Scottish government-commissioned research on children’s services from CELCIS concludes that ‘effective, sustainable change’ must go beyond structural transformation to make a difference for young people and families.

The culmination of the year-long ‘groundbreaking’ study led by independent researchers at the Centre for Excellence for Children’s Care and Protection (CELCIS) reveals that the way services are currently configured is ‘not sufficient’ to meet people’s needs.

Building strong relationships across sectors and between practitioners, children and their families is highlighted as key to any service transformation.

This final report will inform future decisions on including children’s services in the proposed National Care Service (NCS).

Dr Heather Ottaway, Head of Evidence, and Innovation at CELCIS, says this work builds upon more than a decade of detailed evidence:

“With the Children’s Services Reform Research study now concluded, Scotland has the fullest picture yet of what is needed to ensure that all our children are supported when they and their families need support, no matter where they live, what type of support they need or for how long they need it.

“Scotland wants to be the best place in the world for children to grow up, where they can be loved, safe and respected.”

Fundamental to this, according to the report, will be having a skilled workforce large enough to meet demand and are supported by leaders at all levels.

An earlier report from CELCIS already highlighted a lack of evidence that structural integration alone improves children’s service delivery.

CELCIS says any move to change the structure and delivery of services must also help improve the participation of children and their families in decisions affecting them.

One particular area of weakness in current service provision was found in the gap between children’s and adult services – noting transitions to adulthood as a key area for improvement.

The report highlights that relationship-based practice must be supported as the ‘cornerstone of high-quality practice’ in children and young people’s health and care.

Trusting and consistent relationships are considered key to improving outcomes.

Learning from effective reforms

The research study was supported by an Independent Steering Group chaired by Professor Brigid Daniel who said the commitment of Scotland’s workforce has already created a strong foundation, adding:

“The most important message from this research lies in the emphasis placed on the importance of building and maintaining effective working relationships with children and families. Any proposed structure needs to be tested against this guiding principle.

“Improvement requires commitment, consistency and persistence that is driven by collective determination to see the changes through. Organisations in Scotland have not been standing still.

“There have been many initiatives aimed at improving services, including a considerable amount of structural reform that has led to children's and adult's health and social care services being integrated in different ways.”

The future of children’s services in Scotland

Looking at the implications for Scotland’s proposed NCS, the report states that both leaders and practitioners need to be given the time, resources and support to develop and maintain multi-agency relationships.

Practitioners shared a feeling of working against a ‘cluttered’ and occasionally contradictory policy landscape while trying to manage the crisis in recruitment and retention.

CELCIS says that work to improve services should focus on simplifying existing policy and ensuring current and future policy aligns with approaches on the ground.

Professor Daniel added:

“Future changes should not derail current effective reforms in which time and resources have already been invested.

“As shown in the international evidence, reform takes time to bed in, and needs to flow from a clear vision supported by effective national, regional and local leadership.”

The report emphasises that leaders must communicate any changes clearly with those working on the frontline.

It says in doing this, leaders must focus on ensuring this alignment and any structural changes are clearly delineated and communicated to those working on the frontline.

The report calls for ‘effective and wide-ranging measures’ to combat the poverty facing many families and children.

Dr Heather Ottaway said decision-makers “need to pay attention to and take action” on the insights that have been laid out in this.

Dr Ottaway explained that “time and time again” research has found similar principles to this and highlighted the need for investment in a skilled workforce, collaborative leadership and developing expertise and capacity for change:

“While there are no off-the-shelf solutions that can be quickly replicated, there is overwhelming evidence of what gets in the way of making real, meaningful and effective change.

“These barriers can be overcome if, and only if, Scotland’s desire to deliver change to is matched by the investment of leadership, time, and funding in the design, delivery and reform of services.”

Read more: Children's health not improving despite good policy; Carers rights not yet a reality; Carers facing full force of health and care crisis; Outstanding questions stall NCS scrutiny; Holyrood committee fails to back Transitions Bill

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