4.4 Article

Towards sustainable local welfare systems: The effects of functional heterogeneity and team autonomy on team processes in Dutch neighbourhood teams

Journal

HEALTH & SOCIAL CARE IN THE COMMUNITY
Volume 27, Issue 1, Pages 82-92

Publisher

WILEY
DOI: 10.1111/hsc.12604

Keywords

boundary management; functional heterogeneity; information elaboration; neighbourhood teams; team autonomy; team cohesion

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Nowadays, many European countries delegate health and social care responsibilities from the national level to local authorities. In January 2015, the Netherlands similarly introduced a policy programme authorising municipalities to set their own social welfare policy. A specific feature of this programme is that it stimulates municipalities to implement teams wherein professionals from different disciplines are collectively responsible for a team's decision-making. This suggests that teams ideally have (a) high levels of functional heterogeneity (professionals from different disciplines) and (b) high levels of team autonomy (collective responsibility and decision-making). Based on the policy programme, it can be further assumed that (a) information elaboration, (b) boundary management and (c) team cohesion in teams will improve. In practice, the majority (87%) of Dutch municipalities implemented neighbourhood teams in January 2015. A common feature of these neighbourhood teams is that the various professionals are collectively responsible for all the curative and preventive healthcare, social work and voluntary social support of the citizens in a specific neighbourhood. Nevertheless, the structure and organisation of neighbourhood teams (including the level of functional heterogeneity and team autonomy) vary within and between municipalities. Given this situation, our aim was to examine to what extent functional heterogeneity and team autonomy influence information elaboration, boundary management and team cohesion in neighbourhood teams. We developed six hypotheses based on literature that were then tested on data collected (between May 2016 and January 2017) through an online survey from 1335 professionals in 170 neighbourhood teams. An SEM analysis showed a positive effect of team autonomy on information elaboration, boundary management and team cohesion. Results further showed a negative effect of functional heterogeneity on information elaboration and boundary management. The implications of these findings for practitioners and academics are discussed.

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