Published: 22/04/2002, Volume II4, No. 5902 Page 32

Identify best practice as a way of helping disparate organisations work together, says Romi Bowen

The recent Children Bill and Every Child Matters green paper provide us with some important recommendations about how organisations should work together.We are all being encouraged to work across the health, education and social care system to improve outcomes for children, their families and their communities.

But what does it mean in terms of how we organise the work and, more importantly, how are we going to do it? One way may be to learn from the best practice followed by one element of the system.

For example, in health, clinical governance provides a framework and method for checking quality and consistency of delivery, but it has no direct comparison in, for instance, social services.

Clinical governance takes the quality assurance process used in social care a step further.

If this proves good practice for the system as a whole, why not learn from health and use the sector's knowledge and expertise to set up similar systems in social services and beyond?

At Southwark borough council, we have asked: 'Could we use a clinical governance approach to ensure that each agency really takes responsibility for the outcomes we are trying to achieve for service users?'

At present, some of this happens.Health may provide some training for social services and vice versa.But all too often, there is no follow-up.The individual who received the training is then left to their own devices, and receives limited checks to see if they are using their new knowledge in an appropriate way.

We need to recognise that it is no longer acceptable to allow this to happen and must aspire to a whole-system approach.Specialists in one area who may have provided training and support must ensure that the knowledge they have shared is used correctly, appropriately and, most importantly, makes a difference.

We are taking this forward in the field of substance misuse.A random sample of cases will be audited retrospectively to examine the care plans of children with substance-misusing parents.This will be used as a learning opportunity to improve the quality of care plans for this client group, in consultation with substance-misuse specialists, while monitoring the impact that training might have.

The knowledge gained would also be used to shape the design of assessments and interventions.This will mean a real change to the accountability and governance of multidisciplinary working in children's services, create an atmosphere of understanding between professionals and make a real difference for users.

Romi Bowen is deputy director of social services and head of children's services, Southwark borough council.