Focus on leadership needed to integrate services for disabled children and young people

A new report by the Council for Disabled Children, supported by the True Colours Trust, highlights the role of strong leadership in streamlining and integrating the different systems of support that disabled children rely upon.

‘It takes leaders to break down siloes’ is based on interviews with over seventy staff from education, health and social care teams, as well as parents and carers, in three geographically and demographically diverse areas of England.

Researchers found that despite successive government initiatives over the past decade designed to improve how care for children with SEND is coordinated, the system remains fragmented.

Strategic leadership emerged as the single most important factor in enabling or hindering joint working and integration at a local level. It was found that strong local leaders had the power to set strategy, influence organisational culture and support initiatives that enable integration.

The report also highlights other significant barriers to better joint-working:

• A sustained pressure on resources was a consistent theme raised by respondents, presenting a particular challenge in the face of rising demand and the growing numbers of children and young people with complex needs or life-limiting conditions.
• Government policy was found to act as both a lever and a barrier to better integration. Where Government initiatives aligned with local priorities and provided clear directives and accountability – such as the roll-out of Education, Health and Care Plans – it could enhance co-operation at a local level. However, interagency working could be hampered by a lack of join-up between government departments and NHS England in developing and implementing change programmes.
• Good quality data and effective information sharing processes should aid integration at both a strategic level and for individual care. However, areas reported being held back both by practical challenges and poor population level data.

Despite these challenges, there are ways in which local areas are overcoming difficulties and enabling some degree of integration. Joint-commissioning was becoming a reality in some cases – especially around commissioning roles which support joint working such as the Designated Clinical Officer for SEND.

Similarly, participants in the study felt that joint-working arrangements like co-location, helped teams to understand each other’s perspectives and develop their work in a more integrated way.

Local areas also reported how involving children and families in decision-making could improve integration. At an individual level, building dedicated time into support planning processes for a conversation with the child or young person and their family, and ensuring this conversation informs the resulting support package, was found to support better integration by uniting agencies around the needs, outcomes and aspirations of their service users.

Dame Christine Lenehan, Director of the Council for Disabled Children, said:

‘Integrating services is especially important for children and young people with SEND, who not only often rely on support that spans health care, education and social work, but may be vulnerable in others ways. While the urgent need for better integration has long been recognised, in reality families are often faced with a wall of paperwork to get their child’s needs met.

‘The cruel irony is that initiatives designed to improve joined-up working have themselves failed to align with other programmes with the same aims from different parts of the system. Of course some areas, often those with strong leadership structures in place, are finding ways to improve local co-operation, but many others are not. This report is a wake-up a call of the urgent need to break down siloed working.’

‘It takes leadership to break down siloes’ sets out a series of recommendations starting with a call for an urgent review of Government funding for services for children and young people with SEND. The report also recommends that Government and NHS England align key priorities and performance measures across all national programmes impacting this group, and take urgent action to improve data collection and information sharing.

‘It takes leaders to break down siloes’ is available here.