Barriers of Inter-professional Working, with a Focus on Teachers and Social Workers

The barriers of inter-professional working, with a focus on teachers and social workers.

Abstract

This small scale study explores barriers in inter-professional working between teachers and social workers. Four interviews were undertaken, which resulted in four key barriers in this type of work.  These include: information sharing, lack of understanding of roles, pastoral care not being prioritised and media influences.  It is thought that these barriers of inter-professional working have been the main causes for serious case reviews.

Introduction

In 1997, the Labour Government encouraged inter-professional working to tackle poverty and social exclusion of children, young people and their families. 

This study explores barriers with inter-professional working between teachers and social workers.  Two social workers and two trained teachers, one now a pastoral worker and one now a Special Educational Needs Co-ordinator, were interviewed.  The interviewees were all known to the interviewer and all worked within the same Local Authority.  The data collected was iterative, as themes were found and then were expanded on throughout further interviews.  This shows that it is a small scale study, not claiming reliability, as it is not a true representation of wider population opinions. 

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The interviewees opinions were used to compare to secondary sources already published.   The motivation for this research was due to the tensions seen in schools in terms of working in an inter-professional capacity.  Due to previous political backlash and media reporting, there is an increasing anxiety around people joining a profession which includes directly working with children in a safeguarding capacity.  In addition, as reported in the media, the increasing number of serious case reviews in terms of safeguarding is a factor that can affect teaching in the future.

As a result of serious case reviews, Every Child Matters (2003), as well as The Laming Report (2003) was introduced to remove legislative and technological barriers within inter-professional working.  Later, in 2014, Education and Health Care Plan (EHCP) was introduced to replace the Special Educational Needs statements, as no single professional can have an overall picture of every aspect of a child’s life. The EHCP’s allows a child to be assessed from an umbrella perspective of all agencies, detailing the four areas of need. 

Within this study, the main barriers for effective inter-professional working were as follows: firstly, information sharing due to IT systems and staff turnover; secondly, that there is a lack of understanding of other professional roles due to a lack of training in these areas; thirdly, pastoral work not being a priority in teaching due to time constraints and increased demands from the national curriculum; finally, pre-judgements of social workers roles due to media influences. 

Upon reflection, some of the barriers can be overcome by changes being made within working together.  Communication is crucial to overcoming these difficulties.  Furthermore, it is suggested to overcome these barriers an integrated IT system would be helpful, regular joint training between professionals could be effective, and as key professionals, such as class teachers hold valuable information they should be involved in decision making.   The study concludes that if these barriers were overcome, then there would be more positive outcomes.  All professionals should work together with a positive mind set and aim to achieve the best outcomes for all children.

Literature Review

Murphy (2004) defines inter-professional working as practitioners from various agencies and professional perspectives having a common understanding of the child’s situation and working together when dealing with difficulties.  Trodd (2011) goes further, stating that professionals collaborate on many levels of practice and need to be of the same mind set to look for ways to work together effectively. The New Labour government of 1997 encouraged inter-professional working as a new policy to tackle the problem of poverty and social exclusion, with a leading example of this being the launch of Sure Start Centres across the UK in 1998 (Frost and Robinson, 2016).  Within good practice documents, working inter-professionally is now a main focus and is described as benefiting service users, parents, children and young people (Fitzgerald and Kay, 2008).  Integrated working, however, is not only working alongside each other in a planned and formal way but also includes single agencies responding to the ideas and decisions of others (Davis, 2011).  Failures of collaborative working have ended tragically, and in the case of Victoria Climbie, it was made clear that more effective information sharing between professionals may have prevented her death (The Laming Report (2003) in Fitzgerald and Kay, 2008).  The SEND Code of Practice (2001) has a strong emphasis throughout on inter-professional working to support pupils with SEN to provide a ‘seamless’ service.  This continues through the SEND Code of Practice: 0 to 25 years (2015) explaining that professionals have a duty of care and should be developing joint arrangements to improve services for children and young people who have Special Educational Needs and Disabilities (SEND).

Studies show that there is a correlation between burnout and disengagement of social workers due to regular conflict between families and other professionals (Travis and Lizano, 2016).  McFadden et al (2015) suggest that social workers are being over worked with excessive paperwork, poor working conditions and long working hours.  These issues create a huge problem due to consistency playing a significant part in a social worker’s mission (Shim, 2014).  Shim (2014) also adds that this creates significant costs to Local Authorities and creates staff shortages. This leads to higher case-loads for other social workers, meaning that outcomes for children and young people are affected.  Murray (2015) notes that findings from the Social Lives Survey clarified issues such as social workers not paying enough attention to their own wellbeing due to experiencing stress and depression. Alongside this, social workers have to cope with the political backlash portrayed by the media (Murray, 2015). Murphy (2004) explains that there is a constant anxiety around safeguarding issues which needs to be dealt with in an inter-professional manner through consistency and organisation.

Social workers are always ‘at the front of the queue to be blamed’ and experience ‘shoddy treatment’ from the media (Elwin, 2014;  Heyes, 2014).  Due to the social workers involved being advised to not discuss any matters with the media, the only view portrayed of the profession is a negative one (Elwin, 2014).  It is simply too easy to lay the blame for an unsuccessful intervention on an individual, creating a negative perspective on social workers from other professionals, creating a barrier of distrust (Heyes, 2014).  The media can influence the reader’s opinions and this is an issue due to the fact that often reports are biased and want the reader to view a person or story in a particular way (The Daily Quail, 2011).  The New Yorker adds that articles in the media are often the first impression people get of a story and this then influences the reader’s mind set when later recalling the details to coincide with what was expected (Konnikova, 2014).

Murphy (2004) argues that teachers and social workers often do not have any training in working with other professionals and in recent years, training for pastoral and non-curricular activities has not been as prioritised by class teachers due to increased pressures from the National Curriculum.  Lamb (2009) states that information on training, advice and support within the Local Authority are of benefit to all. He additionally states that these kinds of resources should be made available and be advertised to all involved in children’s services.  Inter-professional education allows for wider awareness of services that are available and creates an inter-professional working partnership between agencies, leading to less prejudgement of other professionals (Payne, 1995). It is advised that one should be comfortable in their profession before embracing the understanding of someone else’s; however, this can lead to a lack of awareness of other professionals roles, hence, prejudgements are made before knowledge of the basic skills and practices of other professionals has been understood (Carlisle, Donovan and Mercer, 2005).  Carpenter and Dickinson (2008) support this and add that professionals should ‘learn together to work together’ to overcome difficulties with inter-professional working to promote good understanding of values and perspectives of others, as everyone is aiming for the same outcome.  If professionals are trained to work together within issues such as: using appropriate language; decision making and showing respect and building trust, then each professional will be there to support the other as a collaborative unit when errors are made or when success is to be celebrated (CIHC, 2010).

Lack of information sharing has been a main issue regarding high profile cases such as Victoria Climbie, with the case report stating that there were communication issues between agencies, highlighting a serious failure to share information (Fitzgerald and Kay, 2008). Although outdated, an aim of Every Child Matters (2003) was to improve information sharing between agencies in order to remove legislative and technological barriers, alongside introducing a Common Assessment Framework (CAF) to be used across all children’s services. Although Every Child Matters is no longer in use, the CAF which was introduced is still in use. Each agency involved needs to be responsible for sharing information with other professionals; however, a main concern is the fine line between passing on relevant information and breaching confidentiality (Richardson and Asthan, 2006; Frost and Robinson, 2016).  Anning and Ball (2009) argue that it is difficult to find the balance between fulfilling your role accurately and appropriately protecting information. No single professional can have a full picture of a child’s needs and circumstances, meaning that anyone who comes into contact with the child has a role to play in sharing information and identifying concerns and then taking prompt and appropriate action (Department for Education, 2015).  The Laming Report (2003) recommended that the government should introduce a national database of all resident children in order to facilitate the sharing of information between agencies to make sure that all professionals are kept up to date at all times (Hughes and Owen, 2009).  The Data Protection Act of 1998 provides a framework to help professionals understand the regulations around sharing information in a lawful and professional manner (Cheminais, 2010). The most recent change in SEND provision is the move from Special Educational Needs statements to Education Health and Care Plans (EHCP), which identify needs across these three sectors (Gov.uk, 2014).  To make an application for an EHCP assessment, a number of professionals are involved who need to assess the issues (Ambitious About Autism, 2015). These issues are identified and a realistic plan is drafted of how provision will be implemented and how interventions will meet the child’s needs (Ambitious About Autism, 2015).  It will also detail how professionals will work together to achieve goals (Ambitious About Autism, 2015).

Often there is confusion over roles in inter-professional working.  Teachers can get engrossed in learning achievements and teaching and overlook about the holistic pupil.  This outlines the reasons for children in need, such as: children subject to a child protection plan, looked after children and children with a disability, to be assessed from an umbrella perspective, as professionals need to work together so that the best outcomes can be achieved (Todd, 2011). It is important to understand the responsibilities of individual professionals from their perspective, whilst valuing other opinions (MacDonald, et al., 2010).  It is often difficult to completely understand other professional roles due to different working conditions, working hours and patterns (Joint Improvement Team, 2009). The Joint Improvement Team (2009) also illustrate that there is often a sense of hierarchy of power, leading to a misunderstanding that actually no one is in charge, which can lead to a lack of alignment of perspectives and to mistrust.

Within inter-professional working, relationships need to be positive so that the best outcomes can be achieved. Carpenter and Dickinson (2008) state that working together more effectively will improve the quality of the care given and the outcomes for service users.  The Children’s Workforce Development Council (2009) argue working closely together within a good inter professional relationship prevents issues from happening in the first place, rather than having to deal with the consequences of those issues at a later date.  All members of the professional group and family need to feel valued and respected when sharing their views in order to develop partnerships so that all individuals have contributed to the key principles, which results in providing a good quality service (Great Britain Department for Education and Skills, 2003).  The Department for Education, Working Together Document has two key principles: that all professionals who have a responsibility in identifying concerns share information and take prompt action. They also need to provide a complete child centred approach, where there needs to be a clear understanding of the needs and the views of children (Department for Education, 2013).  This is due to the fact that no single professional can have a full picture of a child’s needs and circumstances (Department for Education, 2013).  The SEND Code of Practice (2015) explains that Local Authorities need to work well together to promote children’s wellbeing and improve quality of provision around them.  Alongside this, the Code of Practice recommends that professionals should work together so that the children and young people’s experiences, ambitions and expectations are provided for.

Methodology

The methods used in this study were semi-structured interviews to allow discussion to flow about the topic, but questions were prepared in advance to prompt conversation.  Interviews allow access to a person’s understanding of concepts that are of interest to them, allowing data to be collected about personal experiences, providing an insider’s perspective (Lankshear and Knobel, 2004). This is a qualitative approach, which allows for open ended responses, capturing unique themes and answers that are up for interpretation (Cohen and Mannion, 2011). This study is open to bias, as only one method of data collection was used out of the four potential methods.  The interviewees were people readily available and known to the researcher. The Hawthorne effect, defined as individuals modifying their behaviour due to the awareness of them being observed, may have had an effect on the results due to this being present (The Association of Qualitative Research, 2016).  Secondary sources have been used and investigated in an attempt to limit the bias. 

Triangulation is when something is viewed from a number of different points rather than just one (Thomas, 2013). With the limited time available to collect data, secondary sources were used to triangulate the data to see a different point of view.  Existing secondary research provides a foundation for a topic to be researched around. This helps with triangulation, analysis and interpretation, allowing the data found to constantly fill gaps that there may be in current research (Stewart and Kamins, 1993).  The process of data collection was iterative.  This was a repeated process of returning to the data already found, then constantly expanding on it.  Data was consistently collected using the last interview to shape the next collection of data (NHS, no date).

The research aimed to ask the same questions to each interviewee. However, when the research started, it felt more appropriate to ask the following interviewees more about the themes that had emerged from the previous interview, rather than using the same questions.  This study is claiming validity due to the potential to repeat the study with the same interview questions.  Small scale qualitative research produces localised data that may not reflect the views of a wider population, making it difficult to generalise. As a consequence, generalisability is not being claimed by this study.  The findings cannot be generalised because the experiences may not be repeated, as there may be different circumstances each time and the same expectations cannot be assumed (Thomas, 2009).  This study is not claiming reliability, as if it was repeated, it is unlikely that the same results would be obtained.  If this study was reliable, then the results would be a representation of the whole population (Golafshani, 2003), rather than just the few people that have been interviewed in this case.   The study complied with the University of Cumbria research ethics policy (University of Cumbria, 2016).  The interview questions were shared before the interview began and no harm has come to anyone during the research.  The interviewees made the choice to take part in the study and had the right to withdraw at any point.  Ethical deliberation occurred throughout the study, which was conducted to widen educational knowledge and develop teacher practice.

After the first interview was completed, it was transcribed and then analysed to find themes. This was inductive analysis, as no particular themes were expected.  Once themes emerged, the next interviews were based around the themes, and questions were shaped to find out more information about those themes.  The following interviews were deductive.  This is what is described as a cycle of inductive and deductive reasoning, as inductive analysis is carried out to generate a theory and then deductive analysis is used to confirm the theories (O’Leary, 2004).  The knowledge derived from the study is subjective and is open to interpretation.  It is the opinion of someone.  The study takes into account two different perspectives which are open to interpretation about the same concept, posing a meaning and opinion on a subject, something Crotty (1998) describes as subjectivism.  The research was conducted within an interpretivist paradigm.  This is where the researcher acknowledges and explores their cultural and historical interpretations of the social world, subject to their own opinions.  The data collected was qualitative, meaning that it cannot be put into graphs or images, as numerical data can be (O’Leary, 2014).  Phenomenology was also used during this study.  Phenomenological research focuses on understanding how people view themselves and the world around them, giving them a chance to give their own opinion, providing flexible outcomes (Robson, 2011).

Results

Four interviews were conducted with both teachers and social workers.  Two social workers and two teachers were interviewed. 

The two social workers are from a Looked After Children Team.  One teacher was the pastoral worker in a secondary school and the other teacher was a SENCo and class teacher at a primary school. All participants had worked with looked after children and worked inter-professionally with each other.

All participants were all asked similar questions, firstly about what barriers they believed existed in inter-professional working, followed by a discussion around their opinions and experiences of inter-professional working.

The interviews were recorded and then listened to, and the main points were written out.  Post it notes were used to gather together common themes to see where opinions overlapped.

Four themes emerged from this:

1. Problems with information sharing involving IT systems affected by high turnover of staff.
2. A lack of understanding of each other’s roles and limited training available.
3. Pastoral care is not a priority in teaching due to time constraints.
4. Pre-judgements of social workers due to media influences.

Other opinions that emerged from the interviews were that:

1. Relationships in inter-professional working were generally good and all practitioners had had good experiences with each other.
2. It depends on how good practitioners are at their jobs.
3. There is a lack of consistency.

A table that shows interviewees’ opinions on inter-professional working.

Discussion

Overall, the data suggests that there are a number of barriers when working together inter-professionally with teachers and social workers that cause concern. 

Both teachers and social workers express information sharing is a priority issue and crucially important in working inter-professionally with children, young people and their families. Information sharing is at the core of inter-professional working practice, as this can significantly impact on children’s outcomes.

The study found that both social workers and teachers struggle with information sharing between professionals and describe it as inconsistent.  This suggests that The Laming Report (2003) has had little or no effect on practice, despite theorising that inconsistent communication results in the reason for serious case reviews, as seen in the enquiry of Victoria Climbie in 2003.

A main issue that was reported and that can affect information sharing is a high turnover of staff, making communication inconsistent, and effecting outcomes, something previously noted by Murphy (2004) and Shim (2014).  The pastoral teacher interviewed described frustrations when new staff become involved, as information has to be repeated and essentially the work has to recommence from the beginning; the child’s story has to be understood, as well as professional relationships need to develop.  The pastoral worker feels that sometimes there can be a turn over as quick as four to six weeks, which means inter-professional working relationships regularly change and cannot be consistently developed.

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Both teachers and social workers explain that they have large case- loads and a time consuming job, which echoes the comments of Travis and Lizano (2016), something that often leads to people falling ill or leaving their job.  Social Workers that were interviewed agreed with this and these reasons could be a main cause for staff turnover.  Themes in the study can be agreed with the findings of Murray (2015) and McFadden et al (2015) that social workers are not paying enough attention to their wellbeing and are making themselves unwell.  The social workers that were interviewed for this study agreed with this, stating that this was the main cause for staff turnover.  However, the SENCo and one of the social workers interviewed had not experienced a high turnover of staff and felt in general they had consistency with professionals throughout.

Due to time constraints the SENCo interviewed explained that she often leaves voicemail messages for social workers, as they are unavailable. These are sometimes misinterpreted and misunderstood, which is a common issue stated by Richardson and Asthan (2006) and Frost and Robinson (2016).  However, social workers from the study are under the impression that teaching staff often leave concerns until a few days after the event, which is not helpful for social workers.  Conversely, this is against advice from the Department for Education (2015) and Hughes and Owen (2009). 

All professionals would like to see the introduction of an integrated IT system common to all departments. This was supposed to be rectified with the introduction of Every Child Matters (2003), so that information can be shared easily and patterns identified. It was suggested by the pastoral worker, that the programme C-Poms, an information sharing database, could be used to improve communication between the different professions.  The Laming Report (2003) had already suggested that the government should introduce a national database for information to be shared between professionals.  The social workers interviewed, expressed regret that although the government had proposed this kind of database, it had never been implemented. 

The SENCo explained that as a teacher, the profile of the non-teaching part of teaching needs to be raised, coinciding with the beliefs of Murphy (2004).  This leads us onto concerns about pastoral care being a low priority expressed by teachers where it is thought that social workers can often have unrealistic expectations of teachers, as outlined by MacDonald, et al. (2010) and Trodd (2011).  Both teachers and social workers agree that there is limited contact with children’s class teachers, which can lead to difficulties such as misinterpretation and misunderstanding.  Teachers can focus and become engrossed in and overlook the holistic pupil.  It would be thought that, as a class teacher sees the child every day, they would be the most important person who would have the significant information about the child. However, all interviewees explained that class teachers are rarely involved in meetings involving children in their class, suggesting that the opinions of the class teacher are not being responded to as well as they should be (Davis, 2011).  The SENCo explained that social workers often expect teachers to allow certain children to be exempt from regular and normal behaviour management strategies.  These exemptions were felt to be because of the child’s home life and circumstances, but this does not work well in the wider classroom of over twenty children.  The Joint Improvement Team (2009) agrees that working together with the same perspective would improve this.

The research has found that there is a lack of understanding of different professional roles, which is believed to have caused conflict between the agencies. It is thought this issue can be solved by joint or central training, agreeing with the recommendations of Lamb (2009) and CIHC (2010) on inter-professional training.   The reason for this issue is that, training is not widely available and if so, is expensive.  The work by Murphy (2004) and Carpenter and Dickinson (2008) suggests that teachers and social workers should spend time together learning about each- other’s roles and should meet regularly to allow all professionals to be kept up to date with the constant changes in each profession.  It could be taken from the interviews that the professionals believed that inter-professional working needed to be done from the umbrella perspective, outlined by Trodd (2011).  As both careers are time consuming and busy, it is often difficult for the professionals to meet on a regular basis.  Both teachers and social workers work similar hours, but due to working commitments, have different priorities and goals.  It is therefore difficult to prioritise time to meet.  During interview, social workers explained that their workloads were too high and teachers interviewed agreed and understood this issue. 

Carlisle, Donovan and Mercer (2005) strongly suggested that one should be comfortable in their profession before embracing the understanding of someone else’s, however, this can increase the likelihood that there will be pre-judgements and lack of awareness of other professionals, as expressed by both teachers and social workers interviewed.  The SENCo commented that class teachers have limited knowledge of what goes on beyond the classroom.  For example; an NQT to experience an inter-professional meeting in respect of another agency’s procedure, such as; a Child Protection Conference or a Looked After Review meeting for a child in care, this would be a difficult process to understand.   This is similar to the opinion of The Joint Improvement Team (2009) in terms of professional hierarchy. 

The social worker interviewed expressed the view and is of the belief that the media represents social workers in a poor light.  The effect of media representation allows pre-judgements to be made regarding the profession, a clear link to the view of Murray (2015) that social workers experience political backlash.  Due to media influences and past experiences, teachers can have a poor opinion of social workers, causing tensions and barriers to working together, which impact on outcomes for children, young people and families in need. Echoing the opinions of Elwin (2014), The Daily Quail (2011) and Konnikova (2014).   During interview, one teacher commented that in serious case review, social workers are ‘vilified’ and the media turn this into ‘a witch hunt’ (Heyes, 2014), as it is easy to place the blame on one single individual for an unsuccessful intervention.  However, social workers believe that professionals should be working together to prevent significant harm to a child or young person.  Both social workers and teachers feel it is unfair that the blame should solely be on social workers.  Agreeing with Elwin (2014) and Heyes (2014) that social workers are always at the front of the queue to be blamed.  The pastoral worker in this research offered the opinion and belief that teachers are often worried about social workers becoming involved, due to becoming centrally involved and being part of the decision making process.

All interviewees indicated that they had experienced good inter-professional relationships, alongside good outcomes.  One social worker expressed that she felt that she had experienced more positives than negatives.  The other social worker believes that relationships have to be established and trust needs to be built.  This is emphasised in the SEND Code of Practice (2015) and Department for Education (2013).

There is a number of ways the barriers described can be overcome within inter-professional working.  The priority issue of, information sharing can be overcome by more effective and regular communication between professionals.  This can be achieved by consistency of staff who can develop positive working relationships who have the time to communicate effectively and regularly.  A variety of communication methods can be employed such as; an integrated IT system, a working agreement detailing response time scales and regular meetings with all key people.  Key people such as class teachers who know the child and hold valuable information should be given the time to be released from classroom duties to be involved in meetings.  A joint training programme between teachers and social workers would be effective in allowing more understanding of each others professional roles and responsibilities.  Collaboration with other professionals will hopefully impact on and encourage joint responsibility for a child’s welfare and outcomes.

The study was limited due to the fact that only four interviews were undertaken. This showed only the opinion of a very small percentage of the population, making it not generalisable.  The interviews did show a rich opinion of the work of social workers and teachers agreeing with Lankshear and Knobel (2004). Only one method of data collection was used so only secondary sources could be used for triangulation.  The method of interviews was appropriate for the study; however using questionnaires might have led to a richer data resource as it would have been from more perspectives would have been available for analysis. With a small sample, if any of the interviewees changed their opinions knowing that they were being interviewed, in line with what is described by The Association of Qualitative Research (2016) as the Hawthorne effect, bias would have been introduced. 

The part of the research that was most surprising was that the teachers and social workers identified the same issues with each other, although if this was the case it might have been assumed that they would have tried to resolve these difficulties between each other.  If the study was to be repeated, it would be recommended that a much a bigger sample base would be used, alongside gathering opinions in another way, such as questionnaires, to make the research more reliable (Golafshani, 2003).

In conclusion, although this topic is a widespread concern and ongoing issue, this study has shown general opinions from four points of view.  Communication; information sharing; understanding each other’s roles through training and working together inter-professionally, are main issues that need to be resolved to ensure future working practices are effective.   It is identified that these barriers of inter-professional working have been the main causes of serious case reviews.  In addition, if communication was more effective, IT systems are improved and integrated between professions and there is less pre-judgement around social workers, future inter-professional working could result in better outcomes for children, young people and their families.  All professionals should work together with a positive mind set and aim to achieve the best outcomes for all children, young people and their families.

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Appendices

Interview Questions

What barriers do you think there are with inter-professional working?

– Confusion over language

– IT systems

– Information Sharing

– Trust

– Timing

– Professional Preciousness.

What changes would you like to see for these barriers to be overcome? Is there anything you think you could do as a practitioner to help inter-professional working run more smoothly?

What understanding do you have of a teachers/social workers role?

How do you think inter-professional working helps the child involved?

Have you ever had a bad experience of inter-professional working?

Have you ever had a good experience of inter-professional working where it has led to a better outcome than what was expected?

How would you describe a usual relationship between teacher and social worker?=-0