Published: 03/06/2004, Volume II4, No. 5908 Page 34 35
Every Child Matters cites the importance of a common language and understanding of children's needs. Terry Philpot examines attempts to establish generic training for children's work
Professionals' failure to work closely across occupational boundaries has been a running theme in most child protection inquiries. But despite ministerial rhetoric to the contrary, the issue has rarely been addressed in practice.
The government has created a plethora of agencies and initiatives all based on the idea of more effective collaboration across professional boundaries.
The drive to reform children's services has shifted into top gear after the damning Laming report on the death of Victoria Climbié.
Far from simply being about strengthening child protection services, the resulting green paper, Every Child Matters, and the Children Bill have been explicitly concerned with the welfare of all children. One of the centrepieces of the reforms, children's trusts, begs the big question about whether new structures will bring about a realignment of professionals.
Any predictions must be cautious as the shape of services is not easy to see a year ahead, let alone a decade. And the numbers are significant. From paediatricians to youth workers, school nurses to teachers and social workers to sports and leisure workers, they number 2.4 million paid staff and 1.8 million unpaid volunteers.
The green paper discusses the training and education needs of the vast majority, but it also says that specialised staff such as GPs, teachers, police and prison officers 'need a common language and understanding of children's needs as a basis for positive, professional relationships'. No-one is deemed to be outside the loop.
Discussion about whether those working with children should have a common qualifications structure has been taking place for some time. Every Child Matters characterised such qualifications as a 'climbing frame' rather than a ladder. This would allow staff to move around services and agencies without having to retrain or requalify.
Sideways progression, rather than starting at the bottom again, should widen the pool of potential applicants, which might include older entrants and those encouraged to 'return to practice'.
There is already evidence of moving around. For example, a third of youth offending team workers are qualified social workers, a third are former youth workers and about 150 are on secondment from Connexions, the advice service for young people.Many Connexions personal advisers have come from social work, careers advice and youth work.
The government is assembling an armoury of tools intended to put its words into action. These include a UK sector skills council for children, a central children's workforce unit, the General Social Care Council and the Social Care Institute for Excellence and pilots for a Changing Workforce programme. In addition, trainee social workers are being resurrected with funding for the equivalent of 600 posts, and all the initiatives are being linked to Agenda for Change.
Change is now so rapid that even new measures planned before the current reforms have to find a place in a quickly changing environment. For example, the new three-year social work generic qualification started last year after a 15-year debate, but it means that newly qualified social workers will continue to rely on postqualification training and supervision to assist them in developing specialist skills.
However, this will be helped by continuing professional development in order to remain registered with GSCC.
Talk of the emergence of a vaguely defined generic children's worker is interesting, but an analogy with medicine - with its GPs and specialists - seems fanciful as children's workers are an extremely diverse workforce.
However, small groups of professionals could merge. For example, the overlap of mentors, Connexions' personal advisers and education social workers is obvious. In 2002, the Institute for Public Policy Research report, From Welfare to Wellbeing: the future of social care, was more specific in suggesting that Connexions' personal advisers could develop into a new profession that supports teenagers, along the lines of the European social pedagogue.
The mistake would be to equate generic work with generic education and training, although there are some encouraging signs of the latter. For example, the Youth Justice Board is devising a gateway programme for workers not yet ready for higher education. It is developing a nine-month higher education professional certificate in effective practice (youth justice), that will count toward a new foundation degree. This type of initiative is intended for a system that draws together social services, police, education and health - sometimes Connexions - and in some places staff working in drugs, parenting and mental health. But this is not intended as a replacement for specialist skills or the creation of a new professional silo.
Likewise, YoungMinds and London's City University run an MSc in interprofessional practice for workers in child and adolescent mental health services (CAMHS). These teams can include psychologists, psychiatrists, social workers, nurses and primary care workers.
North and South Essex Mental Health Partnerships, Essex social services directorate and the Priory Health Care Group combined to create a training programme at Anglia Polytechnic University which acts as a bridge towards a BSc, post-graduate diploma or a MSc in CAMHS.
The Youth Justice Board and CAHMS qualifications are portents for the future, preempting much present thinking around the strengths of each type of professional needing to go hand-in-hand with common areas of competence and core knowledge.
The ground is now so fluid and the workforce so varied that apart from specialist degrees more specialism could emerge in, say, NVQs. Perhaps there will be a more inclusive version of the present social-work postqualifying degree in childcare even a child safety foundation course now that safeguarding and welfare promotion duties are being placed on the police and the health service.
One aspect of making work with children more attractive is pay. But this is not simply a matter of more money.A flexible workforce could be hampered by the disparity in employment terms and conditions that exist between even obviously related professions.
Case reviews that follow child deaths show that effective multidisciplinary practice depends on each professional having a clear understanding of its own role and area of expertise, as well as that of others.
All the indications are that professional boundaries are becoming more elastic and will continue to do so in ways that are difficult to imagine at the moment.However, that does not mean those boundaries will disappear completely. Nor, arguably, that they should. l