Benefits of multi-agency working

It has often proved difficult to establish the exact impact of multi-agency working, mainly because of the difficulty of isolating why and how a particular outcome has been achieved. This is changing as major programmes are evaluated. This section summarises some of the key findings from recent research about the benefits of multi-agency working. It is divided into three main sections:

• Improving outcomes for children and families
  
  
• Benefits for staff and services
  
  
• Providing what children, young people and families say they want  

Improving outcomes for children and families

School staff working with child and adolescent mental health services (CAMHS) identified that the joint work had led to an increase in children's happiness and well-being. They identified a measurable improvement in children's behaviour in two of the services reviewed, and better peer relationships were identified by workers. Although rarely measured, workers identified links to improved academic attainment, as children were able to learn and were developing learning skills (Pettit, 2003).

In work with disabled children, families with key workers to coordinate services report improved quality of life, better relationships with services, better and quicker access to services and reduced levels of stress (Sloper, 2004).

Even at a relatively early stage of development, the multi-agency On Track programme was identified as having a positive impact on children and families, with outcomes reported in the following areas (NFER, 2004):

• Improved behaviour
  
  
• Enhanced relationships with service providers, parents and other adults (such as police officers)
  
  
• Improved access to education
  
  
• Enhanced emotional and social well-being, especially relating to confidence and self-esteem

In healthcare, multi-agency working has been associated with better patient outcomes and lower levels of stress for staff (Sloper, 2004).

Numerous projects report positive outcome measures which are specific to the type of teams and range of work studied:

• Innovative multi-agency projects targeting children's mental health showed a reduction in the proportion of those with clinically significant problems in many cases, as well as better engagement with school (Kurtz and James, 2002).
  
  
• One primary school with access to a behaviour and education support team (BEST) reports that its drastic reduction in exclusions and behaviour problems was due to the BEST. Their impact had been "tremendous - the best we've had. They've been superb in the support given to children, the family and the school. There has been a change in self-esteem, worth and children's expectations for the future" (Hallam et al, 2004).
  
  
• In its first two years of operation the Darnell and Tinsley On Track service reported a 50% reduction in levels of crime among 10-12-year-olds and a 50% reduction in the number of referrals to social services of children and young people aged 0 to 17, against a city-wide backdrop of just over 25% (Yorkshire and Humber Children's Fund, 2004).

Extended schools offering a range of services have identified a positive impact on children's attainment, on their general well-being and on their overall life chances. Some of the key benefits are higher levels of achievement; increased motivation and self-esteem; more opportunity to participate in sports, arts and cultural activities; and specialist support to meet additional needs. Families report seeing improvements in their children's behaviour; being more involved in their children's learning and finding it easier to take up employment due to the provision of affordable childcare.

The multi-agency composition of BESTs was found to be advantageous in terms of working practices and ultimately the impacts achieved (Halsey et al, 2005). Referral systems were said to be more streamlined, while schools, families and children benefited from more immediate access to support when required. The pool of skills within the team meant that BESTs could offer holistic support to those referred, and by addressing the health, domestic and social welfare concerns of children and families, steps were made towards improving attendance, behaviour and attainment.

BEST intervention was also seen to have impacted positively on parents in a number of ways. Most frequently mentioned was improved access to services being facilitated through contact with the BEST, both in terms of services within the BEST and through signposting on to other agencies. Also mentioned were: identification of adult's needs, access to grants or practical resources for families, and improved parent-child relationships through parenting skills and strategies acquired through BEST interventions.

Other commonly identified outcomes of multi-agency work are (Atkinson et al, 2002):

• Access to services not previously available, and a wider range of services
  
  
• Easier or quicker access to services or expertise
  
  
• Improved educational attainment and better engagement in education
  
  
• Early identification and intervention
  
  
• Better support for parents
  
  
• Children's needs addressed more appropriately
  
  
• Better quality services
  
  
• Reduced need for more specialist services

Benefits for staff and services

Practitioners with backgrounds in single, traditional agencies report high levels of satisfaction with multi-agency working. In particular, they feel liberated from the narrow bureaucratic and cultural constraints of their parent organisation. Where the initial bedding down phase is well-managed, they find the potential for cross-fertilisation between the different agencies stimulating; and many value the opportunity to take a more holistic approach to the needs of children (Fitzgerald, 2004).

Schools delivering extended services have identified opportunities for staff to work flexibly and for support staff to access more career development opportunities. Where there are swift referral systems to multi-agency support, extended schools have seen improvements in staff recruitment, retention and workload. They also provide opportunities for enhanced partnership working with the community and better school security.

Working within a BEST was described as having been a rewarding experience for the majority of the practitioners interviewed (Halsey et all, 2005). Many of the positive impacts reflected those cited more generally as benefits of multi-agency working. Most commonly mentioned was professional development: opportunities to share expertise and learn from colleagues through discussion of casework and joint delivery of interventions.

The On Track evaluation identified positive impacts for staff (NFER, 2004). These were primarily associated with new ways of working within multi-agency teams, in particular:

• Less replication between different service providers
  
  
• Better links between service providers, including a greater understanding of their practices
  
  
• Professional development and career progression opportunities
  
  
• More involvement in community development
  
  
• Improved awareness of different services and changed public perceptions of service providers

Providing what children, young people and families say they want

Families of children with additional needs are likely to be in contact with many different agencies and professionals - for example health, education, social services, housing and benefits. For example, families with disabled children see on average ten different professionals and have more than 20 clinic visits a year (Sloper, 2004).

Often families don't understand the roles and responsibilities of different agencies and professionals; they don't know who to go to for what; they may get conflicting information; they may be passed from one agency to another. This can produce rather than alleviate stress for parents and carers, which in turn impacts on relationships with their children.

Families say they want a single point of contact with services and a trusted, named person to coordinate assessments, information sharing and care pathways to help ensure quicker access to the right kind of support (Mukherjee et al, 1999).

As well as this outcomes-based evidence, research has also identified a significant amount of information about the success factors associated with effective multi-agency working. Click to read more about these success factors.

References

Atkinson, Wilkin, Stott, Doherty and Kinder. 2002. Multi-agency Working: A Detailed Study, NfER.

 2005. Extended Schools Prospectus. 

M Fitzgerald. 2004. Multi-Agency Working: Literature Review (Unpublished).

Hallam, Castle and Rogers. 2004. Research and Evaluation of Behaviour Improvement Programmes: Interim Report. London: Institute of Education.

Halsey et al. 2005. Evaluation of Behaviour and Education Support Teams. research report RR706.

Kurtz and James. 2002. What's New: Learning from the CAMHS Innovation Projects. London: Department of Health.

Mukherjee, Beresford and Sloper. 1999. Unlocking Key Working: An Analysis of Keyworker Services for Families with Disabled Children. Bristol: The Policy Press.

NfER. 2004. Qualitative Study of the Early Impact of On Track.

B Pettit. 2003. Effective Joint Working between CAMHS and Schools: research report RR412.

P Sloper. 2004. 'Facilitators and barriers for co-ordinated multi-agency services' in Child Care, Health and Development, 30:6, 571-580

Yorkshire & Humber Children's Fund. 2004. Making the Case for Prevention.