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Save Multi-agency services: Requests for support
Children and young people may be able to access support from the multi-agency service by requests initiated by:
- practitioners
- parents and carers
- the child or young person themselves.
This process is sometimes called referral, though not everyone likes to use this term. It is used here for simplicity, but you can call it whatever you feel is most appropriate in your service.
For integrated services, one of the key principles is that service users access them on a voluntary basis. Because of the range of services on offer, integrated services also tend to be accessed in a number of ways, for example to get information, attend a drop-in or join a breakfast or after-school club.
Referral criteria and procedures
During your start-up phase it is helpful to invest time developing an effective system which sets clear criteria for the scope of your work and the type of support you will offer. These criteria should flow directly from the vision and purpose of your service, to help ensure the coherence of local service delivery.
Increasingly these criteria are likely to be generated with reference to the factors in the Common Assessment Framework for children and young people (CAF). These will be commonly understood across children's services and help promote a common language and understanding. Many services call such criteria their 'referral criteria'. However not everyone likes to use this term as it can undermine attempts to encourage voluntary access to services.
Whatever you call it, it helps to have something written down and made available to all partners. It helps people to understand the specific services you can offer and, in turn, keep caseloads manageable by deterring unnecessary referrals. Current practice suggests that the development of an effective referral system requires:
- an unambiguous definition of the purpose, scope and boundaries of the service
- a clear set of referral criteria which are agreed with other agencies, consistent with the CAF, coherent with other local provision, and accurately reflect the scope of the service
- a referral form which is filled in by those making a referral
- a deadline for referrals to be submitted prior to each panel meeting
- a commitment by referring agencies to work within the scope of the service and supply the required information to help the team respond effectively
- raising awareness with all partners (other agencies, parents/carers and children and young people) so that they understand how they can request support.
You will also need to agree procedures to make onward referrals to other agencies, where a child or young person requires more specialist support (see below).
Referrals by practitioners
A clear referral system saves time, avoids disagreements between professionals and prevents the multi-agency service being overwhelmed with requests for support. Consider offering sessions to those agencies that are most likely to be making referrals. For services working in an early intervention and preventive capacity, key referring agencies will be Early Years providers and schools, although other agencies – particularly those represented in the service – may also refer children and young people they consider to be at risk. Try to get slots at training days run by these agencies to explain how the system will work.
An effective referral system depends on the referrer supplying relevant information about the needs of the child or young person and why they feel additional support is needed.
Some referrers may have used the CAF (either the pre-assessment checklist or the common assessment itself) to consider the needs of the child/young person, whether further action is required, what skills are necessary to undertake this work and what support is available locally. If they are making a referral to your service, they will have concluded that they do not have the skills to do this, and that the case comes within the scope of your panel. A referral form should be completed making it clear what is being requested from the multi-agency service. The CAF is used as supporting evidence for the referral – there should be no need to duplicate the information contained in the CAF assessment on a referral form.
If the referral is not supported by a CAF assessment, you may want to use a referral form which encourages the referrer to write down clear and comprehensive notes about the nature of the presenting problem, any other issues they are aware of, and strategies they have used to address them.
Informal requests for help
In some cases your team members may receive informal requests for help, for example following a conversation in a school staff room. In these cases the team member could offer that person a short consultation appointment to discuss how the staff member might work with the child or young person. In these discussions the staff member may prefer to keep the identity of the child/young person anonymous. If, on the basis of the consultation, it is apparent that the needs of the child or young person come within the remit of the multi-agency service, and that they would benefit from their input, a process should be agreed for carrying out a common assessment and making a referral.
Need for consent
You may need to remind referrers of the need to get the informed consent of either the parent/carer or the child/young person to the provision of services. This means that referring practitioners are expected to obtain consent before they make a referral. The language they use in these discussions will need to be clear and sensitive to cultural differences and perceptions of behavioural and mental health issues.
Click to go to the information sharing section of the website for more details of consent.
Referral by parents and carers
Depending on the nature of your service and the age range you are working with, you may seek referrals from parents or carers. It is important for parents and carers to understand the full range of services on offer and to feel confident enough to ask about them, either for themselves or for their child. In practice, once people have a good experience of some parts of a service (e.g. a drop-in or an after-school club) and get to know some of the staff, they will be more likely to find out about and access other things that are happening.
For parents/carers wishing to refer their child for more targeted support, it helps to have some form of documentation as part of the overall referral process. Staff can offer to help parents/carers fill in the form. It is important to use appropriate and sensitive language in discussing their child's needs, and to ensure that they understand why this information is needed.
Self-referral by children and young people
In some cases, particularly if your service is for older children and young people, it will be helpful to have procedures in place for self-referral. The voluntary engagement of young people can be an important indicator that the service is really meeting the needs of its target group, but to do it effectively the service will need to be:
- seen as non-stigmatising
- accessible
- well-marketed, using channels of communication favoured by your client group.
Referrals to other services
Sometimes your service may need to draw on other support services, for example if an intervention has not achieved the desired outcomes and the child/young person requires more specialist or sustained support.
In setting up onward referral arrangements, the child/young person should remain at the centre of all decisions. To keep their needs at the centre of the process it is helpful to:
- Identify the local agencies which you may need to refer on to and make links with a contact person.
- Understand the scope of these services, their referral criteria, and operational issues such as opening hours. The services directory may be able to provide information to help identify the appropriate agency, if required.
- Set up referral procedures, using existing protocols developed by these agencies where appropriate, to ensure swift access to support.
Even for services working in a preventive or early intervention capacity, it is likely that at some point they may need to make a crisis referral to a specialist service and this issue needs to be given some thought before it occurs. It is important that referral procedures for emergencies are set up with relevant professionals.
The most likely services that might require a crisis referral at some point are:
- health services
- psychologists and psychiatrists (perhaps through child and adolescent mental health services)
- social services
- youth offending teams
- police.
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Last updated on 30/04/2009
