Professional Identity in Integrated Care: A Qualitative Case Study

The aim of this study was to understand more about professional identity in integrated care to inform the development of integration. Qualitative case study methodology was used to explore professional identity in three teams. The integrated care teams, which provided physical and mental health care, were created in the twelve months prior to this study and were based around general practice populations in one UK region. The professional groups which formed the cases in the study, were made up of nursing (n=17), therapy (n=13) and mental health (n=3). Data was collected using observations, individual interviews and focus groups. Thematic analysis was used to analyse the data. Key findings showed that all professions identified with their own professional group. Clear distinctions between the professions were found, with similarities between nursing and therapy. Mental health nursing stood apart. Some members were starting to form a new identity with their integrated care teams. When this occurred, their own professional group identity was always salient. The ways in which staff discussed their experiences of working the new teams contained elements which could be interpreted as tactics, aimed at proving their worth, thereby strengthening, mobilising and preserving their professional identity. These tactics appeared to be used to counteract perceived threats against their profession. The study shows that professional identity should be recognised and celebrated in order to reduce defensiveness, so professions don’t feel the need to assert their value and teams can truly integrate and work effectively together. These findings resonated with Social Identity Theory. Unique contribution to knowledge was made through the following findings: team members identified with their profession in order to provide security rather than discrimination to other professions and a healthy respect existed for all professions despite them feeling threatened, individuals showed how busy they were in order to prove why their profession was needed in the team, a perceived lack of understanding of each other’s professions resulted in distinctiveness threat and all professions missed their peers to differing extents. Recommendations for practice include acknowledgement and facilitation of professional identity and promotion of understanding between professions in integrated care teams in order to support integration and improve patient care