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FEATURES - BREAKING THE BOUNDARIES

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Brighton & Hove is one of the first boroughs to set up a children's trust. Nick Golding reports on its fledgling ef...
Brighton & Hove is one of the first boroughs to set up a children's trust. Nick Golding reports on its fledgling efforts to join up services for young people

'Victoria spent the cold winter months bound hand and foot, in an unheated bathroom, lying in the cold bath in a plastic bag in her own urine and faeces and having to eat what food she could get by pressing her face onto the plate of whatever was put in the bath beside her.'

The appalling case of eight-year-old Victoria Climbié, as described by Lord Laming who chaired the inquiry into her death, shocked Britain.

No one could understand how those delivering services for children failed to co-operate to spot the obvious signs of abuse.

Social care professionals, alongside their counterparts in education, police, youth justice and other agencies, realised they had to realign services to ensure no one could slip through the net ever again.

As the lessons of Victoria's death in 2000 in Haringey were learned, local government tore down traditional structures to create new children's services departments.

But the merger of education departments and children's social services was not regarded as sufficient. Closer co-operation with other agencies dealing with children was also deemed vital when the 2004 Children's Act was drawn up.

The ensuing Every child matters policy envisaged the creation of children's trusts to bring together all organisations working with children.

In the vanguard have been Brighton & Hove City Council and the South Downs NHS Trust which on 1 April set up a joint management team of professionals, locking health service and local government staff together for the first time.

The fledgling trust has already begun work implementing a children and young people's plan and has opened no fewer than five main children's centres from which all of its services can be accessed.

But much work remains to be done before October, when the trust is officially launched. By this deadline it will have a clear, comprehensive management structure also incorporating staff from the youth support service and Connexions, the advice body for teenagers.

David Hawker, the director of the Brighton & Hove Children & Young People's Trust,

admits it is not easy uniting 200 health, 350 education and 350 social care staff in one organisation.

In the longer term, he faces the additional challenge of bringing Learning & Skills Council and leisure staff on board - but Mr Hawker insists the rewards are worth the hard work.

'We recognised there's a limit to what you could do in partnership working - there's structural barriers and dual accountabilities - so we decided to look at the whole service. We are the only trust so far that has brought about full structural integration,' Mr Hawker says.

'And we knew it was pretty radical - we needed a comprehensive reshaping. We've been daunted at various stages along the way when the size of the task looked pretty big, but we've always known it is the right thing to do.'

The change certainly is far-reaching. Under the new system an NHS member of staff can find him or herself with a council boss, and a social care worker can find their manager comes from a health service background. Although the chain of command is united, social care staff will remain council employees.

There was some opposition among staff to being managed by someone from a different discipline and a different employment culture.

Mr Hawker explains: 'There have been lessons to learn all along about communications and keeping the stakeholders on board. We underestimated the amount of effort required on that.

'There's a lot of enthusiasm about the new system. Initially, a lot of that was balanced by fear and anxiety - will my job disappear and who will my line manager be?'

He insists there is a growing appreciation of how much better the new service is likely to be for young people and their parents.

'For the families, the new service should be more joined up. It should feel less bureaucratic with less form filling in and fewer people asking the same questions over and over again. There should be a more immediate service and you should get a quicker response.'

Rather than being focused around the traditional organisational silos, the new system will see staff based in three local area teams. Each service user will have one lead officer who is responsible for their assessment and able to forward cases to a specialist professional based in the same team.

It is the children's centres, where specialists as diverse as youth offending officers, social workers and even some midwives will be based, that will be the hubs of the trust.

But the partners appreciate that there is no point in opening new buildings unless the facilities are well used. They have therefore extensively consulted in an attempt to ensure they meet the demands of users.

The views of Brighton's parents' forum, which brings together countless parental organisations, and the city's young people's council have been sought out. The consultation into the trust's creation received no fewer than 1,200 responses.

As a result of the feedback, it was decided to put a community café into one of the centres in an attempt to entice people inside while another centre will contain a branch of JobCentre Plus - a feature which should help to alleviate unemployment, reducing incidence of child poverty.

James Dougan, the trust's children's services commissioner, explains: 'What's been so good is that people like me have less power. The community and the children themselves have much more direct dialogue.

I think that's very positive.'

Mr Dougan is confident the new system will pump a greater proportion of resources towards the child, at the expense of bureaucracy. Negotiations are continuing with unions on management changes.

'We've been able to reduce management and put those resources back into frontline services. That was one of our raisons d'etre,' he says.

'In the past we found a great deal ofresources and time was spent managing the partnership around the child rather than direct inputs to the child.'

Although the emphasis is on co-operation, the partners are aware that not all information can be shared. Confidential medical

information, for instance, remains as well protected under the new system as it was under the old.

Parents can refuse to allow details to be disclosed between partners, unless the trust believes their decision is not in the child's best interests.

Mr Dougan states: 'If parents refuse consent we'd make a decision that they are withholding their consent unreasonably and putting their child at risk.'

While there might occasionally be confidentiality issues, with professionals from different fields building far closer relationships, it is anticipated the risk of poor information sharing, so apparent in the Climbié case, should be dramatically reduced.

Gillian Cunliffe, the trust's assistant director for communities, says: 'Because people in each geographical area will work more closely in teams, they'll know the prevailing issues in that area. Everyone will have a closer knowledge of the areas which are most at risk and most vulnerable.

'The possibility of people dropping through the gaps between the professionals will be minimised.'

But it is not just in child protection that the trust constitutes a step forward. The organisation believes that the preparation which went into it being set up contributed to the success of the Carlton Hill primary school which gained the best key stage two results in the country.

Many believe the government's education policies are too oriented around academic results and child welfare has been given too little priority. In Brighton they insist the trust's support for families will improve exam results in the long run.

Trust director Mr Hawker explains: 'We are convinced the holistic approach to support families has borne direct fruit in terms of the results the children have obtained.

'There's been a tendency in some quarters to see Every child matters as a distraction because schools should go after results. Our answer to that is children won't get better results if they aren't able to learn - family circumstances and the communities they're in can stop them from learning.'

Financially, the trust has benefited from a£100,000 pathfinder grant. Mr Hawker believes the efficiency savings from the trust's formation will pay even greater dividends.

Even though he praises his NHS partners' commitment to child welfare, Mr Hawker does admit to being concerned about the effects of the health sector's cash woes.

'When you have a health service in financial crisis, there are hard decisions you have to make. You have to make sure that they are made on a fair and transparent basis,' he warns.

The overall success of the trust will be measured in terms of the targets set out in the city's children and young person's plan.

Only when it is known that the trust really is helping children to escapepoverty, raising attainment in schools, ensuing youngsters are protected from abuse, promoting good health, reducing youth crime and cutting teenage pregnancy can Brighton's innovation be judged a success.

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