Multi Agency Benefits For Children And Families
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'… there appears to be a dearth of evidence to support the notion that multi-agency working in practice brings about actual benefits for children and families' The local authority and government agencies have been working together for a long time and not entirely new practice. Jones and Leverett quote 'However, the drive towards integrated working which includes the entire children's workforce (that is, every individual who works, on an employed or voluntary basis, with children and their families across sectors such as health, education, early years and childcare, play work, social care, police, youth support and leisure services) under the 'interagency' umbrella is a more recent and ambitious innovation' (Jones and Leverett, 2008 pg 123)
Multi-agency working can be analysed using three primary policy contexts. 'First, the context of influence, where policy discourses are constructed and key policy concepts - for example, partnership or multi-agency working - are established. Second, the context of policy text production, or the documents that represent policy' (Jones and Leverett, 2008 pg 125). 'These are usually expressed in language which claims to be reasonable and for the 'general public good' (Bowe et al., 1992). They include texts such as the SEN Code of Practice (DfES, 2001) or the new Working Together to Safeguard Children guidelines (HM Government, 2010). 'Such texts are then responded to within the context of practice, or what actually happens on the ground - for example, schools, childcare or health settings - as a result of a particular policy'. (Jones and Leverett, 2008 pg 125)
Jones (2000) added a sixth context, the 'context of hidden values'. This means positive effect outcomes on policy; such as, legislation that promotes interagency cooperation in children's services. They aim to protect children's welfare and improve wellbeing. However, Jones suggests 'that there may be a range of hidden meanings and outcomes. At a central level, policy can be cleverly constructed to disguise a particular set of intentions, values and beliefs. Intentionally or otherwise, policy may be a 'wolf in sheep's clothing' (Jones, 2000)
'There is also evidence that practitioners construct their own meanings related to policy, whether these are intended or not. Commenting on the tendency of policy makers to centrally design forms, e-templates and assessment tools'. (Jones and Leverett, 2008 pg 126) Both, Garrett (2006) and Axford et al. (2006) 'note how these are sometimes resisted by practitioners because they are perceived as exerting central control over hitherto fairly autonomous areas and suspected of being a cost-cutting device' (Axford et al., 2006, p. 172). Consequently, policy could actually sustain or create circumstances that maintain or exacerbate problems. Rather than being a solution to the perceived problem, the interaction between policy and practice may cause a new set of problems. (Jones and Leverett, 2008 pg 126)
The key point is that policy is at three levels local, front line and central. At central level the ideas are made concrete and then articulated nationally and locally. At the time the policy enters the workforce such as schools, practitioners' perceptions can consequently be affected. The question is:' to what extent is the vision enshrined in central policy on multi-agency working likely to change as it travels on its journey from central government to individual practitioner?' (Jones and Leverett, 2008 pg 126)
Governments have a tendency to construct their vision for policy as a statement of aims or intended outcomes. Sometimes the vision is embedded within a wider framework; for example, governments in Scotland, Wales and Northern Ireland (Jones and Leverett, 2008 pg 126)
'In England, children's wellbeing was defined as the five mutually reinforcing outcomes originally presented in the Every Child Matters Green Paper' (DfES, 2003, p. 6):
'SHEEP' is an acronym that stands for:
S - Stay safe
H - Healthy
E - Enjoy and achieve
E - Economic wellbeing
P - Positive contribution
The next steps is to translate these visions into learning which can be implemented into practice by people working in such sectors.
'The five outcomes were integrated into the development of the common core skills and knowledge for the children's workforce' (DfES, 2005) consisting of:
'Effective communication and engagement with children, young people and families
Child and young person development
Safeguarding and promoting the welfare of the child
Sharing information'. (DfES, 2005)
Despite variations, the UK government agreed that all children will benefit from closer working between practitioners and agencies.
The Common Assessment Framework (CAF) is a key part of delivering frontline services that are integrated and focused around the needs of children and young people. The 'CAF will promote more effective, earlier identification of additional needs, particularly in universal services. It is intended to provide a simple process for a holistic assessment of a child's needs and strengths, taking account of the role of parents, carers and environmental factors on their development' (ECM, 2008).
The CAF form is designed to record and, where appropriate, share with others, assessments, plans and recommendations for support. 'Section 11 of the Children Act 2004 places a statutory duty on key people and bodies to make arrangements to safeguard and promote the welfare of children'. (HM Government, 2004)
The ECM states all agencies are required to have:
'Senior management commitment to the importance of safeguarding and promoting children's welfare
A clear statement of the agency's responsibilities towards children, available for al staff
Safe recruitment procedures in place
Effective inter-agency working to safeguard and promote the welfare of children
Effective information sharing' (ECM, 2008)
'The rationale for the CAF is to help practitioners develop a shared understanding of children, which avoids families repeating themselves to all other agencies. The CAF helps to develop a common understandings of what needs to be done and how. 'Do not reassess when the information is already there' (Parents in consultation about assessment, in Scottish Executive, 2005b, p. 23)
'The argument is simple and on the surface persuasive, the impetus based on helping individual children. But the relationship between assessment procedures, their purpose and their outcomes is rarely straightforward' (Jones, 2004). 'Assessment is a lifelong process with social consequences and may be influenced by contextual factors and professional value positions. It is literally a point at which 'certain children are judged to be different' (Tomlinson, 1982, p. 82).
'Some parents' and children's views of their services have highlighted their wanting 'a coordinated service that is delivered through a single point of contact, a 'key worker', 'named person' or 'link worker' (Sloper, 2004, p. 572). Within the CAF, a similar role was produced, the lead professional (LP) who takes responsibility for coordinating the action identified as a result of the CAF process and will support the child and their family as necessary.
One of the daunting aspects of the CAF is the number of professionals that practitioners will engage with, such as health, education, social services and voluntary agencies. It can be also quite daunting in finding out who the support services are and their contact details. However, with the CAF process it can be away of overcoming tension previously encountered around multi agency working and sharing information.
'Just as children and their families have a contribution to make to shape the services they receive through the various forms of partnership discussed in previous chapters, so they can contribute to the development of practice and practitioners. This can happen at many levels through evaluation, feedback, consultation and research, as well as direct involvement in training. Practitioners and the organisations they work for need to recognise that children and their families have specific knowledge that cannot be 'learnt' from anywhere else'. (Rixon, 2008) 'Children are party to the subculture of childhood which gives them a unique 'insider' perspective that is critical to our understanding of children's worlds'. (Kellett, 2005, p. 4)
'Like many who regularly consult children and young people, we find that their views are always serious, concise, thoughtful and highly relevant - and cut through the pre-existing agendas and diplomatic avoidances that beset many consultations with 'professional' adults. We find that even very young children are more than able to analyse and give clear views on many issues within their experience'. (Morgan, 2005, pp. 181-182)
'How is the success of more integrated ways of working to be judged? One element of evaluation might be to consider to what extent integrated teams or new initiatives or structures have overcome obstacles and enabled more positive ways of working'. (Stone and Rixon, 2008)
'As we have discussed, government policy and the literature on children's services all emphasise the importance of agencies working together and the value of partnership structures, yet: Despite such exhortations, there appears to be a dearth of evidence to support the notion that multi-agency working in practice brings about actual benefits for children and families. (Townsley et al., 2004, p. 6)
However, Michelle Warren quotes 'According to Consultancy 4Children (Policy into practice, 4Children, 2009) 'consistent evidence indicates that parents and children are best served if the support on offer is joined up and well coordinated'. It would be appropriate to recognise that although services may be provided in one setting, there is still a risk of services not being joined up, because of different agencies (and competing interests/perspectives) involved. (Warren, 2010)
However, Howell states 'Previously we actually made it incredibly difficult by making children and parents and carers make their own way through the services all being assessed quite separately and getting very mixed messages. So multi-agency working is essential where a child needs it. We mustn't get confused and think multi-agency working has got to be the only way of working. In some cases it's actually the school that will make the difference and that's the agency where the vast majority of children will achieve the best outcomes'. (Howell, 2008)
However, Townsley highlights the actual benefits for families and children. Howell states 'There are tensions between agencies, some of them driven by the different starting point that different agencies have. So the nature of the targets that agencies are measured by are actually quite different. The health targets that health services are measured by are significantly different from the kind of targets that schools work to and particularly are quite distant from the outcomes of 'Every Child Matters'. (Howell, 2008)
As with any Multi agency working, it is crucial to assess whether any new projects or initiatives have been set targets against criteria that can be measured. This is particularly a reflection for evidence based interventions which have been associated with issues, such as value for money. In relation to this, many have targets which have been set and inevitably raise questions whether it is the correct one to be assigned with a particular target. 'Practitioners recognise that targets can enable clarity and equity, and focus attention on important areas of practice' (Banks, 2004).
However, Townsley et al. (2004) states 'review a number of studies that reveal little evidence of improved outcomes of multi-agency working across a range of services and settings. Their review also makes clear that the task of evaluation itself is a complex one. Inherent problems include: difficulties in generalising from individual case studies; diverse views of different stakeholders as to what counts as success; the length of time needed to evaluate change; and causality and attribution'. (Glendinning, 2002, cited in Townsley, 2004, p. 6)
Consequently, Howell states 'Children's participation and engagement is fundamental to the redesign of services - particularly with a multi-agency perspective. It's part of the learning about what makes a difference - the whole issue around personalisation puts the client, the person receiving the services, as the co-designer of their solutions'. (Howell, 2008)
To conclude, 'A formative approach to evaluation that encourages dialogue and ongoing improvements to both policy and practice would appear to offer a positive way forward. However, this is not without its challenges and there are still issues to be addressed, not least training and clarification of roles and responsibilities. It is up to individual practitioners to promote an inclusive approach to professional difference and to develop a range of different models enabling collaboration, respect, reciprocity, realism and risk-taking. (Leverett and Jones, 2008)
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