Joined-up thinking, joined-up services, exploring coalface challenges for making services work for families with complex needs
| Date | 12 March 2014 |
| DOI | https://doi.org/10.1108/JCS-08-2013-0027 |
| Published date | 12 March 2014 |
| Pages | 31-41 |
| Author | Judy Hutchings,Margiad Elen Williams |
Joined-up thinking, joined-up services,
exploring coalface challenges for
making services work for families
with complex needs
Judy Hutchings and Margiad Elen Williams
Judy Hutchings is a Professor
of Clinical Psychology and the
Director of CEBEI (Centre for
Evidence Based Early
Intervention), School of
Psychology, Bangor University,
Bangor, UK.
Margiad Elen Williams is a
Research Project Support
Officer, based at CEBEI,
Bangor University, Bangor, UK.
Abstract
Purpose – This paper aims to describe coal-face challenges to making services in the UK work to ensure
the mental and physical health, safety and wellbeing of children.
Design/methodology/approach – After briefly referring to some challenges to effective joined-up service
provision, it describes examples from the first author’s experience of problems, during 30 þyears as an
NHS clinical child psychologist, and some solutions. It then describes two challenges that underpin many of
these problems: lack of understanding of, or training in, evaluating evidence for interventions and a more
general lack of knowledge about effective behaviour change principles.
Findings – The paper concludes with recommendations about how to achieve effective joined-up services.
Common themes emerging from the research are discussed, including choosing evidence-based
programmes, providing adequate training to staff, and increasing people’s understanding of behavioural
principles.
Originality/value – Having effective joined-up services would mean better services for parents and their
children, and would be more cost-effective for the NHS. The ideas presented in this paper could also be
applied to other services within the NHS.
Keywords Collaboration, Children, Evidence-based practice, Professional practice, Families
Paper type Conceptual paper
Introduction
Ensuring that services to families are co-ordinated and effective presents administrative and
professional challenges. The death of Maria Colwell in 1973 (Field-Fisher, 1974) identified a lack
of information sharing between agencies and led to the establishment of child protection registers.
However, more recent enquiries into the deaths of Victoria Climbie
´(House of Commons Health
Committee, 2003) and baby Peter (The Lord Laming, 2009) have demonstrated continuing failure
to get co-ordinated services. Furthermore, child protection referrals in the UK increased by
6 per cent in 2009/2010 over the previous year (Brooks and Brocklehurst, 2010). Although the
reasons for this increase are unclear, it might in part have been driven by worker anxiety following
the criticism of service providers after the death of baby Peter; however, job losses and economic
collapse in 2008 would have also put increasing numbers of families into stressful circumstances
associated with increased risk to children. Regardless of cause, the need to addresschallenges to
joined up service provision and find solutions remains pressing. The literature mostly focuses on
“service delivery disasters” particularly in relation to children (Frost, 2005; Dunleavy,2010; Dunleavy
et al., 2010) with relatively little discussion of everyday challenges for workers on the coalface.
DOI 10.1108/JCS-08-2013-0027 VOL. 9 NO. 1 2014, pp. 31-41, CEmerald Group Publishing Limited, ISSN 1746-6660
j
JOURNAL OF CHILDREN’S SERVICES
j
PAGE 31
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