Report on the implementation and evaluation of an interprofessional learning programme for inter‐agency child protection teams

Effective collaborative working between the different professions and agencies working to safeguard children is essential. Lack of knowledge of others' roles, perceived differences in status and expertise, and negative stereotypes are examples of why this can be difficult to achieve. A facilitated interprofessional learning (IPL) programme was implemented to assess if such an intervention could overcome some of the barriers to effective interprofessional and inter‐agency team working. Six teams based in primary and secondary care trusts took part with participants from health, education, police and social services. Quantitative and qualitative data were collected from individual participants using a pre‐validated team climate inventory and reflective statements. Findings from this study demonstrate statistically significant changes in five out of six categories in the inventory. Reflective statements suggested that overall the programme offered a positive learning experience at both an individual and team level. The importance of outside facilitation to maintain the team's momentum was acknowledged, as was the difficulty of maintaining a good level of activity once the programme had ended. Nevertheless, the IPL programme provided a timely opportunity to reflect upon the interprofessional and inter‐agency team working needed within Children's Trusts and the implications for staff involved with regard to skills development. Copyright © 2009 John Wiley & Sons, Ltd.     

Developing a Common Language in Children's Services through Research‐based Inter‐disciplinary Training

Two sources of inertia to improving services for children in need are the difficulties of getting evidence into practice and the complications of inter‐agency working. Current training arrangements in social work and disparities between children's services professions as regards training requirements are contributory factors. The Common Language project is a work in progress, adopting a research‐based, inter‐disciplinary approach to working with social workers and other children's services professionals. It comprises core ideas and methods to complement the more specialist knowledge and skills required in each profession. Underpinned by a child development perspective and a scientific development cycle, it rests on a conceptual framework including need, threshold, service and outcome. The approach has three components (each of which includes training): (1) the implementation of practice tools; (2) the planning and development of integrated services; and (3) supporting materials, including practitioner‐orientated modules and a curriculum for PhD students. Distinguishing features include research utilisation, notably a focus on inculcating research‐mindedness as opposed to imparting findings, and also collaborative professional working, in particular via practical connections between different agencies, stakeholders and countries. The project is being evaluated in terms of uptake, change in professional thinking and practice and effects on child well‐being. Next steps for the project relate to broader lessons for social work training emerging from research and development elsewhere.     

Participation or practice innovation: tensions in inter‐agency working to address disciplinary exclusion from school

This paper explores dilemmas and tensions between two models of school based inter‐agency meetings to prevent disciplinary exclusion from school. The first model is characterised by innovative practice developed through long established professional relationships and addresses both individual and strategic issues in supporting young people who are at risk of disciplinary exclusion from school. The second model strongly emphasises the right to participation of young people and their families in school based inter‐agency meetings. Research participants in three Scottish councils (parents, pupils, teachers and other professionals 1 ) had identified school based inter‐agency meetings as key to the process of inter‐agency working to prevent school exclusion.     

Inter‐professional Learning to Prepare Medical and Social Work Students for Practice with Refugees and Asylum Seekers

Social workers and medical practitioners, particularly those in general practice, provide services for individuals who experience social exclusion. Access to medical, health and social care services has been identified as problematic for refugees and asylum seekers, reflecting their marginalised status within society. It is widely accepted that multi‐agency responses and working together are key requirements in improving access to services and promoting social inclusion; however, achieving this across professional and agency boundaries often remains challenging. Joint planning and training have been suggested as being important in improving communication, leading to more flexible and creative services.

This paper describes the genesis and implementation of a series of innovative inter‐professional workshops for medical and social work students, focussing specifically on marginalised groups. Learning and teaching input was developed by, and came from, service users and qualified medical, health and social work practitioners. The paper focuses particularly on the sessions relating to refugees and asylum seekers. The content and structure of the sessions are discussed and students' responses are reported. The implications for future inter‐professional learning and practice in relation to socially excluded groups are highlighted.     

More than the sum of its parts? inter‐professional working in the education of looked after children

This article highlights work underway in three English local authorities to promote effective inter‐agency collaboration around the education of looked after children. Insight drawn from these local authorities is used to review previous literature concerning inter‐agency collaboration in a variety of contexts. The relevance of previous research to issues concerning the education of looked after children is discussed and key factors associated with effective collaboration are highlighted. Barriers which have served to obstruct joint working and strategies adopted to deal with these are also discussed.     

Changing structures: Necessary but not sufficient

Moves are afoot across the UK to change the mechanisms for managing local inter‐agency child protection policy and practice. This is being achieved through the development of Safeguarding Boards in England and Wales and guidance on Child Protection Committees that took effect from August 2005 in Scotland. Following our review of one Scottish Child Protection Committee (the SCPC), we are concerned that these changes focus almost exclusively on structure and pay scant attention to process and relationships. The study we undertook was an in‐depth evaluation of the functioning of the SCPC and used a range of qualitative methods. The main findings were that the size of the committee, its coverage of three local authority areas, and its patterns of working meant that some aspects of its work were highly developed and effective, such as the guidelines and multi‐agency training, while others, such as links with practice and the management of information systems, were poor. Considering these findings in the light of systems theory suggests that improving the effectiveness of child protection committees, and similar bodies, may need to be based on greater attention being paid to issues of authority, trust and negotiation among their members. Copyright © 2007 John Wiley & Sons, Ltd.     

New Institutionalism and Sexuality at Work in Local Government

Recent statutory and policy changes have raised the profile of lesbian, gay and bisexual equalities initiatives in the local government arena. These initiatives are increasingly developed and delivered via inter‐agency partnerships. This article applies concepts from the sociological branch of new institutionalism to the field of sexualities equalities partnership work in local government, drawing on findings from a large empirical project. Notions of norms, ritual, templates and isomorphism all have purchase in this sensitive, value‐laden field, providing insight into the organizational dynamics associated with inter‐agency and partnership working. The article introduces the notion of institutional hybridization as a means of understanding the collaborative, and sometimes conflicting, processes associated with governance in the field of sexualities equalities work.     

A look behind the curtain at social work supervision in interprofessional practice settings: critical themes and pressing practical challenges

Supervision has been an integral aspect of social work practice since the early days of the profession. The literature suggests that ‘supervision is an essential and integral part of the training and continuing education required for the skillful development of professional social workers’ (p. 5). The literature does appear to support that all social workers ought to have some level of supervision; however, within interprofessional settings, where social work is one of many professions, that goal may not be easily attained. Although some interprofessional settings, like hospitals, have social work departments, other settings, like schools, may only have one social worker, resulting in a workplace environment devoid of social work supervision. This article presents findings from a national study of social workers employed in interprofessional organizations. It was hypothesized that this cohort could provide important insights about the nature of social work supervision in agencies characterized by an interdisciplinary workforce. Using both open-ended and specific categorical questions, respondents were asked to describe and convey information about the supervision process and experience in their agency. An Internet-based survey was used to reach a broad spectrum of social work practitioners and educators (975 deliverable and 426 completed) across the United States.     

Achieving Collaborative Competence through Interprofessional Education. Lessons Learned from Joint Training in Learning Disability Nursing and Social Work

The ability to work interprofessionally is widely regarded as essential to professional education and training for social work. The changing contexts of social work practice and the requirement for integrated working are regular reminders of the need for social work students to develop collaborative competence. Guidance preceding the development of the social work degree emphasised that social work students should undertake specific learning and assessment in partnership working and information sharing. This suggests that aspects of interprofessional education are relevant to the teaching and development of social work students if graduates are to successfully engage in complex practice.

This paper seeks to identify the competencies needed for successful collaboration. It then draws on evaluative research of joint training programmes in learning disability nursing and social work in England to discuss the unique experiences and perspectives of graduates whose social work training was exceptionally interprofessional. The paper will discuss how some of the findings from this research can indicate lessons for promoting collaborative competence in singly trained social work students. It will argue that interprofessional learning opportunities are one of the key ingredients for the development of critical practice.     

A case study of failure to thrive and inter‐agency work

Social workers and medical professionals have an ambiguous relationship. Though expected to work together within the child protection regulations of the Children Act 1989, there are many tensions. In general, social workers and health visitors enjoy close working relationships, but tensions are frequently experienced as one proceeds higher up the medical hierarchy. The reasons for this may be numerous, but in practice may obstruct speedy action in detection and prevention of disease which is social in aetiology — yet all professionals have an important role. I hope to demonstrate this in the following case study, where ‘failure to thrive’ took 18 months to evidence but, without inter‐agency working, might have proved fatal to the child. Copyright © 2000 John Wiley & Sons, Ltd.     

Joining up children's services: safeguarding children in multi‐disciplinary teams

In this article we reflect on the complexity and the contested nature of the roles of multi‐disciplinary teams working with children. This is an increasingly important issue in the current UK child welfare policy environment. The article uses the theories of Etienne Wenger to understand data gathered from five multi‐disciplinary teams working with children. We explore key issues relating to location; information sharing; models of understanding; and professional identities. We hope to demonstrate that the teams addressed tensions creatively through their engagement with diversity while at the same time developing common team values. We argue that effective strategies for making multi‐disciplinary teams work will combine inter‐agency issues with internal team‐specific aspects. Copyright © 2007 John Wiley & Sons, Ltd.     

Three Voices: Reflections on Homophobia and Heterosexism in Social Work Education

This article reviews recent developments in interprofessional learning in health and social care with a view to identifying the strengths and weaknesses of current initiatives in this area. As the emphasis increases on interprofessional working as a central pillar of intervention across the social work and health professions, corresponding moves have been made to incorporate parallel learning objectives in curriculum guidance issued by accrediting bodies such as the General Social Care Council and the General Medical Council. It is important, however, not to take the assumed benefits of this development as a ‘given’, or to oversimplify the task of turning high‐level aspirations into practically achievable and pedagogically effective learning experiences. This article therefore gives an account of one attempt to deliver realistic and worthwhile practice‐based interprofessional learning opportunities. The development, implementation and evaluation phases of this initiative are considered in order to draw out the key messages as to the strengths and potential shortcomings of this model, and the positive messages for good practice we believe we can offer.     

Urban Service Partnerships, ‘Street‐Level Bureaucrats’ and Environmental Sanitation in Kumasi and Accra,Ghana: Coping with Organisational Change in the Public Bureaucracy

This is an empirical case study of ‘street‐level’ officials in a classic ‘regulatory’ public agency: the Environmental Health Department in Kumasi and Accra, Ghana, where privatisation and contracting‐out of sanitary services have imposed new ways of working on Environmental Health Officers. Both internal and external organisational relationships are analysed to explain the extent to which these officers have adapted to more ‘client‐oriented’ ways of working. Their positive organizational culture is credited with much of the positive results achieved, but was not sufficient to cope with the negative impact of politically protected privatisations on the officials' ability to enforce standards. Nor could it entirely overcome the deficiencies in training and incentive structures which should have accompanied the changes in service delivery.     

Training the workforce following a serious case review: lessons learnt from a death by fabricated and induced illness

In England, when a child dies as a result of suspected maltreatment, the Local Safeguarding Children Board is required to establish whether lessons can be learnt about collaborative working to safeguard children. These reviews usually include recommendations for both inter and intra‐agency training. In this paper, the authors argue that it is crucial, when planning and delivering training in this situation, to recognise the emotional impact on the workforce of the death of a child from maltreatment. This is particularly important when the child has died as a result of fabricated and induced illness (FII) by a carer and professionals may have inadvertently contributed to the child's suffering. Drawing on a case example of training following the death of a child from FII, this paper considers the challenges encountered by those responsible for commissioning and providing training. Attention is given to managing logistics, such as time delays between the death of the child and the eventual publication of the serious case review. The particular knowledge and skills required by trainers, not only in relation to the subject matter but also in managing complex group processes, are discussed. The support required by course participants and the trainers themselves is explored. The paper concludes with a checklist for those commissioning and providing training. Copyright © 2009 John Wiley & Sons, Ltd.     

Training together--part two: An exploration of the evaluation of a shared learning programme on dual diagnosis for specialist drugs workers and Approved Social Workers (ASWs)

This paper describes a formative approach to evaluating a shared learning training course for ASWs and drugs workers on dual diagnosis. It uses a four-stage approach to evaluation in an attempt to explore issues relating to curriculum content, training methods and design, learners' satisfaction with the training and outcomes in respect of practice. It also draws upon a recent review of interprofessional education undertaken by the British Education Research Association (BERA) to explore to what extent interactive methods of learning are employed through the training delivery as a means of fostering improved interprofessional collaboration that can be transferred from the training environment to professional practice. The paper concludes that although limited in its generalisability and the extent to which changes in practice can be attributed to the training, the training providers have learned some useful lessons about how to maximise the value of a shared learning approach in promoting collaborative working between ASWs and drugs workers.     

Information sharing and reporting systems in the UK and Ireland: Professional barriers to reporting child maltreatment concerns

Across the UK recent policy developments have focused on improved information sharing and inter‐agency cooperation. Professional non‐reporting of child maltreatment concerns has been consistently highlighted as a problem in a range of countries and the research literature indicates that this can happen for a variety of reasons. Characteristics such as the type of abuse and the threshold of evidence available are key factors, as are concerns that reporting will damage the professional‐client relationship. Professional discipline can also impact on willingness to report, as can personal beliefs about abuse, attitudes towards child protection services and experiences of court processes. Research examining the role of organisational factors in information sharing and reporting emphasises the importance of training and there are some positive indications that training can increase professional awareness of reporting processes and requirements and help to increase knowledge of child abuse and its symptoms. Nonetheless, this is a complex issue and the need for training to go beyond simple awareness raising is recognised. In order to tackle non‐reporting in a meaningful way, childcare professionals need access to on‐going multidisciplinary training which is specifically tailored to address the range of different factors which impact on reporting attitudes and behaviours. Copyright © 2009 John Wiley & Sons, Ltd.     

Going beyond training: theory and practice in managing learning

The establishment of new bodies to replace the Central Council for Training and Education in Social Work (CCETSW) and to regulate the social work profession provides the opportunity to establish an improved progressive system of qualifications and continued professional development in the coming years. With the current pressure on social work agency budgets it is imperative that precious training resources—staff and money—are used to make the maximum impact on service delivery. Our involvement in the provision of a range of training programmes leads us to believe that much of the staff development and training effort invested by agencies in their staff often seem to have a limited impact on effectiveness. A change in approach is needed so that learning is placed at the heart of organisational processes to maximise the benefits of affirmation and growing professional confidence. This is essential if we are to continue to ‘nurture’ valuable professional staff and ensure that services remain flexible, creative and responsive in meeting ever‐rising public expectations.

This paper examines some of the challenges of evidence‐based practice and the demands for routine evaluation and objective‐setting. The advantages and disadvantages of a competence specification approach within the development of service and occupational standards as the basis for professional education are discussed. The paper argues that strategies for practice learning require the development of learning organisations and a better academic and agency partnership to support more effective professional education and continued professional development.     

Parental mental health and child protection—making the links through training

This article refers to the impact on single discipline working on professional understanding of mental disorder, particularly as it relates to child protection. The dilemmas of bringing a multi‐agency group with diverse experiences and knowledge base together into one training event are considered, with suggestions as to how the difficulty might be addressed. Topics of common concern are identified and training techniques and methods described. The benefits and outcomes of joint training across disciplines and agencies is acknowledged in relation to child protection and parental mental disorder Copyright © 2003 John Wiley & Sons, Ltd.     

Interprofessional education: a curriculum response to work with children and young people

This paper charts the development of undergraduate teaching material produced at the Open University in the United Kingdom. The School of Health and Social Welfare at the University has a long history of providing open and distance learning and multiprofessionally focused education and training opportunities. In this instance two courses, entitled ‘Working with Young People’ and ‘Working with Children and Families’, were created to meet the needs of a diverse student audience working across the public, voluntary and private social care, health and education sectors. The materials produced were underpinned by the desire of their academic authors to challenge long‐established assumptions about the nature of children and young people's lives. Crucially though, both course developments reflected a requirement to demonstrate how policies and services for children and young people might be significantly improved. Accordingly, the paper offers some useful indications as to how interprofessional working with children and young people could be fostered. Copyright © 2002 John Wiley & Sons, Ltd.     

Refocusing Children's Services Towards Prevention: Lessons from the Literature

Increasingly, western developed countries are committed to improving prevention and early intervention strategies that address risks in all areas of children's lives. This article considers the ‘how’ and ‘why’ of such refocusing activity. Five sets of strategies for refocusing are described: developing and using local evidence; designing, implementing and evaluating new services (alongside de‐commissioning); fiscal control; mainstreaming reforms and ensuring sustainability; and structural reorganisation. Five benefits of such reforms are outlined: improved outcomes; better inter‐agency working; greater efficiency; improved practice and outputs; and enhanced user and staff satisfaction. The article notes ways of mitigating the risks of refocusing and the need for practical methods that connect strategies and overcome obstacles in order to achieve the identified benefits.