Will joined-up working rescue children from the wrong track?

Ever since New Labour came to power in the UK in 1997, it has been promoting joined-up working as part of its agenda for modernizing public services. In children’s services this intention has made itself most obvious in the requirement that local authorities should set up Children’s Trusts to deliver the five outcomes articulated in the Every Child Matters [1] strategy.

But why? Despite a parallel preoccupation with evidence-based policy and practice, there is little robust research to show that the way services are organized has any impact on processes or child outcomes. This apparent contradiction was the starting-point for a study by researchers from the universities of Leeds, London and York.

The research that it reports explored “the daily realities of delivering public and voluntary sector services by multi-agency teamwork”. By analyzing how teams undertook tasks such as sharing knowledge and resolving conflicts, it sets out to forearm those about to step into the world of multi-agency teamwork.

The central concern was processes. The researchers focused on five well-established teams and scrutinized the activities of the members. They analyzed documents such as induction packs and minutes of meetings, observed team sessions and interviewed the people who took part in them. They also asked staff to keep diaries of critical incidents, which were subsequently translated into fictionalized accounts for further focus group discussion.

Insights into how the professionals behaved are published in the form of quotations from the ensuing group work. For example, a chapter on how multi-agency working affects professional identity (“who I am”, “what I do”) demonstrates the vigorous debate that took place on the relative merits of record-keeping, with health workers complaining about the bureaucratic nature of many social work practices.

The authors note (by way of understatement) that “professionals were sometimes required to implement systems and procedures enforced by outsider or dominant agencies which seemed culturally unacceptable to them”.

Another chapter draws on the empirical evidence to discuss a series of individual and team dilemmas. Ideological differences apparently presented a particular challenge, with professionals from different backgrounds offering different explanations for, and therefore solutions to, children’s needs.

The classic manifestation of this is the “medical model” versus “social model” debate, and differences of emphasis in relation to addressing the child’s psychology or environment. The authors argue that no perspective is right or wrong, rather that “the central argument for joined-up working is that multiple perspectives enrich the treatments offered to clients”.

It is an obvious pointer to the value of a common language in children’s services which, experience suggests, professionals find at the same time threatening and exhilarating. More prosaic dilemmas for multi-agency teams concern procedures such as record-keeping systems. The authors conclude – depressingly given the huge resources already spent in the UK – that developing a common system for assessing children’s needs and using that information to plan services is “still a long-term goal”.

This books tackles an important subject in a clear and accessible way. It is rooted in rigorous qualitative research and the methods are carefully described. It is also intensely practical. For instance, an appendix includes an invitation to discuss a checklist of factors which the researchers found affected multi-agency working. Similarly, 15 themes that need to be tackled to make joined-up activity work are laid out.

The advice is straightforward but nuanced: “co-location assists, but does not guarantee, effective joint working”; “effective managers need to celebrate and value differences while building a sense of collective purpose” .

Does the book achieve its aims? In my view it does. Indeed, the usefulness of the research is demonstrated in a recent article in the Journal of Children’s Services [2] that uses the style of a structured conversation to show how one of the authors drew on the study’s findings to coach a multi-agency team manager over several months.

However, we are left with the challenge of finding out whether multi-agency working really does enhance outcomes for disadvantaged children. As the authors remind us on the last page, the life trajectories of rich and poor children start to diverge when they are barely toddlers and they are soon fastened in their different directions all the way to adulthood. This fact alone should focus the minds of policy makers the next time they are tempted to reorganize services.

Reference
Cottrell, D. and Bollom, P. (2007) “Translating research into practice: the challenges of establishing a new multi-agency team for vulnerable children”, Journal of Children’s Services 2 (3), pp52-63.

• Developing Multiprofessional Teamwork for Integrated Children’s Services: Research, policy and practice by Angela Anning, David Cottrell, Nick Frost, Josephine Green and Mark Robinson is published by the Open University Press.