The Scottish Executive has introduced a number of policies in recent years to encourage more effective integration of public services. This review considers the existing evidence base on integrated children's services and highlights issues emerging for developing the evidence base further.
A wide range of sources was identified. Sources selected for review included those that had evaluated outcomes from integrated working, those that involved a discussion of the barriers and facilitators for integrated working and papers that reviewed literature around integrated working and multi-agency team work.
Terminology within the literature is confusing with a number of inter-related terms and definitions within the field of integration. This raises a number of challenges for clearly communicating what the integration agenda is about, gaining a shared understanding among professionals about what it means and for measuring the outcomes from integrated services. A clearly articulated definition of integration may contribute to enhancing communication and understanding.
Evidence to support integrated working
A wide range of potential outcomes is anticipated from integrated children's services, such as improved achievement through school, better health, less anti-social behaviour, better support for vulnerable families. There may also be potential for cost-savings as a result of more effective working between agencies.
Inquires into child protection cases have underlined what can happen when services fail to work in an integrated manner. It is assumed therefore that when services work better together, providing integrated services to children and their families, that better outcomes should be achieved. However there is a lack of evidence to confirm such thinking, compounded by a difficulty in reliably measuring such outcomes. It is also assumed that such a way of working will result in economic efficiencies but again there is a lack of evidence to currently support this.
Much of the literature investigating integrated working comments on the process involved and gathers evidence from professionals involved in that process on the benefits and challenges of integrated working. There is subsequently plenty of literature discussing the barriers to integrated working and the factors that contribute to success. Common themes emerged from the literature reviewed:
- Concern about funding integrated services
- Cultural differences between professionals
- Clarity about roles and responsibilities and the purpose of partnership working
- Organisational climate
Despite highlighting the limitations of the current evidence base on integration, the review demonstrates that a substantial evidence base on the challenges, barriers and key factors for success exists. Such evidence should contribute to further developments in integrating children's services.