How staff, teams and services work together

Quality statement

We expect providers, commissioners and system leaders live up to this statement:

We work effectively across teams and services to support people. We make sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

What this quality statement means

• Staff have access to the information they need to appropriately assess, plan and deliver people’s care, treatment and support.
• Plans for transition, referral and discharge consider people’s individual needs, circumstances, ongoing care arrangements and expected outcomes.
• When people are due to move between services, all necessary staff, teams and services are involved in assessing their needs to maintain continuity of care.
• Information is shared between teams and services to ensure continuity of care, for example when clinical tasks are delegated or when people are referred between services.
• When people receive care from a range of different staff, teams or services, it is co-ordinated effectively. All relevant staff, teams and services are involved in assessing, planning and delivering people's care and treatment and staff work collaboratively to understand and meet people's needs.

I statements

I statements reflect what people have said matters to them.

• I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally.
• I have care and support that is co-ordinated, and everyone works well together and with me.

Subtopics this quality statement covers

• Transitions of care (including from children to adult services)
• Co-ordination and collaboration
• Delegation (for example, delegation of clinical tasks)
• Sharing information