A number of issues have already been raised by both participant groups about the communication which occurs between health professionals. These include: communication between primary and secondary services; different members of the individual primary practice surgeries; and issues related to the professional roles of different health practitioners. This chapter addresses these issues, as it is important to contextualise and understand the complexity of the medical professions before looking at collaboration beyond these professional groups in light of multi-agency initiatives. This chapter will address the relative positions of health visitors, nurses and female general practitioners, and the communication across primary and secondary service providers, in order to identify issues which arise as a result of the differentiation of professional responsibilities. The historical emergence of different health professionals has defined many of the boundaries which currently exist between specific practitioners. It should also be acknowledged that, due to the impact of socially caused ill health, many of these boundaries are shifting as a result of the so-called ‘health crisis’. The following discussions should be considered, therefore, as grounded in these contemporary changes.

Health visitors and practice nurses

The following extracts come from one of the interviewed health visitors, and relate to her experiences of working with practice nurses, other health visitors and general practitioners.