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Closer doesn't mean better

Integrated services for children, one of the major policy shifts over the past nine years since Labour came to power, are on shaky research ground, a study for the Scottish Executive has revealed.

Teachers, social workers and health workers may report increased co-operation but there is "limited evidence" to show integration has improved school results or the health of families, according to a review of all research studies.

There are also few reliable ways to measure progress. Professionals talk about "potential" benefits to children and families rather than "actual hard evidence of improved outcomes".

The findings helped to influence the Executive's decision to backtrack on its central policy of making all schools integrated community schools by next year (TESS, last week).

Researchers Katy Brown and Katherine White say there has been a raft of initiatives to bring together services for children, including detailed reports into the deaths of Victoria Climbie and Caleb Ness. A failure to share information between different agencies was said to have contributed to their deaths.

The researchers state: "We know what can happen when services are not integrated and assume therefore that when services are better integrated there will be positive outcomes across a range of areas."

The Integrated Care Network, for example, questions whether too much emphasis is placed on the structure and input to integrated working rather than on outcomes. Even HMIE has described the success of integrated community schools as "patchy".

Any notion of savings by merging departments is challenged by some. "Again there is a lack of evidence to currently support this," Ms Brown and Ms White say.

Critics suggest better results come from improving attitudes within agencies. "Organisations where staff reported greater job satisfaction, role clarity and fair organisational practices were found to deliver significantly better outcomes for children and families (measured as independent descriptions of children's behaviours by their teachers) than those organisations with poor climates," one study concludes.

Some suggest that services for children and families are improved when agencies focus on stress, workload and low job satisfaction among professionals.

Responding to the research, John Mulgrew, director of educational and social services in East Ayrshire, said there was "no going back" on integrated services. Two-thirds of the council budget came through his department.

"It all takes time and clear, flexible direction from the director of the department. You have to change attitudes and break down professional barriers. Once it starts to move, there is no going back and it only makes sense if you put the young person right at the centre of what you are doing," Mr Mulgrew said.

He believed the most vulnerable young people were now benefiting. At school level, learning partnerships were developing, pushing the integrated services agenda and focusing on attainment and achievement.

Leader 22 Exploring the evidence base for Integrated Children's Services is available on the Scottish Executive publications website.

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