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For Scotland's children report

appendix 4 the elements of effective integrated work

Working Together in Children's Services - A Developmental Tool

The Action Team has worked to bring together what might be identified as the different elements of effective integrated work and in order to promote discussion, learning and change has produced a developmental tool to support both the Executive and agencies in the field to work toward more integrated services. This tool is offered in the context of the recommendations made in the full Action Team report, in itself it is not the checklist or standard by which integrated practice should be measured, the emphasis is on it being something which can be used to support agencies work better together. Better integrated services, and the resultant better outcomes for children and families, will not happen overnight. The development of such services will only come as a result of positive responses to the Action Team's full set of recommendations and as a consequence of successfully working through a change process which might be guided or supported by the tool presented here.

Attempting to work together better is not a new concern. Indeed in some places the Acton Team heard that ground has been lost. It has also become clear during the Action Team enquiry that the development of better integrated approaches is not just of relevance in relation to services for children and families - the work of the Audit Commission and by Audit Scotland in relation to community safety has been usefully examined, the work of the Scottish Office Development Department on partnership working has been sourced, as has the work of the University of Strathclyde Graduate Business School in relation to the management of partnership working.

From colleagues in health account has been taken of related developments, particularly in relation to the tools produced to support clinical best practice being developed by the Child Health Support Group (the Health Minister's Advisory Group on children with whom the Action Team conducted some joint visits). The Action Team is also aware of recent discussion in Scotland in terms of the NHS Performance Assessment Framework and work around the perceptions and expectations of primary care in Glasgow. There is clearly much being written about and discussed within the health sector which emphasises the importance of combined and integrated services. There are common themes running through all our work.

The tool, which is offered here, is concerned with six key elements:

• Policy and strategy
• Planning children's services
• Resourcing children's services
• Accessing children's services
• Processes - that is the experience of children and families and of service providers, and finally with
• Outcomes

It is the intention of the Action Team that this developmental tool is of real help in the drive towards better integrated children's services.

In terms of POLICY AND STRATEGY effective integrated work requires:

• A shared vision, a common purpose amongst partners which is understood and adhered to.
• Public statements, frequently revisited, about the purpose and ethos of the service.
• Clarity amongst partners about their role and responsibilities.
• A shared understanding amongst partner agencies about what is meant by 'children in need'.
• A commitment to improve operational practices or develop different forms of service delivery in the context of Best Value.
• A range of shared policy statements on key areas of concern to the service - for example around equal opportunities or access to information or a partnership agreement between participating agencies.
• An understanding of why the integrated approach to service delivery makes a difference.

In terms of PLANNING CHILDREN'S SERVICES effective integrated work requires:

* That all relevant stakeholders are involved from the outset, including children and families and potential partners in the voluntary sector.

• Due consideration by partner agencies that an integrated approach is required.
• A clear understanding of who is involved in planning children's services with clarity about where responsibility and leadership for the process lies.
• Clarity about the role and authority of representatives involved in the planning process, including the degree to which they are empowered to take decisions or commit resources on behalf of their agency, and a requirement on representatives to attend planning meetings.
• A commitment to planning at the local level that is linked systematically with the Community Plan.
• Clarity amongst partners about their specific responsibilities for service delivery.
• Planning processes which address both universal and targeted services and the access pathways between them.
• Harmonisation of the geographical boundaries within which agencies work.
• Monitoring and evaluation systems which address and assess the individual role of contributing agencies and the continued effectiveness and relevance of the integrated approach.
• Open and transparent financial management systems and an assessment of the costs of integrated approaches to service delivery.
• Clear links with other partnerships operating in the area, other cross cutting issues and current planning frameworks.
• An understanding of how the integrated approach impacts on planning processes.

In terms of PROCESSES (the experience of service users and service providers) effective integrated work requires:

• Effective networking.
• Policy and effective practice in relation to information sharing and related issues such as client confidentiality.
• Decisions that are taken collectively and implemented effectively.
• Clear and effective links between practitioners and those responsible for planning/policy in relation to the service.
• An ongoing, integrated approach to monitoring and evaluation which is linked to the service's 'plan'.
• The ability of partner agencies to recognise and responded appropriately and transparently to conflict which arises.
• Trust and positive working between partner agencies.
• Clarity about the changing role of any partner agencies, including reasons for exiting work within the integrated service.
• That staff are able to talk in an informed and confident way about how service users move through or experience the service.
• The availability of opportunities for service users to talk about the service and to have these views taken on board via appropriate structures, including the participation of children and families in the monitoring and evaluation of the service.
• An ongoing evaluation of how an integrated approach impacts on users' experience of the service.
• An understanding of how the integrated approach impacts on service partners experience of service delivery and in terms of interagency relations.

In terms of RESOURCING CHILDREN'S SERVICES effective integrated work requires:

• Partner agencies to contribute resources to support services which meet common objectives.
• Communication about funding cycles and financial planning.
• Clarity about where the integrated approach has brought extra funding into the area/service, whether it has led to adjustments or better co-ordination of mainstream funding or whether integrated working has meant additional demands in terms of resources.
• An identification of shortfalls in resourcing, any barriers to joint resourcing, and clarity about how these are/have been addressed.
• A commitment to staff training which addressed the benefits and challenges of integrated practice.
• An understanding of how the integrated approach has impacted on resource requirements or use of resources.

In terms of ACCESSING CHILDREN'S SERVICES effective integrated work requires:

• Clarity about how children and families access services.
• Opportunities for single multi-agency assessments, support and information sharing.
• 'One door' entry to multidisciplinary or multi-agency services.
• The availability of clear information about services which is disseminated appropriately to other agencies and potential users.
• The availability of information in an appropriate range of languages and formats and in child friendly versions.
• The regular updating of information across partners/providers.
• That services are located within reach and within child and family friendly environments.
• Partners to utilise alternative means of communication, participation and service delivery, such as those provided by information/communication technology, to overcome barriers to access to services.
• A commitment to equal opportunities at a strategic and operational level.
• An understanding of how the integrated approach impacts on access to children's services.

In terms of OUTCOMES effective integrated work requires:

• A focus on outcomes which are child centred.
• Clarity about the focus of services, with evidence that the balance or focus of any service in relation to preventative/reactive work has been discussed and agreed between partner agencies.
• That partner agencies, where appropriate, utilise research and pilot studies to create an evidence base for service developments.
• Outcomes which are linked to those of partner agencies or to national targets where appropriate.
• Clarity amongst partner agencies in relation to their responsibility for shared outcomes.
• Child and family participation in monitoring and evaluation systems.
• An understanding of how services impact on the lives of children or families.
• A system of monitoring and review of the continued relevance/appropriateness of the service with an exit or continuation strategy in place where appropriate.
• An understanding of how the integrated approach impacts on the identification or fulfilment of service/organisational outcomes and outcomes for participating children or families.

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