Le Grand plan for GP-style social services practices

Looked-after children’s services suffer from a double malaise. Social workers are often demotivated, deprived of autonomy and overwhelmed by bureaucracy. Meanwhile, children in care lack continuous relationships with their social workers and sometimes do not even know their names. That’s why the system needs fixing, according to the government.

The recent Care Matters: Time for Change white paper, the biggest government policy for looked-after children’s services in a decade, set out an idea to radically reform services by introducing social work practices. They are expected to be piloted in nine areas over the next two years.

Social work practices are the brainchild of Julian Le Grand (pictured), a former Downing Street adviser and key architect of Labour’s public service reforms and a professor of social policy at the London School of Economics.

As the man who introduced choice and competition into healthcare and education, he is now keen to bring the same ethos to social work for looked-after children.

When the idea of the practices was first raised last year, it was called a “new vision of social work” by the care services minister Ivan Lewis. He told Community Care that the practices would raise the status of social workers and children in care.

However, no such model has been tried in the UK or internationally, and Le Grand got the idea from looking at GP practices. “Social work seemed to be a profession in decline, with a collapse of morale among social workers. I thought practices might be a way of dealing with this,” he says.

Le Grand discovered an ally in Alistair Pettigrew, director of children’s social care at Lewisham Council, south London, “who had almost exactly the same idea”.

Grounded the idea

After it was mooted in last September’s Care Matters green paper, the government set up a group of professionals and academics led by Le Grand to explore the idea.

“I don’t know whether the idea is grounded in reality. I am an academic, not a social worker, and could be accused of being in an ivory tower, so the working group was set up to see if the idea had legs,” Le Grand says.

Le Grand’s working group report, published with the white paper a fortnight ago, suggests practices would be made up of six to 10 “partners” – most of whom would be social workers. The practices would be independent and contract with the local authority to carry out field work for looked-after children and commission out services they could not provide. Each practice would hold a budget and social workers would fund placements, support and activities as they saw fit.

The practice would own its assets and pay the partners and any staff that it might employ. Social workers would not be given fixed salaries but be paid on the basis of the outcomes they achieved for children.

The commissioning local authority would remain the “corporate parent” for all children receiving services through a social work practice, but it would be allowed to delegate its statutory responsibilities in relation to looked-after children to practices through a contract.

New resources will be required for the pilots, although there are no figures as yet. Professionals’ enthusiasm is “not unanimous”, Le Grand admits, but some councils are interested in running pilots, he adds.

Critical views

The Association of Directors of Children’s Services is among many organisations that have raised concerns. Ann Baxter (pictured), chair of ADCS’ health, care and additional needs policy committee, says she remains unconvinced the practices would give “added value” to services.

“The resources put into pilots would be better placed in existing services to boost training, support, recruitment and retention of social workers,” says Baxter, director of children’s services at Stockton Council.

She warns that lines of accountability could be blurred between social work practices and local authorities. Some councils could also experience a “brain drain” as social workers move to practices because of better pay. “We will be watching the pilots closely to see what happens,” she says.

Le Grand admits that reasons for believing that practices will lead to better outcomes for looked-after children are as yet theoretical, but he has a “gut feeling they will provide answers to big problems” in looked-after children’s services.

“While there is good practice, there are an awful lot of cases where children seem to have a very bad deal, partly because of the high turnover of social workers,” he says. “There is also a decline in morale among social workers, who have no control over the size of their caseloads.”

He says a “rise of managerialism” has led to an erosion of social workers’ autonomy. “Social workers are being trained as professionals but end up as clerks. Even simple decisions have to be made at the highest level, for example a decision about whether a looked-after child can take a taxi.”

Le Grand believes this culture within councils is the “inevitable consequence of poor practice” in cases that have sometimes attracted intense media scrutiny, such as that of Victoria Climbié’s. “Managers in local authorities have become risk-averse, taking decisions at a higher level and not trusting their social workers,” he says.

Social work practices would reverse this culture, Le Grand argues. “Practices would be much smaller, and have no hierarchy. There is evidence to show that in professional partnerships like this people feel they own the business and stay in the job.”

Le Grand blames local authorities’ “monopoly” on providing looked-after children’s services for the “lack of incentives to innovate or improve”. He says social work practices would have to meet council’s contracts to keep providing a looked-after children’s service, giving them incentives to perform well.

Cost of practices

There are as yet no figures on how much the practices could cost, although Le Grand suggests they could be cheaper to run than existing services because they would have “no hierarchy” – but on the other hand could be more expensive because of an increase in staff pay. But he says it is hard to estimate, when the cost of supporting looked-after children is so varied nationally.

Le Grand attacks the view, expressed by some professionals, that making a profit from looked-after children would be wrong.

“The moral argument does not stand up because many people make a living from looked-after children, such as private fostering agencies and independent social workers,” he says.

Le Grand also denies that social workers in practices would be “motivated entirely by financial reward” with no concern for looked-after children. He argues that the smaller “more intimate” nature of practices would mean social workers spent more time with children, and would also be motivated to provide a high standard of care.

He admits that the potential financial rewards of social work practices could mean the they “got all the good social workers”, leaving the “bad” social workers behind in the local authority. In a worst-case scenario, Le Grand says, councils “could be left with the boring bits of social work and poorer quality social workers”.

He says there will be some “transition problems” if practices attract high-quality social workers but suggests this could be justified if they achieved a better service for looked-after children.

Despite the idea being his brainchild, Le Grand suggests practices may not be the only way to improve looked-after children’s services, saying the wider adoption of good practice by councils could rectify some existing problems. He even asks: “Do we need to go down this route when we could reform existing structures in local authorities in a way that is a lot less disruptive?”

For now, the jury is out until the idea of social work practices makes its journey from the ivory tower to the ground.

What’s next
● The government has said it will legislate to establish two-year pilots to test out social work practices.
● Three pilots could be run by local authorities, three by the private sector and three by the voluntary sector.
● Pilot practices could be responsible for children on care orders (section 31 cases) and children voluntarily accommodated (section 20 cases).

Further information
Consistent Care Matters: Exploring the Potential for Social work Practices by Professor Julian Le Grand 
Children in Care

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Contact the author
 Maria Ahmed

This article appeared in the 5 July issue under the headline “Is Le Grand plan the future of services?”