How staff, teams and services work together: good

E4. How well do staff, teams and services work together within and across organisations to deliver effective care and treatment?

Characteristics of services we would rate as good in this area

When people receive care from a range of different staff, teams or services, it is coordinated. All relevant staff, teams and services are involved in assessing, planning and delivering people's care and treatment. Staff work collaboratively to understand and meet the range and complexity of people's needs.

When people are due to move between services their needs are assessed early, with the involvement of all necessary staff, teams and services. People's discharge, transition and referral plans take account of their individual needs, circumstances, ongoing care arrangements and expected outcomes. People are discharged at an appropriate time and when all necessary care arrangements are in place.

Where unexpected discharges, transfers and transitions occur, processes are in place that do not leave people unduly at risk, including communicating people's specific, individual needs.