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Tennis whites and luscious green lawns are hardly symbolic of social care. Yet this was the sight that greeted the employees of Hammersmith and Fulham Council who turned up at the world famous Queen's Club in west London for a consultation on the development of the children's trust.

The spectacular backdrop seemed to instil a feeling of optimism among more than 50 staff from social services and the primary care trust who gathered to discuss how the services will evolve.

Hammersmith and Fulham found out in July that its bid to become a children's trust had been successful ("Birth of a children's trust", page 32, 26 June). As one of the 35 pathfinder children's trusts it has to bring together children's social services, education and health services into a single structure. Along with the other selected authorities, it will receive between £60,000 and £100,000 from the government.

The event focused on one of the council's children's trust projects, a pilot whereby the children and families teams from social services will integrate with the primary care trust. By the end of the year staff from the PCT, including health visitors and school nurses, will join the social workers in child protection, and referral and assessment teams who are already based there.

Improved communication is high on the wish list. At the moment, most of the contact between social workers and the health team takes place over the phone, which can be problematic given that both groups are often out visiting clients. But interaction between the two teams is crucial. The social workers need to find out about the health of children as this can provide insight into how the child is being cared for. And the health team needs to be able to quickly refer any child they are concerned about to social services. Face-to-face contact resulting from sitting in the same office should make this easier, as well as having practical benefits in terms of arranging joint visits and holding informal meetings.

The front-line workers involved in the changes hope that integrating the two teams will improve the service provided to children and families. They expect it to be more accessible for families, and end the duplication of numerous assessments. They also hope that sitting near colleagues from different professional backgrounds will allow earlier identification of problems and more targeted preventive work.

Despite an overall mood of positivity, there are concerns. There is a general worry that, as a result of working in an integrated team, health visitors risk being viewed in the same negative way as social workers. This could result in clients holding back information from their health visitors. But on the flip side some hope that the image of social workers could be improved by virtue of their association with health visitors.

There is also concern about the blurring of the professions. Andrew Christie, assistant director of children's services, did his best to quell fears, stating that, although the two organisations were trying to achieve similar outcomes, "that's not the same as saying anybody can do it from either organisation".


"We need those professions and skills," he said. "That's the whole point of multi-disciplinary working. It's about maximising and bringing together what individual disciplines and backgrounds offer."

The next step in Hammersmith and Fulham's progress will be the creation of a partnership board to govern the children's trust. It will be made up of PCT non-executive directors, two councillors, the PCT chief executive, the directors of primary care, education, and social services, the managing director of the council and the children's trust director, who has yet to be appointed. The first meeting will be in October.

Those who attended the consultation were clear about their role in how the process is carried forward. They want to be involved and consulted along the way. And they were keen to ensure that real change happens and that integration is "not just moving offices".

Pluses and minuses

It will be up to the teams to build on the positives to ensure they outscore the negatives. 

Positives 

• Face-to-face contact. 
• Arranging joint visits will be easier.  
• Making referrals will be easier. 
• Information sharing. 
• Informal meetings will be possible. 
• Will help with early identification. 
• Should enable joint training. 

Concerns 

• Public perception of health visitors may deteriorate. 
• Professional boundaries may blur.  l Integration means being based in the same room. 
• Health visitors offer universal service, unlike social workers.  
• Issues over how notes will be accessed. 
• IT system in need of overhaul. 
• Potential human resources issues over differing contracts. 
• Better understanding of each other's roles will be needed.