New statistical analysis adds to research findings on children’s services reform for Scotland
New research which explores whether there is an association between the type of integration of health and social care services and the outcomes for children, young people, and families in need of support, has been published by CELCIS, the Centre for Excellence for Children’s Care and Protection, as part of the Children’s Services Reform Research study.
Researchers used 25 indicators associated with the welfare and wellbeing of Scotland’s children, support for families and the workforce who support them, and developed a statistical model to analyse these against different approaches taken towards structural integration by Scotland’s Health and Social Care Partnerships (HSCPs) over the last decade.
Looking for any changes in outcomes and the factors behind these, the researchers concluded that:
- There is no consistent evidence of an association between structural integration and outcomes
- While not connected to the structural integration of services, outcomes are changing for children, young people and families
- Context matters: deprivation, population density and the COVID-19 pandemic have all had an impact on the lives and health and social care needs of children and families
- The quality of children’s data in Scotland needs to improve
- There are geographical patterns in the approach to structural integration in Scotland, and
- Greater clarity is needed on the delegation arrangements for children’s health and children’s social care services.
The team also found that as HSCPs were created in 2015 and 2016, only five years or so of data since then was available for analysis and that the nature and extent of integration is complex. These factors will affect the ability of a statistical approach to explore any relationship between integration and outcomes at this stage.
Heather Ottaway, Head of Evidence and Innovation at CELCIS, who is leading the research said:
“This mapping exercise has, for the first time, enabled us to look at whether there is an association between structural integration under the Health and Social Care Partnerships and outcomes for children and their families specifically. Given the limited data available, and how relatively recent the implementation of HSCPs has been, any potential impact on outcomes may yet be realised. However, at this stage no one approach or model has yet shown a significant impact on improving outcomes in the key areas we understand would make a difference to children and families needing support.
“Our analysis further adds to the evidence base for this study and suggests again that integration is a process, with many factors involved which need to be understood when considering if and how integration might aim to improve the lives of people who need the support of public services.”
The research study is being supported by an Independent Steering Group chaired by Professor Brigid Daniel, Professor Emerita of Queen Margaret University, Edinburgh, who said:
“The indicators we collect about outcomes for children and families can only tell a partial story about the impact of services. Nonetheless, the lack of any striking link between formal structures and measured outcomes suggests that it is important to look as widely as possible at all factors that may contribute to the best outcomes for children and families.”
The documents published on 31 August 2023 replace the original documents published in July 2023. These reflect and explain the small statistical changes in our analysis, informed by the reversal in the delegation of some services in one local authority area during the time period we analysed. The conclusions were unchanged by this.