Scottish Government

DISCUSSION

How the CPRP was planned and implemented

The CPRP was planned and implemented in a structured way with the establishment of a steering group and reform team and recruitment of professional advisors who were linked with child protection committees. Documentary analysis evidenced the extent to which all key professions were involved in the CPRP.

There was evidence of a striking level of engagement with the spirit of the CPRP programme across all agencies and of a vast commitment to improving the child protection system. Even when respondents expressed reservations about aspects of the CPRP, they did not question the need for reform, and there was evidence of professionals investing tremendous amounts of energy, time, resources and creativity.

The complexity of the programme was such that it was divided into a number of sub-projects. Overall, there was broad agreement from respondents in Strand A that this was an appropriate approach, even though there were differences of view about the details of the sub-projects and the impact of the tight timescales. The aim of breaking the process into sub-projects was not questioned by respondents even if they may have chosen different projects or carried them out in a different way. Overall there was evidence from Strand B that the different sub-projects were not especially salient for practitioners - instead they had been influenced by the overall impetus for change.

Throughout the programme there was a commitment to extensive consultation and the majority of respondents in Strand A viewed themselves as helping to shape implementation. Respondents in Strand B appeared to have less information about how the CPRP was planned and implemented. The findings suggest that practitioners in the field tend to perceive themselves to be at the receiving end of policy, and to have little, or no, opportunity to contribute to policy development. Although we did not gather direct evidence from service users, some respondents from both strands were of the opinion that children, families and the community should be given more information about policy developments. Interestingly, no-one specifically suggested that the general public should contribute to policy development.

The Charter, Framework for Standards and associated performance indicators, and the inspection programme were key elements of the CPRP from the very early stages. The approach has been innovative, and, despite initial reservations there appears to be evidence of a general acceptance of their value, especially with the emergence of Quality Indicators. Our data showed that respondents were very clear that the aim of all sub-projects, especially the inspection framework, was to improve outcomes for children. The emergent consensus was that we do not yet have a consistent approach to measuring outcomes for children and that it is too soon to know whether outcomes will be improved. These issues are important, especially because the evidence to support the expectation that inspection leads to improvements in outcomes is still scant (6).

The evidence suggested that there was some confusion about the aim of recruiting Professional Advisors. It was very clear that participants felt that they played a crucial role, especially in their linkage with child protection committees, but their role was clearly a complex one. Batten et. al (7) suggest that there is a '…basic contradiction between the power of specialised knowledge and the subordination of the expert.' They found that lawyers working for local authorities were most likely to have given policy advice if they had more political contacts and less specialism. Lawyers were more likely to rise in local government if they lost their specialism. Professional Advisors, seconded to the Scottish Executive, are required to gain more general knowledge about levers of change - to do this may require them to move aside, to an extent, from their profession or specialism. There was no evidence to suggest that Professional Advisors would not be helpful to future projects, rather the indications were that more clarity was required for the Advisors themselves and for the stakeholders with whom they engaged.

The aims in planning the programme in this particular way

Policy making is 'the process by which governments translate their political vision into programmes and actions to deliver 'outcomes' - desired changes in the real world' (8). The vision that the Scottish government wants to realise for children is for them to be safe, nurtured, healthy, achieving, active, respected and responsible and included. The CPRP is just one strand of a raft of policy developments that aim to further these outcomes for children. It has been driven by a combination of reactive and proactive drivers: reactive to issues such as child deaths, adult offending and parental substance misuse; proactive with regard to early intervention, support for parents and holistic approaches to children's needs. In particular, recent policy developments across the whole of the UK have been influenced by calls for the child care and protection system to be 're-focused', i.e. for there to be a to shift in emphasis towards prevention and early intervention and the improvement of outcomes for children. Axford and Little have described this shift in emphasis as involving refocusing:

• from separate services for children at risk of social, health and psychological problems to mainstreaming services so that they can support all children, including those at risk;
• from separate processes for child protection and family support to using family support (9).

The underlying principles for change are similar across the UK and are informed by an extensive body of theory and research about children's developmental needs and factors that impact on parental capacity to meet them. Although there has not been a fundamental challenge to the investigative-forensic aspect of the system the reforms are underpinned by an increased emphasis upon the responsibility of the universal services for the welfare of children by:

• the provision of direct services to all children, including those with needs for extra support;
• acting as part of a multi-disciplinary protective network for children who are at risk of suffering harm.

In the Scottish CPRP this is reflected in the Children's Charter, which is written from children's rather than organisational perspectives. It was clear from our data that the Charter was effective in setting the agenda firmly around the needs of children. It is also reflected in the significant expectation, that the first agency to identify that a child needs help should consider whether they need the help of other agencies, but that:

'Before referral to another service, agencies should take responsibility and do all they can, with the help of others, to support the child. The child should not automatically be passed to another agency' (10).

The CPRP had an ambitious scope, especially because it was attempting both to:

• set a national agenda that will be translated at a local level - a 'vertical' approach;
• and work across a number of organisations, each of which can address different dimensions of the issue - a 'horizontal' approach (11).

The stated aims of the CPRP were clear, although the theoretical underpinnings were not necessarily rendered overt. As a result different interpretations of the CPRP emerged, relating to where it was considered to be located on the spectrum from:

• improving the operation of the statutory investigative system through to
• the provision of universal support for children and parents.

One member of the CPRP team told us that the espousal of the 'universal support' perspective of the reform programme was reflected through the adoption of the language of 'protecting children and young people' as opposed to 'child protection'. While the former encompasses both narrow statutory investigative systems as well as the wider provision of universal support, the latter refers only to statutory investigative systems. It would appear, however, that this understanding was not clearly conveyed to people outside of the CPRP team.

Overall the evidence suggests that there is still a need for further debate about the place of the protection of children from specific risks within the context of universal support for children. This tension is not unique to Scotland. For example, there has been criticism of the Department of Health assessment framework (12) on the grounds that the focus on children's needs deflected attention from risk factors (13). Whilst developmental theory would suggest that most risk to children flows from unmet need, including need for protection - agencies nevertheless seek ideological clarity when planning and resourcing services. A few respondents expressed concern about the dangers inherent in losing a clear focus on the needs of children currently experiencing, (or facing significant risks of), physical and sexual abuse and physical and emotional neglect.

This challenge and complexity was compounded by the fact that other policy developments were taking place at the same time as the CPRP and there were differences of interpretation about how the CPRP related to other developments such as:

• implementation of the recommendations of 'It's everyone's job to make sure I'm alright' (4);
• taking forward Getting our priorities right (13) and Hidden Harm - Next Steps (15);
• the proposals set out in Getting it right for every child (10);
• policies emerging in relation to the Bichard recommendations.

In an analysis of the Climbié report Masson suggests that there is an 'inherently adversarial' relationship between central and local government and that 'Local agencies cannot be expected to give priority to safeguarding children when central government sets them quite different priorities…' (16). Whilst there was a significant amount of engagement by local government, police forces and health boards there were indications that the policy agenda was not always perceived to be consistent. For example, Changing Lives talks of 'reserved functions' that only social workers can carry out - a concept that will need careful articulation with expectations of a multi-disciplinary approach to child care and protection (2). Members of the nursing profession pointed to a tension between the increased emphasis on targeting driven by 'Hall4' (5), and the emphasis on universal provision in the CPRP and Getting it Right for Every Child. The impending developments towards a generic approach to community nursing were also seen to cut across the expectation that health visitors would increasingly use their specialist skills to support vulnerable children and families (17). For staff in Education there were questions about how the aims of the CPRP articulated with the Education (Additional Support for Learning) (Scotland) Act 2004. A few number of the respondents expressed concern that the momentum and principles of the CPRP were in danger of being deflected and compromised by the apparent policy developments in response to the media coverage of incidents involving substance misusing carers. Similarly, although there is documentary evidence of attempts to keep links with developments to tackle adult offending, there was some concern that, at times, the policy developments were on parallel, and sometimes diverging paths.

Whether or not the process was successful

Overall the evidence is clear that the CPRP has been successful to date. There was more evidence on views about some sub-projects than others, and different projects had reached different stages at the time of study:

Children's Charter - there was evidence of widespread knowledge of the Charter amongst professionals and acceptance of its principles. From the media analysis and other contextual studies the evidence suggests that the general public is less aware of the charter.

The Framework for Standards - many respondents suggested that they had had considerable reservations at the early stages of this project, especially about how the standards could be measured. However, they conceded that more latterly they were beginning to see their value.

Child Protection Committee model guidance - the overall consensus was that the guidance was successful, necessary and helpful. There are those who would like guidance to be placed on a stronger legislative basis.

Child Protection summits - the evidence on the summits was slim, but overall it suggested that the summits helped to set the CPRP agenda.

Public awareness - our study did not collect information from the public about their level of awareness. The media coverage suggested that aspects of the CPRP had permeated into public consciousness to an extent, but our respondents were very clear that far more could be done to raise public awareness of how to obtain help on behalf of their own or others' children.

24 hr helpline - this project was under review at the time of our study and had been subject to an internal analysis. There was some coverage of it in the media, but there was very little consciousness of it amongst our respondents.

Letters of assurance - there were mixed views about the success of the letters. The second one in particular, appeared to generate some resentment. They were seen to have focused the minds of chief executives, but there was little evidence that they had contributed to significant local policy development.

Significant case review - the documentation made it clear that work was ongoing on this project, but the main consultation period fell outside the scope of this process review.

Child Protection Strategic Training Group - there was evidence that a massive training endeavour was being undertaken across all disciplines to raise awareness about child protection. There was evidence of attempts to align local training with the framework. However, there was a strong consensus that more work was needed to develop a coherent national training programme that would meet the needs of all professions and all staff-groups.

Overall our study suggested that the most significant developments had been in the areas of heightened awareness and joint working. Flowing from these twin changes was a general concern about resources.

Heightened awareness

There was an overwhelming consensus from all parts of the study that the CPRP had been instrumental in raising awareness of child protection. Again, there was a spectrum of interpretations of the definition of 'child protection' - from greater awareness of children at high risk, towards a widening of the net of concern to incorporate a range of factors that may impact to compromise a child's development. It would be helpful to carry out further research on the impact, but the indications are that there has been dual effect - both a greater focus on the efficacy of the statutory investigatory system, and a greater awareness of the factors that can impact upon children's development, such as domestic abuse and substance misuse.

There was evidence from both strands of the study of a perception of both an increase in workload for all professions, and an increase in referrals for more formal investigatory approaches. The consensus from each strand was that the increase did not represent an increase in inappropriate concerns, but rather an increased identification of genuine need.

Joint working

There is a heavy emphasis throughout the CPRP and Getting it Right for Every Child upon the joint responsibility of all agencies and professions for the welfare and protection of children. We found overwhelming evidence that the principle of joint working was accepted, and that there were huge developments at all levels of the system towards more integrated approaches. There was evidence of a change in the level of information-sharing - to the extent that some were concerned about a possible information overload.

However, respondents did suggest that the detail of how this joint responsibility should be exercised was not clear, and that a blueprint for multi-disciplinary practice is lacking. Despite the assumptions that more integrated approaches are more effective and more economical, the evidence base for this assumption is weak, and is based mainly on the fact that inquiries show integration to be poor when things go wrong (18). It was clear from the evidence that professionals would welcome more debate, clarity and guidance about how to develop an effective protective network. In particular, people wanted further clarification about accountability and the limits and extent of each agency's role and responsibility for the provision of protective action.

Resources

Respondents indicated that the result of the improvements in identifying the needs of children and the associated rise in response had significant resource implications. There was a steady demand for more resources, especially, but not exclusively, for social work services and this was coupled with a concern about the impact of increased demand upon all professions. Certainly the figures show an increase in child protection referrals between 2004/05 and 2005/06 by 15% and an increase of 22% in the number of children placed on the child protection register. Similarly, the rates of referral to the Reporter rose by 9% compared with the previous year and for the first time the number referred on the grounds of 'lack of parental care' exceeded the numbers referred on offence grounds (19). And if, as people reported to us, a considerable amount of support is being offered to children who do not become subject to statutory child protection procedures these figure may represent the tip of an iceberg.

This issue was analysed in the Midwinter report commissioned by the Association of Directors of Social Work which identifies a funding shortfall between Grant Aided Expenditure ( GAE) provision and expenditure on core children's social work services due to a 'mismatch between policy and finance' (3). The Scottish Executive and the Coalition of Scottish Local Authorities have challenged this conclusion on the basis that GAE is not intended to support 100% of the costs of providing services and that additional funding has been provided aimed at helping vulnerable children and families. Nonetheless, we found clear evidence of concern about the system's capacity to effectively respond to the extent and range of children's needs that are being identified.

The evidence from this study shows that the CPRP has been successful in encouraging a multi-disciplinary approach to the protection of children. Getting it Right for Every Child emphasises the importance of pooling budgets across disciplines and agencies in order to maximise the use of resources for the benefit of children. However, it appears that there is an urgent need for a detailed analysis to examine of the real cost implications of the impact of the CPRP and the associated multi-agency working, especially as the assumption that joint working is more economical has not been fully tested (6).

Conclusion

The establishment and implementation of the CPRP has unquestionably been viewed as a significant and important step forwards in the development, improvement, and progression of policy and services for children who are at risk from, or who experience, abuse and neglect in Scotland. We found a strong consensus view amongst professional respondents at the national, agency and practitioner level that the Child Protection Reform Programme has made a substantive contribution towards the improvement and delivery of child protection services in Scotland. At the same time the respondents identified a number of challenges arising from the process of driving forward such an ambitious and complex agenda.

The key issue now is to ensure that the momentum of the CPRP is retained and that it does not become a victim of its own success if the system becomes overwhelmed.

Key findings and points for consideration are set out in table 2.

Table 2: Setting out the key findings and points for consideration.