Practitioner perspectives on what helps and hinders interprofessional and interagency working

Collaborators

University of Sussex, Brighton, United Kingdom.
Brighton & Sussex Medical School, Brighton, United Kingdom

Self-neglect covers a range of behaviours and situations where someone is put at risk by not caring for their health, safety or surroundings. Self-neglect can have serious consequences, from deteriorating health and wellbeing, or even death for some, or unwanted intrusion and surveillance for others. Support to address self-neglect often requires collaboration between many practitioners, from Adult Social Care, Health, Fire & Rescue, Environmental Protection and other organisations. Yet reviews highlight repeated failings in working together. These arise where care and support have not been co-ordinated, where different organisations have not had a joint understanding of the situation, or where existing systems have not enabled joint working. At the same time, there is much to learn from effective collaborative practice which may go unremarked. What little research exists on joint working in self-neglect has overwhelmingly focused on social work perspectives.

Study aims

This study aims to engage with a broader range of practitioners to identify what problems arise in inter-agency and interprofessional practice with self-neglect, and how to address them, in order to improve care and support for people experiencing self-neglect.
The study is run by the University of Sussex between March 2022 to December 2024
and takes place in health, social care and related organisations at five sites across England. It Is funded by The National Institute for Health Research, Health Services and Delivery Programme.

What we did

• Reviewed and analysed:
• the policies and procedures of Local Safeguarding Adults Board across England
• 273 Safeguarding Adults Reviews
• 41 research papers,
• to identify facilitators and barriers of collaborative working with self-neglect.
• Interviewed:
• 69 practitioners / managers from from a range of professions / services, including Community Nursing, Hospital Nursing, General Practice, Social Work, Environmental Health, Housing, Crisis Coordination, Fire & Rescue and Social Prescribing. Each one works for services belonging to one of 5 Safeguarding Adults Boards in different parts of England, which have been actively engaged with the challenges posed by self-neglect.
• 16 people with lived experience of self-neglect, and 2 carers of people who had experienced self-neglect
• Worked with a panel of people with lived experience and a practitioner focus group on how the findings of the study might inform practice. We have been developing outputs from this work, which we are now trying out in practice. 

The Team

David Orr, May Nasrawy, Cindy Morrison, Saeideh Babashahi, Natalia Ivashikina, Reima Maglajlic, Andrew Voyce, Nicky Selwyn and Harm van Marwijk. 

 Funder Information

This study is funded by the National Institute of Health Research (NIHR) Health Services and Delivery Research Programme (NIHR133885). The views expressed in reporting the study are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. 

Study Outputs to Date 

Orr, D. (2023), "Mapping and review of self-neglect policies and procedures from safeguarding adults boards in England", The Journal of Adult Protection, Vol. 25 No. 2, pp. 51-66. https://doi.org/10.1108/JAP-11-2022-0027