Multi-disciplinary professional work: the example of work with children and young people Nick Frost, Professor of Social Work (childhood, children and families) Leeds Beckett University n.frost@leedsbeckett.ac.uk

Sources for the presentation Research in Practice (2005) – ‘Professionalism, partnership and joined-up thinking’, www.rip.org.uk ‘Social workers in multi-disciplinary teams’ – CFSW 2005, vol10, pp187-196 ‘Joining-up children’s services’ – CAR, vol16, 2007, pp184-199 Anning et al ‘Developing multi-disciplinary teamwork for integrated children’s services’, Open University Press, 2010 With Nigel Parton ‘Understanding Children’s Social Care’, Sage, 2009 ‘A future of interdisciplinary professional work: mainstream to oppositional?’ In Brock and Rankin (eds) ‘Professionalism in the interdisciplinary early years team: supporting young children and their families’, Continuum

Changing children’s services: Foley and Rixon (eds) 2014

Communities of practice E. Wenger see: www.wenger-trayner.com Mutual engagement Joint enterprise Shared repertoire

Why inter-professional working? the persistence of complex social problems and inequalities which some thought ‘the welfare state’ and increasing wealth generation might address: the development of information technology that has made ‘networking’ more possible; and the realisation that ‘silo’ professions cannot be effective in isolation

Key themes from research(1) (1) Complexity and ambiguity (Wenger, Anning et al.) (2) Professional identity (Wenger, Frost) (3) Power, status and difference (Robinson et al., Anning et al.) (4) Leadership (Anning et al, Children’s Plan)

Key themes from research (2) (5) Information sharing and communication (Atkinson et al.) (6) Outcomes: the ultimate challenge (Audit Commission, Glisson and Hemelgarn) (7) Structural and organisational issues (Anning et al., Glisson and Hemelgarn) (8) The Team Around the Child (Siraj-Blathford)

The ‘onion’ model: A New Labour paradigm

Moving forward – structural issues Core and peripheral staff Line management / supervision Co-location Workload / deployment Joint planning Y&HConference.ppt

Moving forward – ideas and values Dominant models Professional cultures Celebrating diversity – ‘soup’ or ‘salad’? New forms of knowledge

Moving forward – policies and procedures Common policies and procedures Confronting disagreements Coping with change

Moving forward – inter-professional issues Skills and expertise Identity and status Pay, conditions, and career progression Personal challenge – the ‘smell of practice’

Stage Three How will you share learning and develop your team? Discuss plans for team meetings, case discussion, sharing research and so on. How will you measure and evaluate the impact of your work?

Outcomes evidence? There appears to be a dearth of evidence to support the notion that multi-agency working in practice brings about benefits to children and families (Abbott et al, 2005, p.229)

What sort of outcomes? Outcomes for service users Process for service users Process for professionals Efficiency

English evidence Eleven of the twelve LARC 4 local authorities carried out their own qualitative case study research projects within an overall agreed framework developed by the LAs [local authorities] and NFER [National Foundation for Educational Research]. Each case study involved interviews with LA practitioners, parents and (where appropriate) children and young people. In all, the LAs conducted around 80 interviews across 39 case studies between spring and autumn 2011. Each case study looked at whether the common assessment process is a cost effective way to support improved outcomes and avoid costly, negative outcomes for families later on. (LARC 4, Summary)

English evidence Outcomes for children, young people and their families experiencing problems can be improved – and in some cases very dramatically - by appropriate interventions planned and managed by services working effectively together The Common Assessment Framework (CAF) process encourages, and provides a good basis for, such integrated planning and intervention There are five key success factors for early intervention, all of which should be present

Evidence (cont) engaging children, young people and families as equal partners in the process ensuring consistency of the lead professional support, which helped families and professionals work together better integrating all of the elements of the CAF process, from holistic assessment, TAC (Team Around the Child) model and meetings, lead professional role, action planning and reviews ensuring multi-agency working and information sharing, which improved understanding of need and service provision developing a better understanding of children and young people’s needs at the earliest possible stage.

Financial benefits The researchers estimate that the ‘potential future outcome costs’ of the cases they explored were between £400 and £420,000. The cost of undertaking the ‘CAF and the intervention costs’ were between £1,500 and £27,000. It is argued that ‘potential savings’ range from £6,800 and £415,000. This evidence suggests that this form of early intervention is cost effective.

Summary: policy Inter-agency working is a growing phenomena and is attracting increasing research attention There is emerging evidence that inter-agency working can have a positive impact on outcomes for children and young people There is some evidence that service users seem to appreciate that inter-agency working improves service user experiences of professional services There is strong evidence that professionals find the process of inter-agency working effective and that they can devise innovative methods of addressing the dilemmas that arise There is some evidence of efficiency and effectiveness arising from inter-agency working.

Summary: practice Reflecting on developing multi-professional practice in a complex situation Focus on frontline – supporting, developing and giving space for reflection Key role for qualifying and post-qualifying professional education A focus on the child and young person– ‘the team around the child’ From mainstream to oppositional?