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Multi-agency working is essentially about bringing together practitioners with a range of skills to work across their traditional service boundaries. This is currently regarded as crucial to the effective provision of children’s services. As local authorities re-organise to provide education, social care, and sometimes health provision, within a single children’s services department or children’s trust, three models for multi-agency working are emerging:
- Multi-agency panels or networks - the 'team around the child' - practitioners remain employed by their home agencies but meet on a regular basis to discuss children and young people with additional needs who would benefit from multi-agency input.
- Multi-agency teams made up of practitioners seconded or recruited into the team, making it a more formal arrangement than a multi-agency panel. The team works with universal services to support families and schools as well as individual children and young people.
- Integrated services which bring together a range of provision, usually under one roof, such as school or early years setting. Staff work in a co-ordinated way to address the needs of children, young people and families providing services such as all-year-round, inclusive education; care and personal development opportunities for children and young people; and specialist support for children and families.
Context for multi-agency working:
The idea of professionals and agencies working together is not new. There are many provisions in the Children Act 1989 which require different authorities to co-operate and to consult with one another while multi-agency support is a feature of the special educational needs framework, set up following the Education Act 1981, particularly in relation to statutory assessment and statementing. Since the Labour government came into power in 1997 a number of initiatives such as Sure Start and Connexions have been put in place to promote effective ‘joined up’ multi-agency working to support vulnerable children.
However, the recommendations which followed the Laming inquiry into the death of Victoria Climbié prompted a renewed determination to get services working together and in 2004 a new Children Act established a duty on agencies to co-operate with each other to protect and improve the lives of children. This has resulted in some of the following developments:
- The introduction of major changes to the children’s workforce. A comprehensive curriculum for training all practitioners who work with children is currently being developed by government. While this is not going to make all professionals knowledgeable about disabilities such as autism, they should have the basic skills to recognise a possible developmental delay, be able to support parents emotionally and, crucially, to know when to signpost parents on for more expert advice. Working with children is a key component of the core curriculum which recognises, for example, that some children do not communicate verbally and that practitioners need to adapt their communication to the needs and abilities of the child or young person.
- New ways of sharing information are being developed to avoid duplication, children slipping through the net and excessive bureaucracy. The government has developed ContactPoint, a database holding information on every child in England from birth to 18 years of age, possibly longer for children who are disabled or looked after. With greater electronic recording of personal information resulting in wider access in some cases, issues confidentiality are of concern to disabled people. Cross-professional legal guidance sets out how information sharing should happen and covers confidentiality in some depth.
- The Common Assessment Framework (CAF) which aims to provide a more standardised and preventive approach to identifying need and making provision and which operates across professional boundaries. Some children may be identified as having a possible disability such as autism via this route.
- Every local authority (except the best performing four star authorities) has to have a Children and Young People’s Plan (CYPP) focused on better local integration of children's services in locations such as extended schools and children’s centres. Families with children on the autism spectrum should find it easier to access services as a result and should be consulted about services they would like to see improved and developed. The CYPP covers all local authority services affecting children and young people including early years and extended schools and out-of-school child care, education, youth services, children’s social services. It also includes services provided by relevant youth justice agencies and health services for children and young people, including child and adolescent mental health.
Common Assessment Framework
SENCOs, health visitors, school nurses, workers in children’s centres and voluntary sector workers are among those beginning to use the CAF to assess additional needs in children, particularly where those needs cannot be met by a single agency. An example might be a SENCO who learns that the family of a child on the autism spectrum needs extra support, involving social services by initiating a CAF. While most children on the autism spectrum are likely to continue to be diagnosed following a referral to a paediatrician or other health specialist, the CAF may be the first step which leads to such a referral. Examples of the types of needs that children and young people may have that could require a multi-agency response through the CAF process include children with disruptive or anti-social behaviour and children suffering from anxiety or depression.
The CAF is not designed for use with children who have ‘complex needs’ defined as
- children at actual or potential risk of significant harm
- children in the public care system
- children who have complex health, educational or psychological difficulties
- children with severe disabilities
- children who have existing contact with youth justice services.
Most children identified as having autism which affects their learning in school will continue to be provided for through the special educational needs (SEN) framework. Those who need most help in mainstream schools and those whose parents choose special schooling will need a statement of SEN. There are major differences between the CAF and statutory assessment of SEN. Crucially the CAF brings no guarantee that services will be provided though the Government is currently piloting the idea of the lead professional having the power to commission services that may require funding. It may, therefore, be possible to access services that are not available through traditional routes in this way.
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The Children’s Workforce Development Council website includes information on the core skills, qualifications for practitioners and the Common Assessment Framework
Teachernet provides comprehensive guidelines from practitioners and the Autism Working Group aimed at raising awareness and standards of support for children on the autism spectrum. Autistic Spectrum Disorders: Good Practice Guidance was developed by the DCSF, the Department of Health and the Autism Working Group and includes representation from parent support organisations, practitioners, government agencies, local education authorities and researchers.
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Common Assessment Framework
Role of the lead professional
Children and Young People’s Plan
The National Autism Plan for Children
This is the completion of the work of the National Initiative: Autism Screening and Assessment, and was published in March 2003. Among its recommendations are the need for better multi-disciplinary and multi-agency working.
The report can be downloaded from the National Autistic Society website.
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Islington This project which developed, piloted and evaluated a multi-agency pathway for children and young people and their families with suspected autism came up with a number of key recommendations around parental participation, early identification and multi-agency working. It concluded that developing multi-agency services needed to be done in the context of reviewing all other children services as a whole across agencies. More detailed recommendations included the need for protocols to be clear and detailed to ensure that all involved understand their role and expectations. Agreed protocols needed to be consistently shared with all teams through service heads. There needed to be ongoing review of the way services were organised and structured to make best use of resources.
Well-resourced, integrated multi-agency teams required - time to work collaboratively
- to be co-located
- to include planning and decision making (with parents, nurseries and schools)
- to include parents and schools in the assessment planning, diagnostic and intervention process
- to be able to meet national timescales.
More information on the project can be downloaded by following this link.
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