Traditional multi-agency working tends to focus on addressing specific issues within a limited time constraint. This is fine for the majority of people but for people experiencing multiple disadvantage, more is needed.

MTAM is not just about bringing a lot of teams together to solve a given problem, it is about creating one-team that works together with the person to address their multiple needs and challenges. The focus is on making the system work around and for the client, and making it possible for them to engage in a way that works for them.

Teams spend time building relationships and empower the client to voice their needs. Formulation takes precedence over diagnoses (asking “what is happening to you?” rather than “what’s wrong with you?”) and coproduction is at the heart of the work (“nothing about me without me”).

Workers are also given the time to understand each other’s service strengths, constraints, and the flexibility to work collectively across boundaries to create a cohesive offer of support. This may mean sharing risk when developing a Collective Safety Plan or working with a client for longer to ensure transitions are covered.

In MTAM, the client takes a central role as the expert in their own experience and future. They lead and make decisions about their support network. Alternatively, clients can designate someone they trust to advocate on their behalf, if they prefer.

MTAM acknowledges that not all clients are able to engage actively, and it is designed to be flexible in response to this. Even when a client is not actively participating, the team works from a strengths-based perspective, assuming the client's presence and perspective. Meetings and discussions are conducted as if the client is there, and notes are kept with the possibility of feedback to the client when possible. The approach is to meet the client where they are at, respecting their current level of engagement.

MTAM is not a funded service; rather, it is an innovative approach that can be embedded within any service setting. It thrives on the collaborative efforts and commitment of professionals and agencies to support clients effectively through shared resources and expertise.

That being said, investment is needed to make this approach possible. Workers need to be given the resources and space to work in this way. This may mean giving them smaller caseloads, more time to establish relationships with the clients and other professionals and the flexibility to work with a client for longer if needed.

Several teams across the city are intentionally trialling the MTAM approach. These teams are sharing their experiences so we can learn about ways to implement MTAM which lead to the best outcomes for clients. These teams are currently:

• Bristol Homelessness Move On Team (Bristol City Council)

• Bristol Mental Health Assessment and Review Service (Bristol City Council)

• Link Team (Second Step)

Collective safety planning in MTAM is a collaborative and client-focused process. It emphasises a positive risk-taking approach and involves creating an action plan that addresses safety concerns while respecting the client's goals and preferences. MTAM uses the expertise of the entire support team to explore and overcome individual organizational barriers.

It is crucial to acknowledge the potential impact on the client of the relationship ending, recognising that each individual may have a unique relationship with the departing professional.

It is good to be aware of any limitation on a professional’s involvement within the MTAM team from the outset. Proactive measures can be taken before a team member’s departure, such as planning and sharing their knowledge with the team. Opportunities for their future involvement may be identified, even if it is a one-time intervention, like assisting with formulation.

Our teams have collated a range of resources to support you in working in an MTAM way:

Take me to the tools for practitioners

Take me to the tools for managers

Take me to the tools for commissioners and funders

The MTAM exchange groups are learning and networking spaces hosted by Changing Futures Bristol. These exchange groups provide the means, support, or conditions that empower clients, professionals, and services to work differently.

Find out more about the various exchange groups available.

When sharing data between partnership organisations, MTAM follows The Caldicott Principles. We aim to involve clients as active partners in the use of their confidential information while maintaining an MTAM Collective Safety Plan to avoid people having to repeatedly tell their story.

Each organisation will have its own limitations to what data can be provided, however, within an MTAM approach, data will be shared on a case-by-case basis to ensure the client receives the support they need. Professionals who are unsure about what data can be shared should seek guidance from their Data Protection Officer.

We also recognise challenges around sharing information in time of crisis. To enable shared accountability across services and ensure a client-led approach is taken, practitioners can work within the following guidelines:  

"Effective information-sharing is built on the recognition that the law allows information to be requested and shared, proportionately, when necessary to safeguard the wellbeing of an adult at risk."