Monday, 24 January 2011

Child of ContactPoint?

I was pleased to read last week in Community Care about children’s minister Tim Loughton’s plans for a ContactPoint ‘replacement’.

If, as reported, the plan is for a national database, to be used by hospital A&E departments, containing only the names of children who are looked after, or subject to a child protection plans or who have been the subjects of section 47 enquiries, then it has my wholehearted support.

Putting the names of such children on a database can be justified because they are known to be at risk, and making A&E medical staff the main users is sensible. The police have various national systems that let them know if a child has previously come to attention, but A&E staff frequently have to see children with puzzling or suspicious injuries who are not from the local area. Currently in such cases they can only find out if the child is subject to a child protection plan by making a child protection referral. And it might take several days to discover that the child was at risk, by which time the family is long-gone.

A simple system like this is very sensible and, unlike ContactPoint, the small restricted user-ship of professionals, bound by well-established codes of medical confidentiality, will make it much more secure.

Friday, 14 January 2011

Reducing Bureaucracy - and adding value

Eileen Munro's review has been tasked by the Government with examining ways in which bureaucracy in child protection can be reduced. The Department for Education has recently published a list of questions ( that the review would like answered by professionals, including this one:

“What prescribed procedures and forms do you feel are unnecessary, overly time consuming or cause you to duplicate work?” 

I am apprehensive that this question might produce a rag bag of responses, targeting people's pet hates, while ignoring other work which, although unnecessary, is generally felt to be less objectionable. Ultimately a more analytic approach may be required. How might this be undertaken?

A good starting place is the concept of “adding value”. An activity is said to add value if it contributes to satisfying the needs and wants of the end-user of the service, in this case abused and neglected children. In any business or professional process some activities will add value while others will not. For example conducting an effective and sensitive interview with a child adds value by discovering the child’s needs and wants. On the other hand completing a travel claim for expenses involved in the interview adds nothing from the child’s point of view.

It is not always so easy to see whether a particular activity is value adding or not. Many activities do not provide value directly but do so by supporting an activity that does. And things are made more difficult because child protection is a very complex process that is not always easily understood.

But that should not stop us trying. The first step is to decompose processes into discrete activities. Then to ask, does this activity directly add value, and if so how? If we are unable to answer this question in the affirmative, we need to move on to consider if the activity supports another that is directly adding value. If we cannot establish that, then it is likely that the process is non-value adding and we need to look at ways in which it might be reduced or eliminated.

Many non-value adding activities are likely be found in the “back-office” in areas such as record keeping, filing, staff management and financial controls. While some of these are “necessary evils” (for example legal requirements) constant attention needs to be given to understanding how they can be simplified and their cost and impact reduced.

However, that does not mean that all client contact activities are value adding. Conducting unnecessary assessments, for example, is costly and time consuming. So is poorly focused casework. Clearly child protection social workers need to address constantly the issue of whether what they are doing adds value from the child’s perspective. But that is essentially what is meant when we talk about services being “child focused”.

Non-value adding activities are the same thing as “waste”. Some of the main causes of waste in a business or professional process are:

Waiting and delays
Transportation (e.g. of people) or transmission (e.g. of information)
Set-up time

Having a valuable asset like a social worker being unproductive because s/he is waiting to be called at a court hearing has a direct impact on the quality of service received by other children and young people. Similarly being stuck in a traffic jam on the way to a meeting is not a good use of a social worker’s time. Waiting to receive important information delays important decisions and disrupts the flow of the service. Having to re-do a piece of work is always wasteful, but this happens where the original piece of work was rushed and not done properly. While appropriate planning (set-up time) may make casework more successful, too much planning delays the service and diverts professionals’ effort from actually meeting the child’s needs. Downtime – such as team meetings or training events – needs to be carefully examined. If it is clear that it will improve the service, then it can be justified, but if not it is a poor use of scarce resources.

So it is not just the "back office" functions that need to be addressed in the quest for reduced "bureaucracy". Everybody who works in child protection needs to be alert for signs that an activity does not add value, and there need to be mechanisms by which workers can raise concerns that waste is occurring. Instead of organisations being attached to the way things currently work, there needs to be an understanding that children's needs will only be better met if challenging "the way we do things" ceases to be a nuisance to managers and instead becomes the hallmark of a good employee.