Summary of the impact

Policymakers in the government departments responsible for health and education, Local Safeguarding Children Boards (LSCBs) and many thousands of professionals with child-protection roles have benefited from Bristol's research into inter-agency training. The research provided crucial information on efficient organisational partnerships for training and strong evidence of the effectiveness of inter-agency training in promoting mutual understanding, changing attitudes and developing confidence. Bristol's findings underpinned statutory guidance in the Government's Working Together to Safeguard Children (2010) [b], which required LSCBs to provide such training. The research ended a 30-year period during which inquiries into the deaths of children at the hands of their parents consistently criticised the failure of professionals to communicate and work together effectively and advocated inter-agency training as a solution, but had little or no supporting evidence.

Specific impacts are evidenced in: the citation of the research findings in support of LSCBs' training strategies; the increased provision of training programmes in the three years since publication, in spite of budget restrictions; the successful targeting of previously disengaged groups, particularly GPs; and the use of an NSPCC-sponsored bespoke evaluation toolkit developed by the research team.

Underpinning research

Context
Two prior systematic reviews concluded that the evidence base in support of training to safeguard children was very thin, particularly for inter-agency and inter-professional training. Within the UK, government departments knew little about the organisation, effectiveness or value for money of inter-agency training programmes provided under the auspices of LSCBs.

Funder, researchers and dates
The research was commissioned by the Department of Health and the Department for Children, Schools and Families as part of a national safeguarding research initiative and was undertaken in 2007-10. It was led by John Carpenter (Professor of Social Work, Bristol, since 2005) with Research Associates Drs Demi Patsios (1998-) and Eszter Szilassy (2006-8). Professor Simon Hackett (Durham) was a consultant advising specifically on child abuse research evidence.

Key findings
The research studied the organisation, outcomes and costs of inter-agency training in eight LSCB areas in England [1]. It involved over 60 interviews and case studies, together with the development and use of measures to assess training outcomes for over 2,000 professionals who participated in 129 courses. The main study finding was summarised in Working Together (2010):

"Research for the Department of Children, Schools and Families and the Department of Health (2009) has shown that inter-agency training is highly effective in helping professionals understand their respective roles and responsibilities, the procedures of each agency involved in safeguarding children and in developing a shared understanding of assessment and decision-making practices. Further, the opportunity to learn together is greatly valued; participants report increased confidence in working with colleagues from other agencies and greater mutual respect." (HM Government 2010 para. 4.3)

The research provided evidence, for the first time, of the effectiveness of inter-agency training focused on collaboration between services for children and adults where children are at heightened risk of harm, e.g., in the context of domestic violence [2], where a parent is experiencing mental illness [3] or where the household includes a young person who has sexually abused others [4]. The research identified the conditions under which social services, education, health and criminal justice agencies could collaborate effectively to provide and resource training programmes [5]. It also pointed to the vulnerability of a system in which safeguarding training is a statutory requirement and yet there is no government funding to support it. Finally, the research provided, again for the first time, an analysis of the costs of training and demonstrated its value for money.

References to the research

Grant

[6] Awarded to John Carpenter (Bristol): Outcomes of Inter-agency Training for Safeguarding and Promoting the Welfare of Children. Department for Education and Skills and Department of Health Safeguarding Children Research Initiative (2007-2010) £105k.

Details of the impact

Following the high profile murder of Victoria Climbié by her carers in Haringey, London, the Government commissioned the Laming Report. Laming concluded that "The suffering and death of Victoria was a gross failure of the system and was inexcusable". As part of the solution, he asserted that:

"Multi-agency training is important in helping professionals understand the respective roles and responsibilities and the procedures of each agency involved in child protection, in developing a joint understanding of assessment and decision making practices...However, the scale and quality of multi-agency training needs to be substantially improved..." (5.18).

As part of the Government's response to Laming, the departments responsible for health and education jointly commissioned the Safeguarding Children Research Initiative. This programme of research studies was intended to provide a stronger evidence base for the development of policy and practice aimed at improving the protection of children in England. John Carpenter in Bristol's School for Policy Studies proposed an evaluation of the organisation, outcomes and costs of existing safeguarding training. He pointed out that the evidence to support Laming's assertions about the value of inter-agency training, its scale and quality was entirely lacking.

The proposal was successful and from the beginning generated significant interest from policymakers in both departments. This was reinforced by presentations at a series of seminars for policymakers held as part of the research initiative. There was praise from policy makers for the extent and quality of the study and the encouraging nature of the findings. Within weeks of the report [1] being submitted, presentations of the findings were requested at the annual conference of the Association for Directors of Children's Services, the Children's Workforce Development Council and a major conference in Westminster on the Government's response to Laming's One Year On report [a].

The Government's (2010) revision of Working Together [b] made explicit reference to the research in chapter 4 on training, which has the status of statutory guidance. As quoted above in Sec. 3, the Government was able, for the first time, to cite research about the outcomes of inter-agency training and emphasise its importance. This section of the guidance draws very heavily on the research. Other key findings which are referenced include the effectiveness of LSCB-managed training and the strengths and vulnerabilities in the system. The findings on the effectiveness on inter-agency training have been taken up by LSCBs and have been used in the revision of LSCB's annual plans and promotion of inter-agency training locally, for example by London LSCB [c]. A survey of training coordinators (n = 42) in the North and Midlands (August 2013) showed that all were aware of the research and 98% had cited it in their training strategies and funding plans (report available).

The Royal College of Paediatrics and Child Health on behalf of the other Royal Colleges of Medicine and Nursing (2010) reviewed the roles and competences of health care staff, citing the research report as a primary source for England [d]. Among the findings of the research was the fact that GPs were under-represented in inter-agency training; this is a matter of great concern given their key role in the child protection system. This message was emphasised by the Department for Education (2011) in a research briefing [e]:

"Attendance at LSCB inter-agency training events is effective in making links and encouraging a better understanding of shared roles and responsibilities between professionals. GPs, in particular, need to prioritise attendance at these events and collectively shape and contribute to an effective and efficient local training programme."

In the survey of training coordinators, 80% were aware of this finding and, of these, 96% had made efforts to increase participation, with notable success. For example, a review of Northumberland LSCB's training strategy, which refers to the research, reported that their efforts had resulted in a 30% increase in GPs participating in inter-agency training (Recommendation 6) [f].

The Munro Review of Child Protection commissioned by the coalition Government (2011) reiterated the findings of the research on effectiveness (Sec. 4.15) and went further to warn — as the research had — about the threat to inter-agency training posed by cuts to LSCB budgets [g]. The survey found that 79% of training budget levels had been maintained in spite of cuts to partner agency budgets and that extensive programmes were being provided: 62% of LSCBs had actually increased their provision and only two had reduced it.

Picking up another recommendation from the findings, Munro also stressed that training should be evaluated (Sec. 4.16). With the encouragement of Piat (the organisation of inter-agency trainers in child protection) and the technical support of the NSPCC, the research team developed an interactive evaluation toolkit [h]. This contains everything necessary for conducting a rigorous evaluation, including letters to participants, a set of scales which were designed and validated for the research and downloadable Excel spread-sheets for data entry which automatically generate charts showing the results and enable comparison with the findings from the research. Fifteen LSCBs in the survey had used this resource as part of their training strategy — for example, in North Yorkshire and Coventry [i].

In addition to the Department for Education's promotion of the findings [a], the research was one of four studies chosen to feature in a seminar for policymakers, researchers and representatives of professional bodies in 2011. This seminar launched the overview of the outcomes of the whole Safeguarding Children research initiative in the Department's highly influential Messages from Research series [j] in which the findings of this "high quality" study are summarised and discussed.

Summary
The beneficiaries from this research are policymakers in government departments and across England in the LSCBs which are providing and promoting inter-agency training. The research has provided the missing evidence for its effectiveness and of the necessary organisational arrangements. Through this training, which is currently being delivered to an estimated 100,000 participants annually, professionals from health, social services and education are learning how to work together more effectively. The researchers would not claim that training alone is sufficient to prevent child deaths, but this initiative can hope to reduce the number of gross system failures identified by Lord Laming as contributing to the death of Victoria Climbié.

Sources to corroborate the impact

[a] Department for Education (2011) summary of the study and links to the research report, research brief, papers and associated materials.
www.education.gov.uk/researchandstatistics/research/scri/b0076846/the-studies-in-the-safeguarding-research-initiative/inter-agency-training-evaluation-study
http://www.education.gov.uk/researchandstatistics/research/scri/b0076846/the-studies-in-the-safeguarding-research-initiative

[b] HM Government (2010) guidance on inter-agency working to safeguard children. Chapter 4 on training has the status of statutory guidance. Explicit references to the research are in paragraphs 4.3, 4.17, 4.22 and 4.39.
https://www.education.gov.uk/publications/standard/publicationdetail/page1/DCSF-00305-2010

[c] London Safeguarding Children Board (2010) (Sec 16)
http://www.londoncp.co.uk/procedures/16_super.html#sixteen_five

[d] Royal College of Paediatrics and Child Health (on behalf of the other Royal Colleges and the Royal College of Nursing (2010) Safeguarding Children and Young People: roles and competences for health care staff. (Cited as a primary source p.60.)
http://www.rcpch.ac.uk/training-examinations-professional-development/continuing-professional-development-cpd/current-edu-2

[e] Department for Education (2011) Safeguarding Children Across Services: Messages for health professionals working with children. Research Brief RB164b
https://www.education.gov.uk/publications/eOrderingDownload/DFE-RB164d.pdf

[f] Northumberland Safeguarding Children Board (2011) 6 month review of revised 2011-12 training strategy and programme including GP take-up on NSCB courses. (Copy available.)

[g] The Munro Review of Child Protection: Final report to government (2011). Sec. 4.15
https://www.education.gov.uk/publications/standard/AllPublications/Page1/CM%208062

[h] National Society for the Protection of Cruelty to Children (2011) Connect, share and learn. A toolkit for evaluating the outcomes of inter-agency training to safeguard children
http://www.nspcc.org.uk/Inform/trainingandconsultancy/piat/resources/piat_toolkit_connect_share_learn_wda79888.html

[i] North Yorkshire Local Safeguarding Children Board Annual Report (2012) (sec. 7.11)
http://www.safeguardingchildren.co.uk/files/LSCB-annual-report-2012.pdf Coventry LSCB home page http://www.coventrylscb.org.uk/home_training.html

[j] Department for Education (2011) Safeguarding Children Across Services: Messages from Research on Identifying and Responding to Child Maltreatment. Chapter 6 (especially pps.126-129) and messages for professionals in different services.

http://www.education.gov.uk/researchandstatistics/research/scri/a0076847/safeguarding->children-across-services-messages-from-research-on-identifying-and-responding-to-child-maltreatment