.
This role will be achieved by:
 Pro-active,
regular contact.
 A supportive, open relationship based on respect for the
view of parents, children and young.
 A family centred (not only a child centred) approach.
 Working with the families’ strengths, acting as an
advocate or enabling parents, children and young people to
access advocacy support as required.
What should Co-ordinators Aim to Accomplish?
They should:
 Enable families to see their group professionals working in
unison with similar goals for the good of their child.
 Increase level of information available to parent.
 Increase the level of family participation.
 Reduce to ‘running around’ element for parents.
 Reduce the parental and professional confusion and
frustration.
 Reduce duplication and gaps in services.
What should Co-ordinators do to Achieve that?
They should:
 Listen, hear and understand the concerns and the priorities
for families.
 Address the present, medium and long term implications for
the child’s disability for the family; families do not want specific
answers or predictions, they want opportunity to discuss – and
to feel they are being heard.
 Mediate, if needed (i.e. between the professionals and
between the family and the professionals).
 Facilitate, if needed (e.g. appointments for the family).
 Ensure that the agreed service plan is implemented, through
regular contact with other workers.
 Ensure that the agreed service plan is implemented, through
regular contact with other workers.
 Contact the family regularly and pro-actively (on an ‘I am
interested in you lives’ basis rather than on a ‘ring me, if you
have a problem basis).
 Be a ‘signpost’ for other services.
 Ensure that the family has access to any professional whose
information the family is unclear about.
 Provide support to other ‘client team’ members.
What Skills do Co-ordinators Need to Have?
 The
ability to be unbiased. They must bit be seen to ‘take
sides’ and ‘wave their own discipline’s flag’. They should be
able to accurately reflect what is being said by others, including
the family.
 The ability to take a broad overview of a situation, without
becoming immersed with particular details.
 Skills to work in the multiagency team. They need to have an
equally high regard and respect for families, other
professionals and their disciplines.
 Honesty, so that promises are not made that cannot be
fulfilled by other disciplines.
 The ability to talk to anyone at their level without jargon.
 Skills to negotiate with other disciplines concerning their
contributions to the family, without ‘dictating’ to others.
 They should be human, informal and appear to have time for
the whole family.
 The ability to plan well ahead and anticipate.
 The ability to chair meetings (some professionals feel they
need training).
The Role of Care Co-ordinator is NOT about?
 Being a family befriender or counsellor – other than in the
usual professional role.
 Being responsible for solving all actual and potential
problems for a family.
 Being responsible and / or accountable for the actions or
omissions of other professionals and / or agencies and their
support staff.
 Being a voice for other agencies, other than within the
sphere of an agreed family care plan.
Potential Outcomes ….
Proactive management of needs through multidisciplinary
care co-ordination
Reduced family stress
Reduced duplication in assessment / reporting to families
Holistic view of whole family
Equity of approach
Single access point for families and professionals
Reduction in response time to parents