Interprofessional working: communication, collaboration... perspiration!

Palliative care is rarely delivered by one provider; for most patients their care will be managed by community and one or more hospital teams at the least. This can be problematic for patients, their family and friends, and health professionals. Evidence suggests that, in general, providers work in isolation from each other. Although formal processes are in place for transfer of information between the sectors on discharge between acute and community sectors, there is a de facto lack of communication and therefore a lack of appreciation of the working practices within each environment. This resulting lack of collaboration between teams can lead to disruptive care that detracts from the holistic philosophy purported to be the basis of supportive and palliative care (National Institute for Health and Clinical Excellence (NICE) 2004; Department of Health (DH) 2000). In October 2005, 20% of a clinical nurse specialist's (CNS) full-time post was dedicated to working between the palliative care teams of Central Manchester and Manchester Children's NHS Trust (CMMC) and Central Manchester PCT (CMPCT). The aim was to improve communication and dialogue to promote more effective integrated working between the two sites and develop effective interprofessional working. This article will evaluate the impact of this new post, after 18 months, on collaboration between the teams, their practices and their patients. Finally, it will offer recommendations for future development.