The transition from multi-disciplinary team to inter-disciplinary team : the impact of integrated healthcare on the nature and identity of health social work practice in Aotearoa New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Social Work at Massey University, Palmerston North, New Zealand

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Integrated healthcare aims to transform the health system and improve health outcomes, while managing national health spending, by providing a more co-ordinated, collaborative and cohesive response to patient-centred care. Inter-disciplinary teams (IDT) have become synonymous with integrated healthcare, as it provides a framework for conceptualising an alternative approach to patient-centred care, within the District Health Board (DHB). This study explored how the transition from a multi-disciplinary team (MDT) to an IDT structure, within the DHB, influences the nature and identity of health social work practice. The subjective experiences of the twelve registered health social workers, who participated in this study, reflect the unique Aotearoa New Zealand context at different stages of the transition from an MDT to an IDT. Critical theory and a constructivist theoretical framework guided this qualitative research study, in which health social work is conceptualised within the broader context of competing and inter-related socio-political, cultural and economic demands. Semi-structured interviews were conducted with each of the participants, from across Aotearoa New Zealand. The data from these interviews was collated, according to emerging themes and patterns and analysed in relation to relevant national and international literature. The participants in this study were unanimous in their support of the transition to an IDT, citing the correlation between increased professional collaboration and improved patient outcomes. The findings from this study reveal that while the nature and identity of health social work practice remains unchanged, the transition to an IDT affords further opportunities for practitioners to demonstrate competence and to gain credibility. Findings highlight that exposing other disciplines to the unique knowledge and skills that social work brings to patient-care, positions the profession as integral to the functioning of the IDT. The significance of this study and the recommendations that have emerged, highlight the need for DHBs to be more transparent about the rationale for change and to involve health social work at every stage of the transition to an IDT. This study concludes that distinguishing between the MDT and the IDT, and providing professionals with ongoing education and support around working collaboratively as an IDT, creates sustainable change. The bicultural nature of health social work in Aotearoa New Zealand offers opportunities to strengthen integrated healthcare, by drawing on Whakawhanaungatanga, the practice of appreciating and growing relationships and kotahitanga, which involves bringing people together. These serve as unifying concepts within the IDT.
Medical social work, Integrated delivery of health care, Health care teams, New Zealand