Transcript Assessment of practice

Seductive strategies and multi-professional
mayhem. Health and social care research
with children and young people
Tony Long
Professor of Child
and Family Health
October 2008
The drive for multi-disciplinary
approaches to everything
Uncritical promotion of multidisciplinary working
 Policy documents – especially
from 2000: (The NHS Plan,
Health service for all the talents,
Working & learning together (DH),
Benchmarking academic &
practitioner standards (QAA), etc
 Find a university which isn’t
pursuing IPL!
Meme
“…units of cultural transmission
which propagate themselves in
the meme pool by leaping from
brain to brain by a process
which, in the broadest sense,
can be called imitation.”
 Major issue for validation of
programmes and evaluation of
schools, faculties HEIs
 Research studies to identify
the way forward
Dawkins R (1976) The selfish gene
(p192) Oxford University Press
…sounding seductive,
but failing to deliver…
Inter-professional learning in the
health care professions:
CNO
Chris Beasley
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often demanded
labour-intensive
sometimes enjoyed
hardly mainstream
evidence of outcome lacking
Values for integrated working with
children and young people
http://nmc-uk.org/aArticle.aspx?ArticleID=2344
Children's practitioners value the contribution that a
range of colleagues make to children and young
people’s lives, and they form effective relationships
across the children's workforce.
Their integrated practice is based on a willingness to
bring their own expertise to bear on the pursuit of
shared goals, and a respect for the expertise of others.
Getting it wrong:
1. Language (for effective working)
Terrible Terminology
“Professional and
occupational groups”
“Competent bodies”
SpReg, SSLT, RSW,
FSW, StSW
“The College”
What does “clinical
practice” mean to a
social worker?
Additionality
The output of
additionalizing?
Resources over
and above the
standard quota.
When do social work students
first learn to say “pop”?
“Pop along to the office...”
“Pop it in the post, then.”
“I’ll pop in to see how you’re getting on…”
“If there’s anything…”
Getting it wrong:
2. Perspective – shared goals
We’re all answering a question
“I want a strong, rigorous, worthwhile study.”
That means…
Service
user involvement
Hard evidence
Insight and understanding
Appropriate methods
Local relevance
Generalisability
(But is it the same question?)
Great (but different) Expectations
Write a section for
me on…
Think what the key
questions will be…
Do you have the
reference for that?
Ethics approval
Getting it wrong:
3. (not so) Common Knowledge
Who needs to be
at the table?
“Can’t we just count
the midwives in with
the nurses?
Long T, Davis C, Johnson M. Murphy M, Race D, Shardlow S (2006) Standards for
education and training for interagency working in child protection in the UK: implications
for nurses, midwives and health visitors. Nurse Education Today 26 (1) 11-22.
Local
Strategic
Partnership
(External Consultancy)
Rapidly moving
agendas…
Cultural Change
Development of the collaborative agenda
Children’s
Trust
LAA
SMT
Operational Management Group
Springboard Team
…and associated
terminology
Respect
Action
Area
BHLP
Family Intervention Project
Locality Teams
CAF
TAF
4 Mandates Leads
Ravey M, Long T, Murphy M, Fallon D
(2008) Evaluation of Blackpool Council
Springboard Project. University of Salford
Children’s
Trust
The way forward for collaborative services
Research with YP is (un)ethical
What ethics committee?
The risk of exploitation
Physical and other dangers
Vulnerable individuals
Vulnerable groups
Sensitive topics
Long T, Fallon D (2007) Ethics approval, guarantees of quality, and the meddlesome
editor. Journal of Clinical Nursing 16 (8) 1398-1404.
Vulnerable people, sensitive topics
 MRC, RCPCH guidelines – only if the research
couldn’t be done on adults. Joan Livesley (safety in
hospitals) Who else can tell the young person’s story?
 Substance misusing families – they’ll never talk to you.
Michael Murphy Privileged Access Interviewers
 Sensitive topics – Debbie Fallon (teenagers accessing
emergency contraception) – Who decides that the
topic is sensitive, and who makes it sensitive?
Murphy M (2006) The Childs View: The highs and lows of Family Life Bolton
ACPC/Bolton DAT
Fallon D (2006) To raise dream and ambition – a rhetorical analysis of the
teenage pregnancy strategy. Nursing Inquiry 13 (3)186-193
Getting it right
1. Clarity of purpose
Purpose of a multidisciplinary YP research team
The nature of health &
social care practice with
young people
Ability to understand
complex multi-faceted
reality of life/care/health
Different research skills
…and access
CYP@Salford
Getting it right
2. Ensuring shared values
Agreed values
Partnership working
Inclusiveness
Rigorous and useful
Ethical research
Innovative & flexible
Research with YP is essential
 Improvement of specific services
 Non-exclusion agenda – right to benefit
 They have things to say and…
 They want to be heard
 … and to make a difference
 Whose voice is to be heard?
Mol an oige agus tiocfaidh siad
Praise the young and they will flourish.
Listen to the young and they will flourish.
Getting it right
3. Playing to our strengths
Working at Effectiveness
 Picking the right team for the
occasion
 Sustained commitment to
joint working (the squad)
 Working on communication
 Working to strengths and
being pragmatic
 Understanding the potential.
Being ready to emphasise it
Long T, Fallon D, Devitt P, Oak E, Murphy M, Dugdill L (2008) A community health needs evaluation to
improve uptake of services at a children’s centre in a deprived and geographically isolated town. Journal of
Children’s and Young People’s Nursing 2 (3) 108-114.
Creating a balance for YP by
maximising the team’s attributes
1. Avoid exploitation (but who
decides when it becomes
exploitation?)
2. Protect from danger (but
allow some risk)
3. Hear the voice (but who
chooses the issues?)
4. Respect autonomy (but
what are the limits?)
Luke
In
di
Jack
It may all seem too good to be true…
“To every human problem there
is a neat and easy solution – and
it’s wrong.”
H L Mencken
Multidisciplinary research
with YP is too diffic
Multidisciplinary research
with YP is too difficult!
Many problems
No easy answers
…and the answers
keep changing
That’s life! Get on
with it.
The way forward
(if we choose it)
Sensitivity. Awareness
of selves as well as
young people.
Flexibility…mixed with
creativity.
Listening & learning
Being prepared to be
wrong
…but
Daring to be right!
Seductive strategies and multi-professional
mayhem. Health and social care research
with children and young people
Tony Long
[email protected]
[email protected]