Best practice for disabled children and their families 'still not being applied'
Research for more than 20 years has shown that disabled children and their parents would find it easier to deal with health, social services and other agencies through a single, 'key' worker. Yet multi-agency key worker services are still only available to less than a third of families.
A new study for the Joseph Rowntree Foundation investigates why, up to now, professionals in the NHS, local authorities and the voluntary sector have been so slow to put the evidence of 'what works' into practice.
Based on a detailed, step-by-step evaluation of the way that new key worker services have been implemented in two contrasted areas, it provides further evidence that disabled children and their families are helped by having one worker to relate to, instead of dealing with several, different bureaucracies. Key workers were especially effective where they made regular contact with families, built a supportive relationship with the whole family and worked as their advocate with the various agencies.
But the study also found that spreading research messages describing good practice among professionals was not enough. The commitment of managers to the detailed implementation of new working methods and supporting frontline staff was essential to success. Factors that allowed the necessary multi-agency change to take place included external facilitators, adequate time for detailed planning and clear lines of communication between all those involved. Continuing training, supervision and monitoring of key workers helped to ensure a consistent service.
Patricia Sloper of the University of York's Social Policy Research Unit, a member of the research team, said: "Research evidence alone, no matter how attractively or persuasively presented, is not enough to promote change even when practitioners actively want to make changes. Researchers need to engage more actively with managers and practitioners if research is to be put into practice and disabled children and their families are to receive the support that they need and deserve."
The detailed research findings are published in two, separate reports. Unlocking key working provides detailed description and evaluation of the different ways that key worker services were established in the study areas. The views of disabled children and their parents are reported, as well as those of managers and front-line practitioners. The second report, Real change not rhetoric, considers the wider lessons for best practice when aiming to fit services to people, rather than the other way round. Although focused on disabled children and their families, its findings are relevant to all those working in multi-agency settings.
