Demand management is making problems worse for local authorities under pressure

By Rick Hood

Social work leaders often talk about ‘managing demand’. For some this has probably become an all-consuming topic as they attempt to reconcile budget cuts and the impact of austerity policies.

But the evidence is beginning to suggest that demand management is part of the problem rather than the solution – particularly for those local authorities with higher deprivation and less money.

My colleagues and I at Kingston University have been examining the national datasets for children’s social care in England from 2014-2017 looking for correlations and trends.

More child protection interventions

Two conclusions have emerged most starkly.

The first is that social work has moved into a distinctly interventionist and protectionist model. More children are being put on child protection plans and taken into care despite referral rates remaining stable.

The second is that those local authorities in areas of high demand are being trapped in a cycle of spending less time and money per child which is only leading to higher re-referral rates and workforce churn.

Referral rates for both children-in-need (CIN) and child protection (CP) have remained stable over the period 2014-2017 and were only slightly higher in 2017 than in 2009.

High demand and screening thresholds

However, rates of child protection conferences increased by 70% during the same period, while rates of section 47 investigations more than doubled. Local authorities also saw a 24% rise in rates of child protection plans, a 25% increase in care orders and a 56% rise in care proceedings. .In contrast, rates of section 20 accommodations, which is a voluntary arrangement consented to by parents, were 26% lower in 2017 than they were in 2009.

We found that local authorities experiencing higher rates of referrals tended to screen out more referrals as needing no further action (NFA) or ‘not CIN’ than those local authorities with lower rates of referrals.

These same local authorities were also more likely to close CIN cases within three months and were less likely to have CP plans lasting one to two years.

But this seems to be storing up problems for later as these same local authorities were also more likely to have higher rates of re-referrals within 12 months.

Less time with children equals higher staff turnover

Local authorities less inclined to escalate cases from CIN to CP also saw much higher re-referral rates.

On the other hand, those with lower rates of referrals tended to work with both CIN and CP cases over a much longer period and consequently had fewer re-referrals within 12 months.

So, the more referrals received by a local authority the less work is done with each child. We also found that local authorities with higher levels of demand (ie referrals, assessments, CIN, CP and care orders) were found to spend less per CIN and have more cases per social worker. Unsurprisingly there was also a correlation in these local authorities with higher rates of agency workers, staff turnover and vacancies.

Screening increases risk of re-referral

The findings here indicate a greater willingness on the part of social work services to investigate families and then ‘screen out’ at a later stage than would have been the case in 2009. This is hardly surprising given the scale of cuts to community-based services and the resulting pressure on early help provision, which means there are fewer places to send families and children who need support.

However, the data suggests that efforts to manage demand by ‘screening out’ more cases at the point of referral or assessment makes it more likely that children will re-enter the system again later on, possibly with more entrenched and complicated problems to resolve.

In previous research (Hood et al, 2016a) we have also found that local authorities rated ‘inadequate’ by Ofsted seem to shift resources towards child protection and other researchers have found that those local authorities in high deprivation areas are more likely to receive a poor inspection when unable to spend more than the average (Webb and Bywaters, 2017).

One of the risk factors likely to increase the chance of a poor inspection outcome is workforce instability (Hood et al 2016b) – which these latest findings indicate are often the result of attempts to ‘manage demand’ within a system under pressure.

Crisis

There appears to be no way out for those local authorities under such intense pressure and it is no surprise that directors of children’s services are warning of a crisis

It is worth remembering that when preventative programmes were better funded in the early 2000s it was accompanied by an expansion of statutory involvement with children and families.

It may be time to acknowledge that the ‘safeguarding’ paradigm, heralded by the Every Child Matters policy has finally run its course, a casualty of austerity politics and the bureaucratic, stigmatising system through which investment was made.

It may also be time to question the legality of managing demand on the basis of thresholds intended as a framework of checks and balances for statutory intervention.

Bravery needed

A new framework for child and family social work, which seeks to manage risk to children through family support and community development rather than alienating and intrusive forms of targeted intervention, is needed to confront rising levels of poverty and inequality in our society, as well as the reduced levels of funding available to help  vulnerable and marginsalised citizens.

This may well mean moving away from our current protectionist model, which is preoccupied with risk, and towards what Featherstone et al (2018) describe as a social model of child protection in which statutory services reconnect with the families and communities they serve.

It means replacing ‘screen and intervene’ with relational and developmental models based on ethical caring principles and rethinking our current approach to demand management and rationing.

What is clear from the emerging evidence is that solving these problems will require political as well as institutional bravery.

References

Hood R, Goldacre A, Grant R, et al. (2016) Exploring Demand and Provision in English Child Protection Services. British Journal of Social Work 46: 923-941 https://doi.org/10.1093/bjsw/bcw044

Bywaters, P., Scourfield, J., Jones, C., Sparks, T., Elliott, M., Hooper, J., … Daniel, B. (2018). Child welfare inequalities in the four nations of the UK. Journal of Social Work. https://doi.org/10.1177/1468017318793479

Hood, Rick, Grant, Robert, Jones, Ray and Goldacre, Allie (2016) A study of performance indicators and Ofsted ratings in English child protection services. Children and Youth Services Review, 67, pp. 50-56. http://dx.doi.org/10.1016/j.childyouth.2016.05.022

Featherstone, B., Gupta, A., Morris, K. & White, S. (2018) Protecting children: A social model. Policy Press, Bristol. https://policy.bristoluniversitypress.co.uk/protecting-children