Integrated Working Presentation to Camden PCT and London Borough of Camden 30 th August 2007 Mary Galashan, DCSF

Contents What is Integrated Working (IW)? Why and how was Integrated Working developed? Is there any evidence that IW improves outcomes for children and young people? Why should health practitioners participate?

What is Integrated Working? Integrated working is where everyone supporting children and young people works together effectively to meet their needs and improve their lives. By combining their professional expertise, knowledge and skills and involving the child, young person or family throughout, practitioners can: identify needs earlier; deliver a coordinated package of support that is focused around the child or young person; and help to secure better outcomes. Integrated working is achieved through collaboration and coordination at all levels, across all services, in both single and multi-agency settings. It requires clear and ongoing leadership and management. At an operational level, it is facilitated by the adoption of shared service delivery models, tools and processes.

Technology change is only one part of the picture of Integrated Working … ICS ContactPoint e-CAF Technology Change + Business Change + Culture Change Lead professional Safeguarding arrangements Improved information sharing Early & holistic identification of needs Coordinated service delivery Integrated needs analysis

Why was Integrated Working developed? The cross government Every Child Matters: Change for Children (ECM) programme and the Integrated Working processes and tools were developed following the inquiry into the death of Victoria Climbiè. The development of the NSF for Children, Young People and Maternity Services was also influenced by the inquiry’s recommendations. The policies set out in ECM and NSF are designed both to protect children and maximise their potential. Evidence from existing collaborative practice and consultation on ECM endorsed the view that better outcomes will be secured by services working together more effectively on the front line.

The challenge for ECM – Sept 2003 Conduct disorder Statement of SEN Children in need At risk register ASSET APIR Social Worker Youth offending team Child psycho- logist Ed welfare officer Connex -ions PA SENCO & Ed Psycho- logist LEA special educational needs Connex -ions EWSCAMHSYOT Social Services Youth workers Youth Service = assessment = worker = agency Health visitor PCT Risks to parents Children’s Fund Universal Education Universal Healthcare

Better service experience for children, young people and families Benefits of integrated working Earlier, holistic identification of needs Earlier, more effective intervention Faster, more co- ordinated delivery of service for the child or young person Improved information sharing and collaborative working across agencies Improved outcomes for children, young people and families

Key elements of Integrated Working Integrated Processes and Tools Information sharing guidance Integrated Front-Line Service Delivery Children’s Centres Targeted Youth Support Children’s health NSF Extended Schools Safeguarding Youth crime Reduction Improved outcomes: Be Healthy Stay safe Enjoy and achieve Make a positive contribution Achieve economic well-being Common Assessment Framework (CAF) Lead professional ContactPoint Service directories Championing Children ICS Children Missing Education

Key integrated working processes & tools Information sharing guidance – cross government guidance that seeks to provide clarity on the legal framework for practitioners sharing information about children, young people and families, and give practitioners confidence in making decisions. Widely endorsed by professional bodies including GMC, RCN, RCM, NMC, RCGP, RCPCH and ICO. CAF - The Common Assessment Framework is a standardised approach to conducting an assessment of a child's additional needs and deciding how those needs should be met. eCAF – national IT system that will support the CAF Lead professional - practitioner who takes a lead role to ensure that services to a child and young person are co-ordinated, coherent and achieving intended outcomes

Key integrated working processes & tools (cont’d) ContactPoint – will provide practitioners with an online directory to find out quickly who else is working with the same child or young person, making it easier to deliver more coordinated support. It will not hold case data Service Directories – online resources developed by local authorities to provide comprehensive information on local providers, eligibility criteria, geographical location and referral procedures Championing Children – a framework that establishes a common understanding of the abilities required by managers of children’s services who are responsible for teams that include professionals from different sectors and backgrounds

Key integrated working processes & tools (cont’d) ICS – The Integrated Children’s System is a framework for working with children in need and their families. The ICS practice and case record keeping is supported by information technology designed to handle a large amount of information on individual children. Children Missing Education – statutory guidance and other resources supporting the duty on local authorities to identify children not receiving education. Reflects practices that local authorities have already found to be effective for identifying children missing education. Integrated Front-line Services Delivery – multi-agency teams providing integrated support to children and young people through Children’s Centres, Extended Schools, Targeted Youth Support, youth crime reduction programmes, etc

The focus of these tools is generally early intervention & prevention Common assessment from this point Information sharing between practitioners - supported by ContactPoint Lead professional from this point Lead role already required by statute or best practice, e.g. key worker Statutory or specialist assessments

Implications for Health practitioners Children Act 2004 placed statutory duties on all services including: to participate in making arrangements to promote co-operation to improve the well-being of children and young people to put in place arrangements to safeguard and promote welfare of children and young people to participate in the Local Children’s Safeguarding Board to disclose information to and permit access to information databases (ContactPoint) NSF Standards 1,3,5,6,8,9 all promote integrated working

Extract from NSF for Children & Young People 1.The health and well-being of all children and young people is promoted and delivered through a co-ordinated programme of action ….. led by the NHS in partnership with local authorities. 3.Children and young people and families receive high quality services which are coordinated around their individual and family needs … 5. All agencies work to prevent children suffering harm … 6.All children and young people who are ill … will have timely access to appropriate advice and to effective services which address their health, social, educational and emotional needs … 8.Children and young people who are disabled or who have complex health needs receive co-ordinated, high quality child and family-centred services … 9.All children and young people … who have mental health problems and disorders have access to timely, integrated, high quality multidisciplinary mental health services

Integrated working in practice "Talk…Don't Walk"—a local, charity-managed partnership project with the police, the local authority, health services, Connexions and the voluntary sector— is having a significant impact on reducing incidents of running away and associated risks to young people. Their second year report summaries the achievements: A total reduction of 313 runaway incidents in the Warrington area, exceeding the original target by 166 Recordable crime reduced by 51%. Over 16,000 Warrington people directly informed about the dangers of running away Over 300 young runaways and their families have actively engaged in the preventative work of the project Cost savings made by the project in excess of £1million to date

“Being healthy” supports the other 4 ECM outcomes Health practitioners have a key role to play as part of an integrated workforce supporting children and young people including: providing universal support service in very early years role in preventive services promoting a healthy lifestyle supporting children with particular health needs Improving all outcomes for children, young people and their families

For more information Every Child Matters website - Information on integrated working available at Latest updates on CAF, eCAF, ContactPoint are available from the IW page Latest updates on ICS are available at Guidance and training materials for integrated working processes and tools – also go to Fact sheets, case studies, Making It Happen

Integrated Working Additional information

Information sharing agreements (ISAs) The view of the DCSF is that ISAs and information sharing protocols are NOT required before frontline practitioners can share information about a specific child ISAs are primarily about agreeing and establishing processes, roles and responsibilities, and are particularly relevant to the supply of data from one organisation to another by electronic or other means. The decision to share or not to share information about an individual child should always be based on professional judgment The cross-Government Information Sharing: Practitioners’ Guide (published in April 2006) and training can support these judgments The lack of an ISA or protocol between agencies should never be a reason for not sharing information that could help a practitioner deliver services to a child.