What to do when communication breaks down in the MDT

Communication challenges in multidisciplinary teams (MDTs) are inevitable — but manageable. This article explores the most common reasons why communication breaks down and offers practical strategies for restoring collaboration, clarity, and trust. Whether it's unclear roles, information silos, or conflicting priorities, case managers can take the lead in navigating breakdowns and keeping the client at the centre of care.

Despite our best efforts, communication can occasionally falter. When this occurs, taking proactive steps can aid in restoring collaboration. A multidisciplinary team comprises various professionals—occupational therapists, psychologists, physiotherapists, social workers, and legal professionals—each with their distinct priorities and working methods. Sometimes the complexity of the team dynamic can impact on the effectiveness of communication in the team.

Common causes of communication breakdown in the MDT

1. Unclear roles and responsibilities
   When team members are unsure of who is doing what, important tasks can be duplicated, missed, or fall through the cracks. This often leads to assumptions, frustration, and finger-pointing.

2. Information silos
   Professionals may hold onto information within their own service or discipline, either due to system limitations, confidentiality concerns, or cultural habits. This can prevent critical details from reaching the wider team in a timely manner.

3. Lack of regular contact
   Infrequent or inconsistent meetings mean team members miss opportunities to align on goals, flag concerns, or update each other. Without a regular touchpoint, misunderstandings tend to fester or go unnoticed.

4. Overreliance on one mode of communication
   Exclusively using email, for example, can lead to tone misunderstandings or overlooked messages. Important nuances may be lost without face-to-face or verbal follow-up.

5. Conflicting priorities or values
   Each professional may be working under different organisational pressures or frameworks (e.g., clinical, legal, financial), which can make agreement difficult if these priorities are not acknowledged and discussed openly.

6. Dominant or passive team dynamics
   If one voice dominates discussions or others feel unable to speak up, important perspectives can be lost. This imbalance can damage trust and lead to communication avoidance or resentment.

7. Lack of shared language or jargon misuse
   Different disciplines use different terminology. What is clear to a psychologist may be misunderstood by a physiotherapist or social worker, creating confusion around plans or progress.

8. Client or family conflict spillover
   Tensions between clients or families and professionals can indirectly affect the communication dynamic within the team, especially when team members take on advocacy roles or feel emotionally involved.

Addressing a communication breakdown
The Case Manager can be pivotal in navigating a pathway to stronger team dynamics. There are a number of strategies that can be deployed when a communication breakdown has occurred.

• Identify the breakdown point: Ascertain whether the issue stems from unclear expectations, information silos, or interpersonal conflicts. Understanding the root cause enables targeted solutions rather than superficial fixes.

• Re-establish clarity: Reiterate shared goals and responsibilities to align all parties. Miscommunication often arises when roles or objectives are unclear, so reinforcing these helps to prevent confusion and conflict.

• Engage a neutral facilitator: Involve an impartial third party to mediate discussions and resolve misunderstandings. Neutral facilitators ensure all voices are heard and assist in de-escalating emotionally charged situations, promoting productive discussions.

• Leverage written communication: If verbal discussions become tense, shift to written formats to ensure clarity and accountability. Written communication provides a reference point, reduces misinterpretations, and ensures key decisions are documented.

• Establish an escalation pathway: Implement a predefined process for escalating unresolved issues to higher authorities or governing bodies. This guarantees that ongoing challenges do not hinder progress and that serious concerns are dealt with at the appropriate level.

Prevent communication breakdown

Establishing clear communication channels is key to preventing communication breakdown in the MDT. Creating a clearly-defined communication structure ensures that crucial information is shared efficiently. Here are the core elements of a communication structure that will help prevent communication breakdown.

• Set up regular MDT meetings with a structured agenda.

• Use secure, shared documentation platforms to maintain transparency.

• Clearly define roles and responsibilities to avoid duplication or gaps in care.

Final Thoughts

Communication breakdowns in MDTs are not uncommon — but they don’t have to derail progress. By recognising the root causes, taking proactive steps to rebuild clarity and trust, and embedding good communication practices from the outset, teams can maintain strong collaboration even under pressure. Case managers play a pivotal role in creating the conditions for open, respectful dialogue — ultimately ensuring the client remains at the heart of every decision.

If you are experiencing difficulties within an MDT, please feel free to reach out to our team to learn more about our Case Manager Confidential drop-in sessions. These sessions are for Case Managers to get more tailored support when dealing with situations arising in difficult cases. Please contact sarahsawyer@healthyyoultd.co.uk for more information.