Tuesday, 27 May 2014

Narey on privatisation

Government adviser Martin Narey is quoted in Children and Young People Now as saying:

“There is, in my mind, no reason why a properly managed private sector organisation – by itself, or more likely, in partnership with a public or voluntary sector provider – could not compete to play a role in child protection.”

Could there be a more convoluted and equivocal statement on the issue? It says that there is no reason why a private firm should not ‘compete to play a role’, but does not provide a reason why it should or could. On top of that any private organisation would probably be in partnership with public or voluntary bodies, but we are not told how.

One is left wondering what such outsourcing would look like and why anybody thinks that something as vague and unclear as this should be the focus of policy, let alone that it could deliver any tangible benefits.

Saturday, 24 May 2014

Birmingham Blues

Birmingham’s latest Ofsted report certainly makes for unhappy reading. 

http://www.bbc.co.uk/news/education-27542757 

I also found the quality of the Ofsted report itself very disappointing. 

http://www.ofsted.gov.uk/local-authorities/birmingham 

Like many other Ofsted reports this one puts the boot in, but offers hardly any analysis or insight. It simply does not provide an adequate explanation of what is going wrong in Birmingham.

The inspector says:

“Long standing and historical corporate and political failures continue to impact upon the current political and professional leadership of children’s services in Birmingham. In addition, inadequate strategic partnership arrangements have underminded (sic) a range of initiatives to improve services."(Paragraph 3, page 3)

That doesn’t tell us a lot – in fact it tells us nothing that wasn’t already very obvious. And the rest of the report continues in a we-are-here-because-we-are-here-because-we-are-here-because … vein simply deploring the woes of Birmingham without any real intellectual effort to understand why they have come about or how they can be put right.

The report’s formulaic recommendations I find utterly unhelpful. I won’t bore you with the long list but the first two (both requiring ‘priority and immediate action’!) should be enough to convey the flavour of it all:

“Strengthen operational and senior management arrangements so that there is sufficient capacity and experience to tackle the deficiencies in the service.”(Paragraph 24, page 7)

“Ensure that strategic and operational management oversight is effective, including supervision and that case file audit arrangements are robust so that workers have a full understanding of their roles and responsibilities and deliver work of a consistently high standard.” (Paragraph 24, page 7)

The inspector might just have well said, “Put it all right and be quick about it.”

We will never begin to tackle the issue of under-performing children’s services authorities if all we (do I mean ‘Ofsted?) do is point the finger of blame and to call for robust action, effective and coherent strategy and use other sorts of buzz words and vague concepts to make it sound like we know what we are talking about. And to blithely continue to do so when nobody seems to have any explanation of why things are different in Birmingham is not just unhelpful, it is wrong. Management messes do not just happen. They can be explained. And usually they have to be explained to be put right.

Meanwhile, the other consequence of wagging the finger of blame so robustly (I just love that Ofstedism) is that public stigma is robustly attached to the authority. Struggling to recruit staff, it is now lumbered with persuading people to risk their careers by joining an ‘inadequate’ employer.

The pull-yourself-up-by-your-own-boot-straps approach will not work. And there is no evidence that by turning the whole operation over to a third party organisation any improvement can be achieved.

The only obvious solution I can see is to inject resources and expertise from outside at the operational level. Perhaps a mobile force of experienced practitioners and front line managers could be deployed to reduce backlogs and improve morale?

The analogy of fighting a forest fire comes to mind. A team of fire fighters have been battling against a blaze that has got out of control. They are tired, dispirited and they risk being overwhelmed. Do we start wagging fingers and calling for more robust management or a more strategic approach? Of course we don’t. We bring in fresh reinforcements, transport in more water and more appliances, perhaps deploy fire-fighting aircraft and try to stop the blaze before it reaches the village.

Wednesday, 21 May 2014

Minister’s clarification on outsourcing children’s services


I was pleased to see in Community Care that Children’s Minister, Edward Timpson, has said that there are “absolutely no plans” to turn children’s services over “wholesale to large companies with no expertise in this area”.


That sounds like a big relief. But it doesn’t stop me thinking that the government still needs to be much clearer about what the supposed advantages of limited outsourcing, of which Timpson is clearly in favour, would be.

I think that the obstacles to outsourcing parts of children's services are substantial, suggesting that any hoped for benefits would be hard to realise.

But most importantly we need to be a lot clearer about what kinds of service improvements are necessary, before we get involved in a lot of discussion about who is going to provide them.

How to improve services should be the focus of policy, not issues of organisation and ownership.

Monday, 19 May 2014

Outsourcing – some further thoughts


A couple of additional points have occurred to me.

Firstly, it is interesting that so far the discussion about outsourcing child protection services seems to assume the outsourcing of all the service to one supplier. The discussion of outsourcing in commercial organisations, on the other hand, usually focuses on activities that firms undertake and seeks to determine which of those activities are most suitable for outsourcing.

For example, Willcocks, Petherbridge and Olson [1] argue that activities that are ‘necessary evils’ (such things as administration, facilities management and payroll) are often good candidates for outsourcing. They also believe that ‘qualifiers’ (activities that are essential for business operations but which do not differentiate one firm from another, such as airline maintenance) can be candidates for outsourcing but only where cost and quality criteria are very closely met. On the other hand those activities that they call ‘order winners’ (activities that are absolutely essential to a firm’s success and which differentiate it from other firms) should NOT be outsourced.

Outsourcing the whole service is in effect withdrawing from the market. It is simply admitting that someone else is better placed to provide the service. It seems to me that any firm seeking to win an outsourcing contract of that nature needs to be able to demonstrate very well that it is the better option on all counts, which is not easy to do, even where existing services are deemed to be failing.

The second thought concerns contracts. Even for simple activities of the ‘necessary evil’ variety, outsourcing contracts can be fiendishly complicated. The problems arise from trying to anticipate what will happen in future circumstances that are often difficult to specify in tight legal terms. Unforeseen circumstances often result in two firms arguing, and not uncommonly resorting to law, about issues that have arisen but which are not clearly set out in the contract.

If that can happen with relatively simple activities, such as payroll or IT maintenance, it takes little imagination to see what disaster might occur in child protection when a highly complex and unforeseen circumstance comes about. While the two parties argue it is likely that a child, or several, will suffer as a result.

And how do local authorities that have outsourced child protection ever get to grips with how they monitor the implementation of a contract concerning such a complex service that is meeting a highly variable range of complex needs. The thought is breathtaking.

The more I think about it, the less well thought out this proposal from Mr Gove and Mr Timpson is. I think they will need to do a lot more thinking if they are to convince many people that there is merit in this idea.    

[1] Leslie Willcocks, Peter Petherbridge, Nancy A. Olson
Making IT Count: Strategy, Delivery, Infrastructure Butterworth-Heinemann, 2002


Abusive Head Trauma

There is a very good article by the NSPCC’s Sally Hogg in Community Care about preventing abusive head trauma in infants.

What I liked best was that the changes she discussed were simple and straightforward and capable of being measured. There is much talk of ‘evidence-based practice’ but often comparatively simple research and data collection does not take place while complex or obscure studies consume research funding and expertise.

I expect Sally Hogg was referring to, among others, the important research by Dias et al [1]. This shows that a hospital-based, parent education programme for the parents of newborn infants can reduce significantly the incidence of abusive head injuries among infants and children under three years of age. The incidence of abusive head injuries decreased in the study group by 47% over a six-year period while death rates in a control area remained unchanged [2].

That’s the kind of innovation that is needed everywhere. We should be experimenting with pilot programmes in Britain. 

End notes
[1] Mark S. Dias, Kim Smith, Kathy deGuehery, Paula Mazur, Veetai Li and Michele L. Shaffer, “A Hospital-Based, Parent Education Program
Preventing Abusive Head Trauma Among Infants and Young Children” Pediatrics Vol. 115 No. 4 April 1, 2005 pp. e470 -e477 http://pediatrics.aappublications.org/content/115/4/e470.abstract 

[2] From 41.5 cases per 100 000 live births to 22.2 cases per 100,000 live births.

Saturday, 17 May 2014

Outsourcing angst

It is hard not to agree with much of the the letter written this week to the Guardian by 37 professors and other senior figures in child protection and associated research.

http://www.theguardian.com/society/2014/may/16/privatise-child-protection-services-department-for-education-proposes

http://www.theguardian.com/society/2014/may/16/child-protection-privatised

Alarmingly they raise the possibility that private security companies would be among the providers of outsourced child protection services. I say 'alarmingly' because to my knowledge companies of that type have no track record of providing anything that resembles current local authority child protection services.

One thing that business strategists tell us is that an organisation requires 'a distinctive competence'  to successfully enter an area of activity.  I can only suggest that any local authority that outsourced its child protection services to an organisation which had no experience or proven competence in child protection would be acting recklessly.

In Britain there are, perhaps, some charities which have child protection expertise. It might also be possible to form mutual organisations or partnerships composed of experienced and highly qualified practitioners. There is little evidence, however, that there are currently large, established private sector companies that have the necessary experience and expertise.

As I said in a post last month on this subject, I think the biggest danger here is that we will all fall into a debate about outsourcing and lose sight of the main issue: how to improve service quality.

http://chrismillsblog.blogspot.co.uk/2014/04/outsourcing.html

Tuesday, 13 May 2014

Numbers of Care Orders - a respite at last


There must be considerable relief that the latest figures from the Children and Family Court Advisory and Support Service (Cafcass) show a decline in the number of applications being made for care orders on children in England. 

After years of sustained increases, such a respite reduces the seemingly relentless building of pressure within the system, which threatened to compromise the quality of services. Those at the front line will breathe a sigh of relief.

I would not, however be as sanguine Alison O’Sullivan, Vice President of the Association of Directors of Children’s Services, who is quoted in Children and Young People Now as saying: “By changing the way we work and further improving the quality of our assessments, we have shifted the burdens of the process away from the courts and back into the care planning process which is the right thing to do for children and families.”

I see no clear evidence that changed working practices or better quality assessments are the causes of the fall in  numbers. They might be but I think we need to see a proper investigation of why the figures have fallen, before anybody starts taking the credit.

Sunday, 11 May 2014

Decision Fatigue

They say that ‘the Curate’s egg” is “good in parts”.

That strange expression dates from a cartoon in the satirical magazine Punch at the end of the 19th century. The nervous junior clergyman is too scared of his bishop to admit that breakfast egg he has been served is bad.

 

Bishop: "I'm afraid you've got a bad egg, Mr Jones".

Mr Jones (the Curate): "Oh, no, my Lord, I assure you that parts of it are excellent!"
[Not copyright material – see http://en.wikipedia.org/wiki/File:True_humility.png]

A curate’s egg is what I thought of the research report on decision making by the Behavioural Insights Team for the Department for Education [1]; it was good in parts.


Incidentally there is a useful summary of the report in Children and Young People Now.

The good bits are:

  • The report recognises that time and workload pressures increase the reliance upon social workers’ intuition in making decisions.
  • The authors draw attention to the kinds of biases that affect social workers’ ability to make objective judgements. Such as  ‘availability heuristic’  (making judgments about the probability of events based on how easy it is to think of examples), confirmation bias (only looking for evidence that confirms pre-existing views) and the tendency to judge cases on their relative rather than objective merits.
  • They recognise the complexity of social workers’ decision-making
  • They note that many sequential decisions have to be made everyday, which can result in ‘decision fatigue’
  • And they note that the information provided to social workers is often of relatively low quality. Resulting in the need to spend time and energy making sense of a complex jigsaw.

These findings lead to some sensible recommendations:

  • Introducing feedback loops to help social workers learn from past decisions
  • Developing simpler systems for filtering out irrelevant information
  • Developing checklists to guide decision-making that are much less complex than current ‘actuarial tools’, such as the Framework for the Assessment of Children in Need

The bit of the report where I began to find the smell of hydrogen sulphide a bit overpowering surrounded what was said about evidence and what works. It wasn’t that I disagreed with the view that the evidence base for child protection social work is weak, but I thought that the discussion of this tended to be mechanical and na├»ve.



The authors of the report talk as if “… an almost total lack of robust evidence available or given to social workers on what works…” is just some sort of unfortunate oversight which can be quickly corrected by introducing “… quantitative, predictive modelling to identify effective practices” which they say will result in social workers making “… faster, more evidence-based decisions in the future”.



However, I believe that it is not simply a matter of some group of clever people building a database – the report speaks of unlocking and connecting the data. It is much more a cultural issue of creating the conditions in which practitioners can become learners from their own practice.



Child protection in Britain – and I expect elsewhere – has suffered for far too long from quick fixes being imposed from the outside. Yes, we do want to make better use of data and yes we do want to learn what works and what does not. But just as professions such as medicine have had to climb their own learning curves, so too must child protection social work embark on a long, hard journey towards building a more robust evidence base. That will not come from data mining existing corporate systems; it will come from creating in the people who do the work a scientific spirit of discovery and a commitment to never-ending improvement. It needs the creation of organizations that value and encourage learning, not which insist on toeing the corporate line and keeping your mouth shut. 



 [1] Elspeth Kirkman and Karen Melrose. Clinical Judgement and Decision-Making in Children’s Social Work: An analysis of the ‘front door’ system. Research report. April 2014 - https://www.gov.uk/government/publications/clinical-judgement-and-decision-making-in-childrens-social-work