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Emma Parsons and Nick Triggle look at some real examples of how ...
Emma Parsons and Nick Triggle look at some real examples of how

public services are being brought together to tackle some of the major problems facing Britain's communities

Teenage pregnancy in Salford in 1997 was a serious problem - the city was in the top 10% for conception rates among people aged under 18 in the country.

Salford also ranked 23rd on a list of most deprived council districts in England, according to the 1998 index of deprivation.

The two factors are clearly linked, with a study by the Social Exclusion Unit on teenage pregnancy finding that 'teenage parenthood is more common in areas of deprivation and poverty'.

The report, Teenage pregnancy, which was presented to Parliament in June 1999, identified poverty, children in care, children of teenage mothers, educational problems, sexual abuse, mental health problems and crime as key risk factors, pointing clearly to the need for a cross-cutting solution through joined-up government.

It concludes: 'No one group - teenagers, parents, schools or government - can achieve by itself a reduction in teenage pregnancy rates. Tackling teenage pregnancy will mean a concerted effort by local and central government. Whitehall, town halls and the health services will each need new mechanisms to deliver the whole strategy.'

The unit's report led to the setting up of the Teenage Pregnancy Unit within the Department of Health which works with local partnerships all over England. It is jointly funded by the Department for Education & Skills, the Office of the Deputy Prime Minister, the Department for Work & Pensions and the Home Office. Staff are drawn from within the civil service and from outside areas of expertise.

The Teenage Pregnancy Unit's programme manager for the national teenage pregnancy strategy, Alison Hadley, cites voluntary organisations, education departments, housing, social services, relevant government departments and primary care trusts as just a few of the agencies which work together to develop and progress policy in this area.

'Partnership working is the flavour of the day and work on teenage pregnancy is a trailblazer in this area. It is ahead of the game,' she says.

In the former industrial northern city of Salford significant results have been seen as a result of partnership working. The under-18 conception rate fell by 13% between 1998 and 2000 as a result of a joint approach focusing on prevention - involving better education and easy access to contraception - and support services.

A teenage pregnancy strategy was published in

June 1999 and a co-ordinator was appointed jointly by Salford City Council and Salford Primary Care Trust in January 2000. The teenage pregnancy strategy group

and three implementation groups - covering sex and relationship education, sexual health services and support to young mothers and their children - followed in September 2000.

All services are delivered by a partnership board which brings together housing, social services and education departments, the chief executive's office, the primary care trust and Salford Royal Hospitals Trust. The family planning Brook Advisory Centre and schools are involved with the strategy group.

Co-ordinator Tim Smith says: 'The strategy has put in place structures and systems and is better co-ordinated than partnerships which were in place before.'

He adds: 'Teenage pregnancy was an issue people were aware of in Salford [before the partnership]. All Salford's wards are in the top 30% of wards nationally with the highest number of under-18 conceptions.'

The partnership has concentrated on improving sex education in schools. The council has worked with the local youth service to revamp sex education policy and there is now a contraception distribution team working with the youth team and the young offenders team.

Ante- and post-natal care and counselling services have been improved, and the team has secured funding so the Brook advisory clinic is now open six days a week. Cash from the Department for Education & Skills has been used to help reintegrate teenage mothers back into school and overcome problems such as housing and childcare.

The existing social services sexual health policy has been revamped. There are subsidised condom machines in leisure centres, an early years development partnership, a new director of services for young people and a health adviser to work in schools.

The team is on course to meet the government's target of a 15% drop in teenage pregnancies by 2004.

'Joined-up working is the crux of the teenage pregnancy strategy because it's so cross-cutting,' Mr Smith says.

'You have to have a good partnership approach. We want these new posts to change the way mainstream services work. We've seen an increase in the number of people [under-18s] presenting themselves for termination and for emergency contraception. It starts with prevention in terms of education and if we get that right and decent access to services and support we'll have met our targets and our own goals too.'

Case Studies

Islington Crime Reduction Partnership

Partnerships between councils and police have become more popular over the last five years, particularly in London, as it has become clear that social inclusion and crime go hand-in-hand. In the past crime was seen as the police's domain, whereas councils concentrated on social problems.

But that has changed. The Crime and Disorder Act 1998 placed a legal obligation on police forces and local authorities to establish effective partnership arrangements to reduce crime.

The Islington Crime Reduction Partnership (ICRP), involving the police, council, probation service, local health authority, business and community, is one such example. Set up in 1999, the partnership aims to use the combined resources and expertise of the agencies involved to 'look at ways to make Islington a safer place to live, work and socialise'. The police provided two officers to work in tandem with council staff under the CommunitySafety Partnership Unit (CSPU), which was set up to implement the ICPR policies.

By the end of the year the partnership produced a strategy, which highlighted a number of key areas to channel resources into - youth offending, drugs, racist crimes, burglary, nuisance and vandalism. It placed a strong emphasis on 'good information sharing'. In practice this has meant the council's drug and youth offending teams working together with the police.

A council spokesman says: 'If a crime is committed that is obviously the responsibility of the police, but if they say it is caused by youths that hang around on estates that is where we get involved. It is all about joined-up government.'

The work of the partnership is constantly reviewed by the project board, comprising of representatives of the council, police, Inner London Probationary Service and Camden and Islington Health Authority. An audit is also carried out every three years.

But the partnership will always be judged on its effect on crime. Overall it fell by 6% from 1999-2000 to 2000-01 in Islington. Yet a closer look reveals that violence against the person, the type that causes people most concern, increased by 4%. What is more, the number of people murdered more than doubled.

The Office of Public Services Reform

Going into the last election, prime minister Tony Blair made investing

in and improving public services his key manifesto pledge. Within days

of being returned to office, the prime minister set up the Office of Public Service Reform to achieve just


Dr Wendy Thomson, the former director of inspection at the Audit Commission and Newham LBC chief executive, was brought in to head the office, which though part of the Cabinet Office reports directly to Mr Blair.

According to Sir Andrew Turnbull, the cabinet secretary, the role of the OPSR is to support the government in the reform of the health service, education, police and central and local government.

It is understood to be a key plank in Whitehall's attempt to join up internally, although moves are afoot to shift this function elsewhere.

But beyond that the work of the OPSR remains relatively secret. A spokeswoman for the office said it did not publish reports or reveal what it was working on. She added: 'The office's work is all about improving public service, there is nothing that is out of bounds. But it is all kept internal.'

Nonetheless, some of the projects it has concentrated on have emerged despite the protective cloak placed around the office.

An investigation found that the former Department of Transport, Local Government & the Regions failed to meet the required standard in its handling of local government. And the office is also thought to be conducting reviews into local government in general and the Department of the Environment, Farming & Rural Affairs.

However, some remain unconvinced about the effectiveness of the office. George Jones, professor of government at the London School of Economics, says: 'It is part of a process of centralisation. I think it is a mistake to have this top-down approach. Wendy's outfit is still searching for its niche.'

Manchester Local Strategic Partnership

The National Strategy for Neighbourhood Renewal highlighted the need for joined-up working if deprived areas were going to be regenerated. Local Strategic Partnerships form an important part of this policy.

Manchester City Council, using the new powers given to councils to promote the economic, social and environmental well-being of residents under the Local Government Act 2000, took the lead in setting up an LSP in early 2001.

The council launched its consultation in June that year and seven months later the partnership was setting out to help regenerate the area and improve services.

A host of agencies were signed up, including the police, chamber of commerce, Greater Manchester Transport Executive, Manchester Health Authority and local schools, universities and museums.

But the partnership faces a challenge. While Manchester is the UK's second largest economic region behind London, it still experiences some of the highest levels of deprivation in the country - 27 out of the council's 33 electoral wards are among the most deprived 10%.

Council leader Richard Leese (Lab) said: 'No one should be under any illusion that there is a lot more that needs to be done to improve the economic performance, quality of life and ability of all residents to share in those improvements.' But, he added, the LSP provides a real opportunity to improve residents' quality of life.

The work of the partnership is overseen by the Manchester LSP steering group, made up of 41 representatives from the partnership's members. The group sets priorities and has the final say on what initiatives are pursued. It is also in charge of allocating government and European Commission money and setting up working groups to carry out specific initiatives.

It is perhaps too early to assess how well the partnership is doing, but significant progress has already been made in the form of the Manchester Community Strategy, which was launched at the inaugural meeting of the partnership back in January. The strategy set out a comprehensive programme for achieving regeneration through investing in schools, community safety and health. It also promised to create a 'modern' transport infrastructure and 'enhanced' cultural base.

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