The impact of inter-professional working on service delivery for Sure Start & the Children’s Centre A M HOUSTON L PARKER North Leyton Sure Start 2005

In the beginning… A pleasant surprise! NESS What to evaluate? Who to appoint? Louise The meeting of decision makers – Louise again! Untangling all interested parties agendas – the importance of keeping it small The vehicle being SALT Devising the key questions Tender process

Issues Ethics Time The unknown Keeping everybody happy Keeping staff on board Ethics – a review to avoid having to get full ethical approval – the chair of ethics

The Purpose of the Review To address referral & access patterns, with particular reference to SALT To examine the Sure Start Language Measure To examine inter-professional working: assessing effectiveness of structures & processes

The Purpose of the Review To address client perception of new service provision To consider any barriers to integration & identify good practice to take forward into children’s centres

Methods Realistic Evaluation One to one interviews Focus groups – client & professional Thematic analysis

Comparison between the old & the new system: the case of SALT Methods Comparison between the old & the new system: the case of SALT Local Community Clinic figures vs. Sure Start figures for Initial Assessment Hard data Hand collected from local community clinic

Findings: Community Clinic 56.2% of children not making it to initial assessment appointment in clinic 27.6% Unable to attend 28.52% Did not attend 13 week wait for initial assessment

Findings: Sure Start 63.7% seen within one week 28.2% seen within 2 weeks NO 2nd waiting list

Positive elements of team working included: Findings Positive elements of team working included: Speed of referral within the team Speed of follow-up within the team Proximity of team members impacting on team learning

Difficulties with team working included: Findings Difficulties with team working included: Team Structure Communication Confidentiality Joint record keeping

Parents Views “most things under one umbrella” “I think of her as being like my sister” “Sure Start speaks for itself…people appreciate what you are doing ...they begin to tell others & they are the advertisement”