WORKING TOGETHER

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The importance of multi-agency working and integrated working
Integrated or multi-agency working is a formal way of working together in partnership. A partnership can be formed by a number of individuals or organisations with a shared interest. Different services and professionals working together with other teams of people in order to meet the needs of children, young people and their parents[1].

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Multi agency working enables different services to join forces in order to prevent problems occurring in the first place. It is an effective way of supporting children, young people and families with additional needs and helping to share improved outcomes[2].They provide benefits for children, young people and families because they give tailor-made support in the most efficient way. The benefits include:

·         Early identification of issues and intervention

·         Easier or quicker access to services or expertise

·         Improved achievement in education and better engagement in education

·         Better support for parents

·         Children, young people and family’s needs addressed more appropriately

·         Better quality services[3].

The children Act 2004 clearly sets out the integrated children’s services agenda requiring agencies to work much closer with local communities to ensure a more seamless provision of service to children young people and their families’[4].The basic elements that enable integrated working involve the following:

·         Information sharing

·         The common Assessment Framework(CAF)

·         Lead practitioner

·         Team around the child

·         Localities[5].

By working with professional and agencies we can help improve the outcomes for children learning, which is a requirement of UK government initiative ‘Every child Matters’(ECM).

Integrated working is everyone supporting children and young people-working together effectively to meet the needs of individual children and improve their lives. It involves everyone who works with children and young people, part or all the time; whether employed, self-employed or in a voluntary capacity. If you are a nurse, a teacher, youth worker, sports coach, social worker or any other member of the children’s welfare, integrated working concern you[6].

If you work with children, your career is likely to involve close working with other agencies. Multi-agency working is an effective way of supporting children and families with additional needs. Its work brings together practitioners from different sectors and professions within the workforce to provide integrated support to children and their families, for example a ‘team around the child’. It is an effective way of supporting children with additional needs and helping to secure real improvements in their life outcomes[7].
Multi-agency working is basically a team that work around a particular family in order to give them the help and support that they need. It often includes different people from different professional backgrounds, e.g. police, social workers, Early Years etc. 
It is an effective way of supporting children with additional needs and helping to secure real improvements in their life outcomes.

If you work with children, your career is likely to involve close working with other agencies. It is at the Centre of making a real difference to the lives of children, young people, and their families.
It is made up of different processes and tools to help practitioners and manager to work together. Integrated and multi-agency working is also collectively known as partnership working.

How integrated working practices and multi-agency working in partnership deliver better outcomes for children and young people.
Integrated working involves changes to the current practice culture across the children’s workforce, to provide services that make more sense to the parents, children and young people using them. Change is required in all agencies at every level of organisation management and practice.

Without any professional and service specific boundaries, the plan integrates delivery of services for children and their families in constituency Areas integrated at the point of delivery with no duplication of service. These require practitioners to use common approaches and process and share information.
There are a number of integrated working tools and guidance documents available which will help to ensure that a child or young person only has to tell their story once to get support they need.
The basic elements that enable integrated working are:

·         Information sharing

·         The common Assessment Framework(CAF)-is the key part of delivering frontline services that are integrated and focus around the needs of children and young people

·         The Lead practitioner

·         Team around the child

·         localities[8]
The multi-agency share common assessment information with the consent of the young person/family) so it can be analysed and understood. Also they identify how support can be offered to the child and family to meet needs assessed through one of a CAF assessment. The agencies agree possible solutions and appropriate actions, including actions for the family and child to undertake where appropriate. They also record these actions and timescales as a CAF Action plan.
They also provide copies of the plan to all TAF members including the family of the child/young person, as appropriate. They arrange as necessary, additional requests for involvement/referrals, supported by a common Assessment, as a pathway to other targeted and specialist services. Decide if a lead professional is needed to coordinate the acts of agencies and to liaise with the family[9]. Multi agency working is a holistic approach to child care and education and is an important feature of government’s Every Child Matters Framework. The five outcomes for ECM are:
 
·         Be healthy

·         Be safe

·         Enjoy and achieve

·         Make a positive contribution

·         Achieve economic wellbeing.

Working in partnership, when done well, enables partners to:

·         Ensure that everyone communicates about the whole child

·         Prevent problems occurring in the first place

·         Support children, young people and families with additional needs

·         Help to secure improved outcomes[10].

There are many reasons as to why integrated working practices and multi-agency working deliver better outcomes for children and young people than just an individual opinion or observation would. More observations and more opinions mean that it is more liable to come to a more accurate result, which will benefit the child as they will more than likely receive the help they need a lot quicker, and it is more likely to be the help that they require[11].
There are many outcomes for children that will be positive if the professionals working with the children and their families can share and agree upon the way they might assess, plan and implement for the child. Both the children and their parents can be involved in any plans to ensure that a child can achieve their potential. If the outcomes for any child are to be positive it is important that all adults involved understand what information can be shared and the importance of confidentiality.

The functions of external agencies with whom your work setting or service
My work setting works together, adopting a joint, multi-agency approach with external agencies. Those that we work together are other children carers and teachers. These are involved in maximising the child’s learning and experiences. The others are the outside professionals who work on providing support in other areas and these are:

·         Child care workers

·         Social workers

·         Police officers(with special training)

·         Child’s GP

·         Probation officers

·         Education welfare officer

·          school nurse

Also we work with new organisations known as Children Trusts which are now bringing together services for children and families:
·         Health services- including health visitors, speech and language therapists and education psychologists

·         Social services- including social workers, family support workers and child protection teams[12].

All these agencies are regulated by many laws and regulations covering the provisions of --- equality of access and opportunity for all children, in addition to health and safety: Every child matters contain the government agenda which set out five major outcomes for all children:

·         Being healthy

·         Staying safe

·         Enjoying and achieving

·         Making a positive contribution

·         Economic wellbeing[13]

So that to help children who are not progressing well you should be able to seek the support that they may need to make the progress they need in consultation with parents, carers and children.Specialist support and advice can be sought from many professionals who focus on particular areas including:

·         Educational psychologists-focusing on behaviour and learning

·         Child psychiatrists- focusing on though and emotions

·         Play therapists- focusing on dealing with emotions through play

·         Paediatricians-focusing on health and development

·         Health visitors-focusing on development of under fives

·         Physiotherapists-focusing on the function of the body

·         Speech therapists- focusing on speech and language

·         Advisory teachers-focusing on learning and progress towards national or local curriculum

·         SENCO advisor- Focusing on supporting SENCO (special education needs coordinators)[14].

The different agencies share findings of their assessments with parents and carers and others, informing them about the progress about the child and young person’s progress which is a crucial part of working together.

·         Education welfare officer | Education welfare officers (sometimes known as education social workers) work with schools, pupils, and families to resolve issues of poor attendance. Closely related to this job is the schools attendance officer. |

·         Educational psychologist | An educational psychologist is concerned with helping children or young people who are experiencing problems within an education setting with the aim of enhancing learning. |

·         Teaching assistant | Teaching assistants (TAs) usually work with a teacher in their classroom, making sure pupils get the most out of lessons (e.g., by helping them find their way around a computer). |

·         Higher level teaching assistant | HLTAs usually undertake more complex tasks and tend to work more independently than other classroom-based staff. |

·         Play worker | Play workers plan, organise and supervise play and activities for children and young people inside and outside school. |

·         Learning mentor | Learning Mentors work with school and college students and pupils to help them address barriers (and potential barriers) to learning through supportive one-to-one relationships and sometimes small group work[15]. |

·         The role of a speech and language therapist (SLT) is to assess and treat speech, language and communication problems in people of all ages to enable them to communicate to the best of their ability. They may also work with people who have eating and swallowing problems. Using specialised skills you will work directly with the client and provide support to them and their carers.

Therapists use a variety of strategies, including:

• Language intervention activities

 • Articulation therapy

• Oral-motor/feeding and swallowing therapy Activities they would do with a child:

 • Language intervention activities:

 The SLT will interact with a child by playing and talking, using pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct pronunciation and use repetition exercises to build speech and language skills[16].
Common barriers to integrated working and multi-agency working and how these can be overcome.
There are various barriers to effective integrated working:

a).communication difficulties: often there are differences in cultures of different agencies and this can lead to difficulties in understanding the specialist terminology and language used by other professionals. This can also be in the form of poor communication or a lack of communication, misunderstanding of situations, inconsistent or inaccurate record keeping and also not following policies or procedures. Barriers such as the few I have just named can stop people from effectively communicating with one another, which can then cause distress and also could lead to certain harmful situation.

b).information sharing
The ways in which a lack of communication can cause problems can be seen in the case of Victoria Climbed. As we know the systems that were involved such as social services and other agencies did not communicate with each other and so therefore tragically, Victoria died in a gruesome way due to the fact there was a lack of information being passed on from one agency to another. Good aspects that have come out of this terrible situation though include ECM (Every Child Matters) and also the Children Act 2004.
c).lack of support: not knowing whom to contact for advice and support with information sharing. This often leads to lack of confidence.
d).The fear of the new: some practitioners may feel threatened by new approaches that require them to work differently ad to work across service boundaries. They feel out of their ‘comfort zone’
e).Lack of understanding of different agency roles: if practitioners do not fully understand the roles and responsibilities of other services and practitioners, they may lack trust and worry that a different agency may not treat the matter confidentially, or even that other practitioners may make things worse for the child or young person or family[17].
f). another way a barrier can be made is if practitioners do not follow certain policies and procedures. A way that this can cause problems is that it can put children in harmful and dangerous situation. A way that this can be overcome is to have regular safety checks by other professionals in this sector to ensure that the setting is safe and that staff members are following procedures, this will help to make sure children are not victims and are not in any risk.
g).Finally one last barrier that can be caused is a misunderstanding of information that has been passed on. Even though the fact that the information has been passed on is good, you must always make sure what is being passed on is a clear indication of the situation and that it has been received clearly too. A way in which this barrier can be overcome is to always check with the person who is receiving the message that they understand clearly the message[18].

h). not everyone will agree on things and different professions may work in different ways and word things differently. People may have been trained in a different role to which they may find it difficult to be managed by a person with different skills. Some people may not be used to sharing their knowledge with others. It’s important that each profession respect one another and that they value there knowledge and expertise by doing this it will make better multi-agencies working together. Make sure they have clear aims, roles and responsibilities and timetables that have been agreed between the different agencies also that good communication and information sharing is carried out[19].
 Multi-agency working helps to meet the needs of children, their parents or carers, different services, agencies, teams of professionals and other practitioners will work together to provide the services that a child or their family may need. Visits to a child’s home or could even have links to training or employment opportunities for families with children under five. In my work setting we help to support working parents by some children may have a range of needs, and the way that we work together can have a positive impact on their health, development, learning and well-being.ECM Every Child Matters, the five outcomes of ECM is that we should be working together to achieve the best possible outcomes for the children in our care these outcomes are as follows. 1. Be healthy 2. Stay safe 3. Enjoy and achieve 4. Make a positive contribution 5. Achieve economic well-being][20].

 How and why referrals are made between agencies
Most children and families who need additional support can obtain it through one of the professionals working in a school or community health setting such as a family worker, health visitor or personal advisor. Many local authorities have set up a multi-agency referral panel(MARP) or something similar. This comprises a team of local professionals from a variety of backgrounds. The panel usually includes a:

·         Health visitor

·         Social worker

·         School attendance officer

·         School nurse

·         Psychologist

·         Youth worker.

The panel meets regularly to work together to produce a holistic solution to an individual child’s circumstance. Because each individual has different needs, and possibly a variety of problems, different agencies agree to take the lead on different aspects of a case. No case is closed unless everyone is happy with the outcome[21].
Children and young people may be able to access support from multi-agency service by requests initiated by:

·         Practitioners

·         Parents and carers

·         The child or young person themselves

Before making a referral, practitioners are expected to obtain the informed consent of the parent, carer or the young person to the provision of services. Often the Common Assessment Framework Form (CAF) is used as supporting evidence for referral-meaning that there is no need to duplicate the information contained in the CAF assessment on separate referral form. If not supported by CAF assessment, then the referrer should use the multi –agency referral form to make detailed notes about the individual child’s needs, any other issues they are aware of, and what they have done so far to meet those demands[22].
It’s important that referrals are made in order for the child to get the best possible outcomes and by practitioners doing observations and recording evidence this is made possible for the child to be referred to the correct professional.
It’s important to identify the need for additional support as early as possible without it the children will not get the help they need at the right time and this could have an effect on the child’s wellbeing. You must get the parents’ permission for any child to be referred and keep them well informed. Early intervention teams have been set up in England to work with children with additional needs from birth to the end of EYFS. In my setting if a referral is made from the SENCO teacher she will get in touch with the right agency who will then come and do an initial assessment or observation on the child and then the correct help will be put into practice for the child. If concerns are that a child is not being looked after or is being abused then if the child is in no immediate danger then the child will be observed and spoken to without asking any leading questions and all findings kept in a secure file which is strictly confidential and on a need to know basis it is then up to the safeguarding person in school to pass his concerns and evidence on to children’s social services[23].
It’s important that referrals are made in order for the child to get the best possible outcomes and by practitioners doing observations and recording evidence this is made possible for the child to be referred to the correct professional, for example; a child with hearing difficulties mat need to be referred to a support service for deaf children or children who have impaired hearing.

 Panels are usually made up of different agencies and these panels determine the access that is available between settings these panels aim to support the early identification of children’s needs, monitor children’s progress, ensure a child’s needs are identified and assessed quickly and referred to the appropriate setting, coordinate provision through the development of partnership with parents, settings and different agencies and support inclusion in mainstream early years settings.
 It’s important to identify the need for additional support as early as possible without it the children will not get the help they need at the right time and this could have an effect on the child’s well-being. You must get the parents’ permission for any child to be referred and keep them well informed. Early intervention teams have been set up in England to work with children with additional needs from birth to the end of EYFS. The early year’s intervention team will be part of the multi-agency panel enabling referrals to be made between settings. Early year’s intervention team promote inclusive practice, provides advice support and training in settings, supports transitions into schools, ensures that parents are fully aware of and involved in any referral process and they liaise with parents, carers and multi-agency professionals[24].

The assessment frameworks that are used in own UK Home Nation.
A CAF(Common Assessment Framework) is standardised approach to assessing the additional needs of children who are at risk of not achieving their potential. It is a process of identifying the needs of children at an early stage so that agencies can deliver a coordinated approach to children families[25]. The CAF is a standardised approach to conducting an assessment of a child’s additional needs and deciding how those needs should be met[26].

The Common assessment framework is a shared assessment and planning framework to be used across all local areas and children's services in England. [It aims at helping in early identification of children's extra needs and promotes provisions to meet these needs.][27]
The common Assessment Framework is also an important method of communicating with other agencies and professionals’. The CAF is a key component of Every child matters programme and is used by practitioners to assess the additional needs of a child and their family which will help to identify which services will meet their needs. The CAF has three elements:
1.    A simple pre-assessment checklist: to help practitioners identify children or young people who would benefit from a common assessment.
2.    The three step-step process(prepare, discuss, deliver) for undertaking a common assessment to help practitioners gather and understand information about the needs and strengths of the child, based on discussions with the child, their family and other practitioners as appropriate.
3.    A standardised form: to help practitioners record and where appropriate, share with others the findings from the assessment, in terms that are helpful in working with the family to find a response to unmet needs[28].

 The potential tension between confidentiality with the need to know
Confidentiality is an important principle in children’s and young people’s setting as it imposes a boundary on the amount of personal information and data that can be disclosed without consent. Confidentiality arises where a person disclosing personal information reasonably expects his or her privacy to be protected such as in a relationship of trust[29].In the multi-agency working private information about a child or young person may often be shared with other professional persons within the partner   network. The obligation to preserve the child’s confidentiality then binds all professionals equally. Records should only show information that is essential to provide the service, and in many instances should be available to the scrutiny of the child and his or her family[30].
The need to gain a young person’s trust and to build a positive relationship with him or her often leads to misunderstandings. To maintain a trusting relationship, practitioners should:

·         Be explicit with young people regarding the boundaries within which they work; the boundary will normally exclude information which if withheld, may leave someone exposed to danger.

·         Not lie on behalf of young people and it is important that they make them aware of this.

·         Be aware that young people may assume that, through implication, confidentiality goes further than it actually does.

·         Understand that they may need to make a tactical withdrawal so that they do not witness an anticipated incident[31].

All settings should have a designated person to deal with child protection issues. If you have concerns that a child is being abused it is our job to disclose this information to the designated/manager of the setting unless you think by disclosing the information will put the child/young person in further danger. This can be very hard to work out so having colleagues to discuss this will help you come to a quick conclusion and more accurately. This can become very difficult if you feel that there is child/young person abuse issue and the designated/manager thinks that there isn’t. I think if you have a doubt then it is better to be safe than sorry, maybe monitor the child and gather more information but if the child is in significant danger then report it to the safeguarding board immediately. Parents will have had a copy of the child protection policy which states that information regarding every child will be disclosed if it is deemed that any child is in significant harm/danger. This gives us the right to report any kind of abuse to the safeguarding board without the parents/carers permission. It is important to follow the right steps whilst reporting a case of abuse or a suspected case, we need to gather the correct information

When a child/young person discloses information to you. Do not promise to keep a secret. If the child/young person confides in us we cannot promise to keep it a secret because we will have to disclose the information given and this will make the child think that they cannot trust that person anymore, they trusted you in the first place to disclose the information[32].


©2014 All rights Reserved

[1] C. Meggitt(2011) Children and young People’s Workforce, Hodder Education p.178
[7]cypwdiploma.com/cyp-3-6unit-6-working-together-for-the-benefit-of...
[10] C. Meggitt(2011) Children and young People’s Workforce, Hodder Education p.179
[12] M Walker(2009) Children’s Care ,learning and Development 2nd edition, Nelson Thornes p.144
[13] M. Walker (2009) p151
[14] M.Walker (2009) p281
[21] C. Meggitt(2011) Children and young People’s Workforce, Hodder Education p.189
[22]  C. Meggitt(2011) Children and young People’s Workforce, Hodder Education p.190
[26]cypwhelp.com/cyp-3-6unit-6-working-together-for-the-benefit-of...
[28]   C. Meggitt(2011) Children and young People’s Workforce, Hodder Education p.186

[29]    C. Meggitt(2011) Children and young People’s Workforce, Hodder Education p.186

[30] C. Meggitt(2011) p.187
[31] C.Meggitt(2011)p.187

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