In recent years there has been a growing perception amongst public sector professionals that a ‘climate of fear’ has descended on children and young people’s services.1 This is a climate in which councils and social workers are not responding adequately to the needs of children and young people, in part due to the bureaucratisation of public services but also for fear of making mistakes, damaging their reputation or fuelling a scandal. Local councils have been under pressure for some time, but what are some of these barriers they face, and what can be done to overcome them?
This was the question experts from across the health and social care sector came together to discuss at a roundtable hosted by PPL in December. The aim was to identify practical ways forward to transform outcomes for children and young people.
Initial reflections on the past decade were sober, with a feeling of what Lord Michael Bichard has previously termed as an ongoing ‘failure to learn from failure’ within the public services. Despite decades of breaking down boundaries, professionals continue to work in silos, and fail to share information between the agencies responsible for delivering outcomes for children and young people, including the NHS, police, local authorities and schools. As a result, it is still very problematic to identify and support those children most in need. In addition, equality between mental and physical health is still yet to materialise, whilst an overemphasis on progress and regulation is making the profession less attractive to staff who are faced with greater workloads and increased stress. When combined, these factors can encourage an over-professionalised or risk adverse culture, in which the focus is shifted away from the wellbeing of children and young people. These issues are not surprisingly exacerbated by universal pressures on public sector resources. The Local Government Association (LGA) has said central government funding for local councils will fall 24% by 2019-20, which will mean many services, in particular preventative services, are likely to be cut or have their funding greatly reduced.2 In the face of such changes, working in isolation is no longer sustainable.
We shouldn’t forget that society itself is evolving so rapidly that it becomes increasingly difficult to respond to challenges. Children and young people are exposed to an increasing range of pressures both inside and outside of the home, via the media and on the internet. We are playing catch-up with dramatic social and technological changes, which have a direct impact on the children and young people we are trying to help.
Identifying the barriers to transformation is one thing, but what can actually be done to build upon and bring to scale the wealth of good practice out there? During the roundtable discussion, experts identified 6 practical steps transform services for children and young people:
1.Improve clarity around outcomes for children and young people
Transformation cannot be successfully achieved without a clear vision and goals. We need to be able to articulate what success looks like for children and young people and build local cases for change around this, linking short term goals with the bigger picture. We must be challenging about what is right for children and young people, not just what is right for the systems supporting them.
Investing in developing and recognising leaders capable of transforming the services we provide is key to larger scale transformation. This includes looking at how the best leaders, whichever organisation they are part of, can be given more responsibility for outcomes as a whole.
3.Develop national policy guidance
Working in partnership to produce guidance that describes what we are trying to achieve will support shared learning, provide a framework for measuring success, and incentivise positive behavioural change across the system.
4.Take a ‘whole system’ approach for children and young people
Current integration work is primarily focused on adult physical health, and a lot of work has been done in this area. The next step is using the lessons learned to understand the implications more broadly, and how we can apply some of the learning to catalyse progress for children’s services.
5.Make co-production in children’s services real
We shouldn’t underestimate the role of co-production in engaging children in the services they interact with, and the value of the unique perspectives they can provide. This can be done by building on existing children’s panels, but also by finding new innovative ways to harness the unique perspectives of young people about the challenges they and the system face.
6.Identify and develop centres of excellence
Recognising areas of specialist knowledge and centres able to address systemic issues, and using this to support redesign based on the lessons learned from past successes and failures.
Information sharing lies at the heart of all this. A recurrent theme during discussions was that the more you integrate information, the more you drive integrated services, supporting agencies to work together cooperatively. The responsible sharing of information does, of course, require investment. And it is not only new technology which is required but also the new culture and ways of working which must be embedded to ensure maximum benefit. However the benefits for children and families are clear, with organisations given the support to identify the most vulnerable children and families and target resources more effectively at these individuals.
There are no quick fixes to these problems, and it will take time to establish meaningful and long lasting transformation for children and young people. However, bringing professionals together to open up a dialogue and begin to address the challenge is a step in the right direction. Reflecting these 6 principles locally will strengthen leadership, support local areas to develop a vision for children and young people and learn from best practices and centres of excellence elsewhere. Transforming outcomes for children is undoubtedly a big challenge, but one we should accept, not fear.
The next PPL Roundtable will focus on Mental Health Services and take place 2nd March 2016. If you would like to attend, please contact us at email@example.com or call 020 7692 4851.