Annex: The factors shaping successful team working

Table 1: Examples of team-based factors that can support MDT working,,,,

Domain

Example enablers

Planning and design

Emphasis on workforce and workflow planning

Carefully designed skill mix mapped to patient needs

Engagement and inclusion of patients and the public in design and implementation of teams. Ongoing co-production

Clear governance arrangements

Treating MDTs as core, rather than just a ‘bolt-on’ to existing services

Track implementation progress and iterate as needed

Learning and development

Access to good clinical supervision

Appraisals incorporating team goals and involving feedback from MDT members

Emphasis on cross-professional and cross-organisational training

Willingness to learn from and with each other

Training for skills to both support the staff member’s role in the MDT and for making the most of MDT working itself

Gaining buy-in from team members for changes in ways of working

Culture and leadership

Shared commitment to the delivery of high-quality, coordinated care

High levels of respect and trust

Appreciation of the importance of relationships and creating time and willingness to build them

Commitment to creating a shared system of beliefs, values and common philosophy within the team

Embracing collective leadership

Working across boundaries

Clarity on roles, responsibilities and lines of accountability (especially for roles shared or spread across different organisations)

Willingness to identify, name and work through cultural differences between staff from different organisations and professions

Inclusion of bridging roles such as care coordinators within teams

Communication

Prioritising, valuing and constantly improving communication within the team

Promotion of psychological safety (staff feeling able to speak up or make mistakes without retribution)

Use of huddles and other forms of short, frequent check-ins between team members

Access to digital communication tools and agreement on preferences and expectations for their use

Adoption of MDT regular meetings that follow best practice

Communication with patients about what the MDT is and does, what it can mean for their care and what patients want it to mean for them

Technology and estates

Shared IT systems and access to patient records

Redesign of physical spaces to promote collaboration

Co-location of team members (where appropriate)

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