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The adoption register and national standards have arrived, but while they are tested in pilot runs, tension still exists between speeding up adoptions and finding and funding the right family. Sarah Wellard investigates.

The 'catch-up' exercise for the adoption register

All councils are required to take part in a "catch-up" exercise to ensure records on children waiting for adoption and approved adopters are up to date.

The DoH will facilitate local briefing sessions, after which councils will be asked to review the cases of all children waiting for adoption, and check whether there are any potentially suitable adopters in the pipeline. Councils will then complete a register input form for each child and approved adopter.

Quality Protects regional development workers will set up meetings with groups of adoption agencies to share details of children and adopters waiting in their region. Information about children who wait the longest and parenting skills in short supply will be analysed to inform a recruitment strategy.

Once local and regional action has been taken, details of children and adopters waiting will be submitted to the national register to generate possible links.

Department of Health, Paving the Way - The 'Catch up' Exercise for the Adoption Register (Local authority circular LAC (2001) 21, August 2001, available from www.doh.gov.uk/adoption

Draft standards

For adopted adults and their birth relatives:

- The welfare, safety, needs and wishes of adopted adults and others concerned with the adoption to be the first consideration.

- Adopted adults and birth siblings to be provided with information by agencies about local and national support groups and services.

- Agencies to advise and help adopted adults and their birth siblings separated by adoption wishing to make contact with birth relatives.

- Adopted adults and birth siblings who request information from adoption agencies to receive response within three months.

- Adopted adults and birth siblings to be informed of their right to make representations and complaints.

Department of Health, Adopted Adults and their Birth Siblings - Draft National Adoption Standards for England and Practice Guidance, DoH, August 2001

Two key elements of the government's drive to increase adoptions from care were put in place last week, with the launch of the new national adoption register for England and Wales and the publication of national adoption standards for England.¹

Health minister Jacqui Smith confirmed that the three-year contract to run the adoption register has been awarded to the charity Norwood Ravenswood. The idea behind the register is to reduce delays and increase the number of children adopted from care by placing details of all children awaiting adoption and all approved adopters on a central database.

Ruth Fasht, director of Norwood Ravenswood and the Norwood Adoption Society, has no doubt the system will increase the chances of children being placed. She says: "It's so simple it's amazing it hasn't been done before."

She points out that the register will be more than just a simple matching exercise: "A professional team will undertake what I call the creative bit - the sensitive scrutiny of information from the system. It will be child-centred. Suggested matches will be looked at and discussed for their potential to provide children with new families."

A list of possible matches will be sent to the child's social worker, and it will be for them to investigate further. There will be no charge for using the register.

What is not clear is whether ministers' hopes of a large pool of potential adopters will be realised. "We don't know the number of families in the voluntary sector waiting to adopt," says Fasht. "Very few voluntary adoption agencies have responsibility for children, but they are often the first port of call for people wanting to adopt."

Fasht believes the system will also help focus the recruitment process, by highlighting mismatches between children waiting for adoption and approved adopters. It is widely believed that there is a shortage of places for older boys, sibling groups and children of mixed race, but no one knows for sure, because the data is not collected.

Over the next nine months, existing information about children and families will be submitted by councils and voluntary adoption agencies for entry onto the register. This will be a three-stage process, with the pilot phase beginning this month. Most of the councils and agencies participating in the pilot are already part of consortia sharing information regionally about children and families. The pilot agencies are the South West Adoption Consortium, the Manchester Consortium and three London councils.

Westminster Council is one of the councils asked by the Department of Health to pilot the register. Louise St John Howe, cabinet member for social services on Westminster Council explains: "We see the register as a continuation of the work Westminster is already doing with Hammersmith and Fulham, and Kensington and Chelsea Councils. We work together well, which is presumably why we have been selected. We very much welcome the register and believe it should help speed things up."

Westminster regularly places children outside London where no local family is available. Just over 7 per cent of children in care in the borough last year were adopted, compared with just 4 per cent nationally.

The government hopes the national adoption standards will tackle variations in performance between councils and ensure more consistent, high quality services. It is acknowledged that adoption services have tended to be the preserve of the voluntary sector and a few dedicated practitioners in local authorities. The new standards should give adoption greater status and priority within children's services and also promote good child care practice more generally by emphasising the importance of purposeful planning from when a child first enters care.

The standards have been widely welcomed, but there are doubts about whether the timescales can be achieved in practice. Under the standards, a replacement family is supposed to be found within six months of approving a child's adoption plan. This may be reasonable for a 10-month-old, but is hardly realistic for a 10-year-old with complex needs.

There are also concerns that the expectations for the register and national standards are unrealistic. Many of those working in adoption believe there is no quick-fix solution to increasing the numbers of children adopted from care, because the real problem is the shortage of people willing to take on older children, who may have disabilities or have been damaged by their early experiences.

Research shows that children who have been taken into care because of abuse or because of their challenging behaviour are at risk of experiencing placement breakdown, whether they are placed in foster care or are adopted. To make adoption work for such children, sensitive and intensive post-adoption support is needed.

Although the government has made available additional resources for adoption services through the Quality Protects initiative - some £66 million over three years - much of this is likely to be spent on the front end of adoption to increase the number of placements. Not much of this money is likely to be left for post-adoption support, as Anne van Meeuwen, adoption adviser at Barnardo's, points out: "We need to address the provision of support services and adoption allowances if we are to make a significant difference to the numbers of people coming forward to adopt," she says.

Until now, the government's review of adoption has focused exclusively on the needs of children. So last week's publication of draft standards and practice guidance on adopted adults and their birth relatives is long overdue.²

At the moment practice is patchy. Helping birth mothers and siblings contact adopted adults is something of a grey area legally because, although the Adoption Act 1976 allows adopted adults access to their original birth records, no similar right was granted to other members of the birth family.

The government is not proposing to change the law, as many campaigners had hoped, but the new draft standards make clear that agencies should be prepared to offer advice and help to people wishing to renew links.

Ann Haigh, project leader of Barnardo's counselling services, wants to see a duty on local authorities that goes beyond acting as an intermediary between adopted adults and their birth relatives and encompasses provision of support services. Renewing contact with long-lost relatives is a delicate and complex matter. Birth mothers may set their hearts on establishing new relationships with relinquished children, now adults themselves, but adopted people may not want contact.

Haigh says: "The standards and guidance should improve consistency and quality and that is very helpful. But it will still be open to interpretation by individual authorities whether to provide a service."

As well as providing counselling for adults adopted through Barnardo's adoption agency, Haigh's project also provides support groups for birth mothers. Services like this don't come cheap. Barnardo's and other voluntary sector adoption agencies, such as the Children's Society, fund this work out of voluntary income. But when resources for post-adoption support for needy children are already over-stretched, few councils regard providing services for adults as a priority.

¹ Department of Health, National Adoption Standards for England; Draft Practice Guidance to Support the National Adoption Standards for England, DoH, August 2001.

² Department of Health, Adopted Adults and their Birth Siblings - Draft National Adoption Standards for England and Practice Guidance, DoH, August 2001

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Denise Platt and Sarah Mullally are in the driving seat of social care reform. Talking exclusively to Lauren Revans and Jonathan Pearce, the women describe where they will be steering social work.

Last month's shift towards a "delivery-focused" Department of Health saw the tearing down of internal boundaries between public health, the health service and social care. Significantly, this involved the more integrated future of health and social care services being placed jointly in the hands of the chief inspector of the Social Services Inspectorate, Denise Platt, and the country's chief nursing officer, Sarah Mullally.

Together, Platt and Mullally will be responsible for the development and direction of the care trusts which form the central plank of the government's modernisation agenda. The voluntary NHS bodies were brought in under the Health and Social Care Act 2001 to commission and provide delegated health and social care functions.

Of the first nine care trust pilots announced last month, at least five will focus on mental health issues. Under the reorganisation, specific responsibility for mental health policy, services and legislation lies with Mullally, along with policy on health and social care for people with disabilities and long-term conditions, policy on nursing, midwifery and health visiting, policy on allied health professions and service user involvement.

Up to four of the pilot care trusts will focus on older people. Platt has specific responsibility for health and social care services for this client group, as well as for children's services, maternity and health services for women, general social care policy and the Social Services Inspectorate.

"We will work very closely together," Platt says. "We work with and meet together with the same ministers. Then together with our ministers we talk to the secretary of state."

Mullally says: "Historically, Denise and I have worked closely together, not least on issues around older people, around children, around discharges. With all of those, you can't separate out what I was doing before around nursing and user involvement from social care provision. Older people is a good example - there are issues for social care, for nursing, as indeed there are for user involvement. People using those services don't see those divides."

Until last month's reorganisation, Platt was joint head of the Department of Health's social care group. She denies that social workers and social work values will become lost in the more integrated health and social care systems of the future, and believes that although social workers will find themselves working in a whole range of new environments, their identity as a profession will remain intact.

"The challenge of the new agenda if you are a social worker is that your career is not now going to be in something called a social services department," Platt says.

"Social workers are going to be in many different environments, working with a range of professionals, and they'll need to be confident of their skills and what it is they offer."

It is crucial, in her opinion, to identify the "unique contribution" social workers can offer, and ensure they are trained and deployed for specific functions while still able to influence the wider social care agenda.

For Mullally, this will involve social workers revisiting the ways in which they have traditionally worked.

"The boundaries are changing and that is something social workers will have to contend with," she explains. "There is an issue for them around understanding how they utilise the breadth of skills they have.

"There's a responsibility around that in how we support people through training, as well as listening to their concerns around it and moving forward," she adds.

Mullally cites social workers' client-centred approach as one of their more distinctive features. "If there's a nurse or doctor providing care, they will have a real focus on the individual. But as you move up slightly in health they often become system-focused, whereas I think social workers always remain client-centred. They have a really strong ethos - their centre is very much community, individual, social health."

Aligning these different working practices is part of the challenge of creating a more integrated service and placing service users, patients and carers at the centre, Mullally states. "You can't underestimate that if you bring groups together they will bring luggage with them."

Platt suggests that social workers in diverse locations will be able to "anchor their professional identity" in the General Social Care Council and use the Social Care Institute for Excellence to keep up to date with the latest social care ideas. The DoH envisages her convening meetings with the heads of all the new social care bodies to ensure shared thinking on the quality agenda.

While accepting that the current difficulties facing social services are partly due to pressures of rising costs in both children's and older people's services, as well as the economy pushing up salaries and wages, Platt believes it is also essential to take a critical look at traditional methods of service delivery.

"It is not yet entirely clear - and our Best Value reviews are showing this - that the configuration of these services is in the right balance. It's not entirely clear that we've got all the money in the right place to deliver effective services," Platt explains.

"Just to throw more money at it before we've really looked at what we are asking services to do and how we are asking them to deliver is the wrong way round."

Part of the current cross-cutting spending reviews of children's services and public sector workforce will address these issues.

"You can't deny that it is tough to supply services at the moment," Mullally accepts. The question, though, is why.