With so many players involved in providing services, children’s trusts might find it a struggle to form the relationships necessary for success, writes Bob Hudson.

In June the Commons health select committee response to the Laming report had this to say about children’s trusts: "We are concerned the model is too vague, and there is a danger of new structures and mechanisms running ahead of any coherent strategy. We recommend that the forthcoming green paper should provide further clarification on the contribution that might be expected of children’s trusts, and the nature of the preferred model." Now at last the green paper is out, how closer are we to a better understanding?

The proposals have created more clarity about some issues. The vision and remit of children’s trusts have been fleshed out, with more emphasis given to the need to integrate key services around the needs of children, in particular education, social care, health, youth justice and Connexions.

All local authorities will be required to appoint a director of children’s services who will be accountable for education and social services and for overseeing services for children delegated to the local authority by other services. Current legislation requiring the appointment of a chief education officer and director of social services will be amended to reflect this. The green paper (paragraph 5.8) notes that "we expect that in time this will lead to a single children’s department in most authorities, although we will not require it."

There is also some more detail about what will be required, and what will be discretionary. Paragraph 5.14 confirms that three key services should be within children’s trusts - education, children’s social services and community and acute health services, but beyond this there is flexibility in relation to the range of partners, the focus of activity and the extent to which services will be integrated.

We know a little more about how children’s trusts are likely to be rolled out. Earlier guidance emphasised that the government did not see them as the preserve of "better" partnership localities. Instead, children’s trust status would be open to all - a different approach from care trusts and foundation trusts. On the back of this - and without waiting for the results of local or national evaluation of the 35 Pathfinder projects - paragraph 5.12 of the green paper states that most areas should have trusts by 2006.

As paragraph 5.18 notes: "The move to children’s trusts is an ambitious agenda... the pace of change will need to vary according to local circumstances." This caveat on the nature and scale of extending the model is wise, particularly since several issues still appear rather murky.

In particular there are major question marks hanging over the way the partnerships on which children’s trusts depend are to be forged. The first of these problems concerns those public sector agencies which will remain outside of children’s trusts. These include the police, learning and skills councils and some health functions. Others are expected to participate but since they do not fall within the remit of the children’s minister at DfES, there is bound to be a question mark over their full involvement. The most prominent of these is youth justice, which remains at the Home Office. The green paper fails to address this tension within government about the relationship between children’s services and youth services.

Even more worrying is the questionable leverage the new directors of children’s services might have in relation to the core partners in the children’s trust. The smallest and most pliable is children’s social services, but health services and education are very different animals. In the case of health services, paragraph 5.19 states that, at a minimum, primary care trusts will be asked to ensure that the relevant sections of their delivery plans in relation to children are agreed with the director of children’s services, but delegation of commissioning and the transfer of budgets is said to be the preferred model. Furthermore, partnership working on children’s services will, it is said, be viewed as an integral part of the agreement that PCTs reach with their strategic health authority as part of the performance management system. The value of this leverage remains to be seen, but it is difficult to envisage a children’s director having much clout over a PCT fixated with meeting key NHS targets on waiting lists and waiting times.

A similar situation applies to the world of education. Extended schools constitute one of the key planks for delivering integrated provision in universal settings, but the commitment of autonomous individual schools to the green paper vision simply cannot be taken for granted. In particular, it is not easy to see how it can be squared with a policy that has hitherto emphasised competition between schools. Many head teachers feel that their schools, by being made accountable through crude league tables, have been driven into putting their own interests before those of the community they serve. And it is worth remembering that in the furore earlier this year about teacher redundancies and school funding education secretary Charles Clarke could not even find out which schools were under-funded or why.

Another complication will be the way children’s trusts relate to existing partnerships because as the new kids on the block they will be moving into a crowded partnership arena. New and unclear relationships will have to be formed with existing children’s strategic partnerships, Connexions partnerships, children’s fund partnerships and residual adult social services, among others. Only in the case of Connexions partnerships does the green paper give a clear steer, stating that from 2005 they will be expected to use children’s trusts as their local management committees, and that Connexions business plans will need to be signed off by local children’s trusts before ministers will agree them. There remains a need for greater clarity about the co-ordination of a multiplicity of local partnerships.

Overall, the green paper still leaves the children’s trust model shrouded in some uncertainty. Indeed, it remains the case that willing local partners across social services, education and health, could already have achieved much of the green paper vision by maximising local use of the section 31 Health Act Flexibilities. However, the reality is that education services, in particular, were reluctant partners in this respect, and the impetus provided through children’s trust status allied to the new directors of children’s services might well make a difference.

There seems to be little disagreement with the vision laid out in the green paper for the integration of local services; what remains to be accomplished is effective implementation of the vision. The scale of ambition is high, and much faith is placed in a partnership model of limited proven effectiveness. It would be churlish not to give the green paper in general, and the children’s trust model in particular, two cheers out of three. However, partnership working has no qualities of spontaneous growth or self-perpetuation, and effective integration of children’s services will require greater clarity from the centre, and hitherto unparalleled skill and commitment within localities.

Bob Hudson is senior associate at the University of Birmingham’s Health Services Management Centre.