Multi-agency working in services for disabled children: what impact does it have Blackwell Publishing, Ltd.
David Abbott LLB Hons, M.Phil, M Soc Sc, Ruth Townsley BA Hons, PhD and Debby Watson BA Hons, MSc, CQSW Norah Fry Research Centre, University of Bristol, UK
David Abbott Norah Fry Research Centre University of Bristol 3 Priory Road, Bristol, BS8 1TX E-mail: email@example.com
Abstract Whilst agencies in many sectors have been encouraged to work together to better meet the needs of service users, multi-agency working is now a central feature of government policy. In relation to children’s services, the National Service Framework, the English green paper, ‘Every Child Matters’ (DfES, 2003) and the Children Bill (DfES 2004) give a high priority to an integrated approach to service provision. This paper focuses on multiagency working for disabled children with complex health-care needs, a group of children who, perhaps even more than most, require the many professionals who support them and their families, to work more closely together. Drawing on the findings from a 3-year qualitative research study, this paper examines the impact of working in a multi-agency service on professionals. Interviews with 115 professionals concluded that staff were overwhelmingly positive about working as part of a multi-agency service. They reported improvements to their working lives in areas such as professional development, communication, collaboration with colleagues, and relationships with families with disabled children. However, whilst professionals felt that they were able to offer families a more efficient service, there was concern that the overall impact of multi-agency working on disabled children and their families would be limited. Keywords: disabled children, impact on professionals, multi-agency working Accepted for publication 5 October 2004
Introduction and background
Disabled children with complex health-care needs Children with complex health-care needs and their families have the same range of needs for services and support as other disabled children. But they also have additional care needs specifically related to the use of medical technology. This group of children typically require technical and/or medical equipment in the home, both because of their need for intensive ongoing care, and to compensate for the loss of a vital bodily function such as the ability to breathe or feed independently (Wagner et al. 1988). The combination of this group of children’s needs for health, social care and education means that it is inevitable that several agencies will be involved throughout their lives. Research © 2005 Blackwell Publishing Ltd
has shown that on average, families of disabled children have contact with at least 10 different professionals, and, over the course of a year, attend at least 20 appointments at hospitals and clinics (Care Co-ordination Network UK 2001). For families of disabled children with complex health-care needs, these numbers are likely to be very much higher. It is well established that the range, diversity and different levels of support are, in themselves, major problems for families (Townsley & Robinson 2000; Kirk & Glendinning 1999, Sloper & Turner 1992). The sheer number of professionals who may be involved in supporting a disabled child in the community can often lead to a lack of continuity and coordination and may leave families uncertain about who to contact regarding specific problems (Kirk & Glendinning 1999, Townsley & Robinson 2000; Wilcock et al. 1991). 155
D. Abbott et al.
Multi-agency working – the policy imperative Multi-agency working became a policy imperative when the new Labour Government fixed on ‘partnerships’ as an alternative ethos to the internal market and competition in services (Alexander & Macdonald 2001). Current legislation requires professionals to...