New ways of learning for social workers for integrated children’s services.

Imogen Taylor, Jackie Rafferty and Hilary Burgess - SWAP

- University of Sussex

Introductions

• Who you are and where you are from?• What engagement do you have in developing

learning and teaching for the integrated children’s workforce, if any?

Plan for workshop

• Introduction.• ICS-HE Project

– Overview,– Knowledge Review,– Conference and network,– Recommendations.

• Small work groups (UG; PG; PQ).• Feedback • Barriers and enabling factors

ICS-HE Project Overview

• Integrated Children’s Services in Higher Education (ICS-HE).

• One of 6 ‘Employer Engagement’ Projects selected by the HEA with funding from HEFCE for SCs to link with SSCs.

• Funding agreed Dec 2006; project ran May 2007-May 2008.

Intended Project Outcomes

• Raising awareness of the evolving agenda in children’s services for HE staff working across the disciplines and professions,

• Identifying examples of emergent practice for integrated provision in HE,

• Identifying barriers to change & ways to overcome these,

• Promoting collaboration between disciplines,• Contributing to knowledge generation about IPE in this

arena,• Promoting dialogue between HE and Sector Skills

Councils.

Partners

• HEA Subject Centres for:– Education (ESCalate),– Psychology,– Medicine, Dentistry and Veterinary Medicine (MEDEV),– Health Sciences and Practice (HS&P),– Social Policy and Social Work (SWAP),

• Children’s Workforce Development Council (CWDC).• Children's Workforce Network (CWN).

Relevant disciplines and professions

• Education,• Early Years,• Social Work,• Nursing,• Midwifery,• Other allied health

professions,

• Psychology,• Youth and Community,• Careers,• Medicine,• Police,• Probation.

Policy context

• Laming Inquiry (2003) into death of Victoria Climbie,• Every Child Matters (2003),• The Children Act (2004),• Children’s Trusts,• The Children’s Plan (DCSF 2007: 17), • National Service Framework for for Children, Young

People and Maternity Services (2004+2006),• Youth Matters (2006).

FFI: http://icshe.escalate.ac.uk/1459.

Activities

• Stakeholder Reference Group,• Knowledge Review,• Networking,• National Conference,• Web-site,• Links to the IQF,• Reports.

Stakeholder Reference Group

• Partners,• Regulatory Bodies (e.g. the Training Development

Agency, General Teaching Council, the General Social Care Council),

• Higher Education representative bodies (e.g. JUC-SWEC & UCET Universities Council for the Education of Teachers),

• Employer organisations.

Knowledge Review

Prof Imogen Taylor, University of Sussex:

Research question: What is known about the nature, contexts and participants in IPE in Higher Education Institutions (HEI’s) in England that brings together students from two or more disciplines to contribute to the development of collaborative practice with children, young people and their families?

» Research review.» Practice Survey. » Policy map.

A common understanding of terms

Interprofessional education: ‘Occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care’ (Freeth et al. 2005, p. 112).

Integrated services: ‘A set of processes and actions by which partners ensure outcome-focused front-line delivery. It means a holistic approach within which needs can be identified and priorities – national and local - can be addressed’ (DfES 2005, p. 11).

Research Review Methodology

• Leads from each HEA Subject Centre asked to identify up to 3 key journals in their own discipline (or involving their own discipline with others) considered to be the most likely outlets for publication of papers about the involvement of HE in Integrated Children’s Services.

• Where the recommended journals turned out to yield few or no relevant articles, or could not be accessed, Subject Centre leads were asked to nominate further journals, which were also scrutinised.

• Identified journals from some disciplines yielded far less relevant material than others.

Research Review Key Findings

• Learning for integrated children’s services is inadequately conceptualised and theorised;

• Variable findings - researchers agree about the logistical challenges of developing interprofessional learning for integrated children’s services;

• Dearth of robust evidence about outcomes for students; outcomes for children, young people and families are rarely discussed.

Practice Survey in HEIs

Scoping study of HE Practice re ICS: on-line and telephone survey (Sept-Dec 2007) of 36 universities (43 interviewees) in England plus one each in Wales and NI.

There is a wealth of innovative initiatives at all levels, and primarily at foundation and undergraduate levels, in full programmes, individual modules, practice and work-based learning.

Typology of approaches to IPE for ICS-HE

• 6: Four types of integrated children’s services provision in HEIs

1. Interprofessional students and interprofessional staff.

2. Uniprofessional students and interprofessional staff.

3. Uniprofessional students and uniprofessional staff teaching interprofessional issues.

4. Generic non-professional programmes and interprofessional staff.

Interprofessional students and interprofessional staffA shared learning and teaching experience, Stranmillis University College and Queens University Belfast

• Students level 3 : ECS (Stranmillis College) came together twice with Social Work (Queens), to share knowledge and explore stereotypes of each other, and to participate in a case conference role play. Voluntary – most participated.

• Staff: ECS and Social Work • Plan: Consideration will be given: 2008-9 to the inclusion of

other student groups e.g. Nursing and Police; 2009-10 to paired student placement experiences; 2010-11 to providing a full interprofessional module.

• Challenge? Very resource intensive in the planning rather than the delivery.

• Evaluation: All participants found the experience beneficial in terms of meeting the needs of families through multi-agency collaboration.

Interprofessional students and interprofessional staffAfter Every Child Matters: Integrated Working - An Interprofessional Conference. University of Sussex.

• Aim: for students to learn with, from and about each other in relation to children’s services; to focus learning on changes in integrated practice.

• Activity: A day long conference; elective placement shadowing.

• Students: 2007 and 2008 social work and teacher education students; plus medical students (SSCs) in 2009.

• Conference process and content: large group presentations and small group discussion with interactive tasks; cop-facilitated by social work and teacher education faculty.

• Most pleased? The ‘buzz’ from the participating students and staff.

• Most challenged? Organising appropriate space; the only suitable space is the Sussex Conference Centre, hence the framework for the day.

Leadership and managementMA in Leadership and Management for Integrated Children’s Services. University of Sussex

• Aim: to enable managers from a range of disciplines to develop the knowledge and skills needed for new roles set out in Championing Children (DfES 2006): to build teams competent and confident in this new means of service delivery; to put the child and family first; to lead those from outside their own area of expertise; to manage resources in new ways: and reconcile team members’ different working practices and expectations.

• Learning outcomes include being able to:– Operate effectively in the managerial role in line with the Championing Children

descriptors (DfES, 2006)– Demonstrate key knowledge, skills and behaviours required from Championing

Children:– Demonstrating effectiveness in line with the Generic Management and Leadership

Standards (Management and Leadership Centre).• Work-based learning (including action learning sets and mentoring) will enable students to

ground their learning in emergent management practices of the new integrated services sector. Students must be currently engaged in management of children’s services for at least 15 hours per week and be nominated and supported fully by their employing agency in undertaking the programme (including funding, work release for study time and provision of appropriate mentoring within the agency).

Uniprofessional students and interprofessional staffEarly Childhood Studies, University of Northampton

• Staff: Education, Social Work and Health.• Students: 2006-7 ECS Year 1 students spent two IPE days with health and social care

students at the Universities of Leicester and De Montfort based on the ‘Leicester model’ (Lennox and Anderson, 2007). In 2007-8 this will be further developed.

• Assessment: Year 2 ECS students role-play a Child Protection Case Conference. The Conference is chaired by practitioners.

• Placements: in Years 1 and 2 students undertake placements in each of education, health or social care settings; in Year 3 they ‘specialise’ in one of the three areas. Placements are supported by teaching on common themes such as the Common Assessment Framework.

• Progression: ECS graduates can achieve Early Years Professional status (EYPS) but as Northampton only has a BA Social Work and does not offer a Masters of Social Work programme, students must transfer to another HEI for this.

• Vision: either i) combine ECS and Social Work into a four-year programme; or, ii) develop a Social Pedagogue route.

• Most pleased? ”I teach on every single course in the School of Education – every teacher knows about child protection and Looked After Children even if it is only a three hour input.”

• Biggest challenge? Professionals unwilling to move outside their disciplines.

Uniprofessional students and uniprofessional staff teaching interprofessional issuesLaw and Ethics, University of Manchester Medical School

How confidential are consultations?• You are in the child psychiatry clinic and see John Smith and his mother with the

Consultant: the referral made by a paediatrician because of unexplained physical symptoms occurring at school and at home. When they have gone, the school doctor shows you a copy of the letter from the paediatrician to the child psychiatrist – at the bottom of the letter are the names of a number of people, including the school doctor, who are to receive copies of the letter.

• A couple of weeks later, the Hospital Undergraduate Dean arranges to see you. He shows you a letter sent by Mrs Smith to the Patient Advice and Liaison Service.Dear Sir/Madam,I’m writing to complain about a breach of confidentiality by X, one of your medical students. I met X at the child psychiatry clinic and then with a school doctor the next day. I had made it clear that I didn’t want school to know that John was being seen by child psychiatry, but the school doctor knew. The only way I can understand that happening was that X told her. I think this is unacceptable.I’m most surprised that this has happened as X was extremely courteous, and my son and I both enjoyed meeting him. He made sure that we were happy for him to be there and, in fact, having him there made it a much easier visit in the end as he spent some time talking with John. This meant I had a chance to talk more privately with the consultant. Yours sincerely, Mrs Smith

• You explain that you did not breach confidentiality. The Dean makes further inquiries and finds that in some paediatric clinics it is routine practice for school doctors to receive copies of letters sent to GPs.

Non-professional programmes and interprofessional staffBA Children’s Interprofessional Studies, University of Hull

• Structure: Full-time, part-time degree. Modules also available for children's workers to access as continuing professional development.

• Staff: Children’s nursing, social work, education; pitfalls of joint validation: ”We don’t talk the same language though we think we do... We are learning from each other.”

• Students: Fifty HEFCE funded places – start 2007.• Placements One day each week in a work placement. Focus on learning

interprofessional work; students assessed by university staff. Year 1 students placed in three settings from within Health, Education and Social Care; Years 2 and 3 placements in two settings. The development of the children’s workforce creates placement challenges: variations in payment, travel funding etc.

• Progression: For progress to children's nursing there are opportunities to exit after 2 years with a Diploma in Children's Interprofessional Studies and transfer to Year 2 of a nursing degree. For those who complete the full degree there are progression opportunities to Masters programmes in teaching, social work or youth and community work.

• Main challenge? The university unidisciplinary structure lacks systems for allocating funds etc.

Placement issues in non-professional programmes

• Practice learning or observation? What is the purpose of placements in non-professional programmes?

• The availability of placements and variation in their quality, particularly in a context of increasing competition for scarce placement resources

• A need for common standards and practice competences at pre-professional level. It is unclear if a student can fail if there is no agreed standard

• In part to ensure a supply of placements, and in part to ensure parity across placements which are very different, HEI staff assess students

• Students are CRB checked but not health checked

Small group

• What ICS learning, teaching and assessment activity are you considering developing?

• What three things do you need to enable change to happen?

20 minutes and bring back three key messages to the whole group

Participation by Young PeopleLeeds Metropolitan University

Module ‘Children, Young People and their Families’ began in 2004.Students: postgraduate Health Visitors, School Nurses, Community Children’s Nurses (approx

55-65); and Social Work BA and MA students (approx 70-80).Staff: Teaching team of Nursing and Social Work staff.Focus: A case study builds from vulnerable children, to children in need, child protection and

looked after children. The focus in each area is on understanding the professional role.Structure: Six full day workshops where students come together for large group presentations.

In addition they work in core groups of approx 12 mixed profession students who remain together throughout the module. Here they are expected to use their experience and interact in relation to their understandings of roles and responsibilities.

Student feedback: Very positive about the opportunity to work with colleagues from other professional groups; the day-long workshop structure demanding and intense.

Pleased with? The rolling case study has developed since the module started and works well.Main challenge? The practical demands of working with large groups of students

(accommodation, equipment etc). Future development? Meeting with Education colleagues to explore possibilities for including

teaching students. Previous discussion has indicated there are real issues about accommodating more student numbers and whether there is sufficient ‘space’ in their curriculum.

Whole system change

• Senior level leadership – senior staff who can commit resources and can engage external stakeholders at a comparable level

• Active engagement with external stakeholders, particularly employers who can commit engagement of staff and the purchase of places

• Cross faculty appointees who extend ownership of ICS initiatives across faculties and departments, including some more peripheral participants such as drama and sports science

• Cross-faculty academic development (programmes, modules, research)• Seed funding from HEI funds to support innovation in teaching• University wide seminar and/or lecture programmes to promote and

disseminate ICS development as it relates to teaching and research• Linkage to interdisciplinary research centres.

Enabling factors for ICS-HE

• Enthusiastic students.• Entrepreneurial interest, individual commitment.• Senior HEI leadership.• Strategic cross-faculty appointments. • External partnerships with stakeholders.• Seed funding (e.g. by HEIs or stakeholders).• Seminar programme to promote and disseminate.• Linked to research.• 7 HEI’s ‘whole system change’ most or all of the

above; most opt for incremental change.

Barriers to ICS-HE

• Equivocal research findings from existing IPE & mixed views about ‘transferability’

• Variable interpretations by HEI’s of ‘integrated children’s services’ and implications for HE.

• Disciplinary ‘silos.’• Departmental administrative boundaries.• Lack of suitable space for large groups. • Lack of development time and funding.• Need sustained stakeholder support (business case). • Lack of synergy between accrediting bodies.• Fast changing, complex policy context and fragmented

practice context.

Recommendations (1)

• Government should involve HE as strategic partners in researching, developing and implementing policy & practice for the ICS workforce, nationally & regionally;

• Universities should strengthen their links with SSCs and employers and appoint ICS coordinators;

• Regulatory bodies should explore collaboration, building on initiatives like the Joint Statement of interprofessional values underpinning work with children and young people (GTC, GSCC, NMC);

Recommendations (2)

• Professional bodies should commission initiatives;• Employers, supported by government should

collaborate with universities to develop programmes with a sustainable and robust business case;

• Children, young people and families should be supported to contribute to learning, teaching and assessment;

• Research funders should target funding to ensure a robust evidence-base and to develop the conceptual and theoretical base essential to learning for ICS;

• The Higher Education Academy and Subject Centres should extend the dissemination of the ICS-HE project across disciplines and stakeholder groups, and support educators through information exchanges and briefings.

Recommendations (3)

For more information

http://icshe.escalate.ac.uk/