mashIn an exclusive excerpt of his special report for JFHC magazine, Andrew Chilvers delves into the background of new multi-agency safeguarding hubs, commonly referred to as MASH, with people on the frontline of delivery:

Child safeguarding in Doncaster has yet again been under scrutiny following November's release of two damning reports highlighting systemic failures to protect vulnerable children in the borough.

"Poor practice" led to failures  

The first, by Ofsted, savagely criticised Doncaster's child protection services in the wake of the serious case review into a vicious attack on an 11-year-old and a nine-year-old by two brothers, aged 10 and 11, in Edlington, in 2009.

During the Ofsted inspection in October 2012, 508 children were the subject of a child protection plan - the highest ever recorded in the borough - but Doncaster could not be confident that all children known to the children and young people's services were safe. The report concluded: "In too many cases, professional practice was poor, management oversight ineffective and risk to children not identified or progressed."

At the time of the Edlington assaults, Doncaster Council was characterised by Ofsted as having a poor performance at senior management levels, a demoralised social work profession, with unacceptable churn of staff, and inadequate communications between agencies.

Urgent need for collaborative work  

For those working in child protection these failures in early interventions are often a result of historic silos going back decades. Many professionals see it as a systemic failure, rather than one of inadequate training and management, which invariably leads to the periodic witch hunt of staff, senior managers and directors by the press and politicians. It is at this systemic level that senior figures have started to collaborate on the multi-agency safeguarding hubs (MASH), intent on rebuilding the rules on safeguarding. It is an important buy-in from the top, which involves council cabinet members, directors of social services, chief police officers and senior managers in the NHS.

Early vision for MASH  

Nigel Boulton, designer and national adviser on MASH, admits that the original vision for the model, which originated and was trialled in Devon, came from a desire to reduce harm and identify vulnerable victims much earlier and within partnerships. He explained how the overall aim of a MASH staff team is to provide advice and information on safeguarding matters, deal with referrals, identify current information on vulnerable children, and provide an initial rating on assessed levels of risk. The team can then decide appropriate action and allocate cases accordingly. This process includes providing "pertinent information" and guidance to operational staff, but means that some of the detail may remain confidential within the MASH team.

MASH model to roll out nationwide  

Along with Devon County Council's involvement with MASH, several other local authorities have signed up to the programme, including Nottinghamshire, Staffordshire and a tri-borough collaboration between Westminster, Kensington and Hammersmith. The latter's partnership is a first step to building a tri-borough MASH early next year.

Pan-London MASH

Elsewhere, the Metropolitan Police is leading on a pan-London MASH involving 32 boroughs (not including the tri-borough partnership), and is joined by social care directors and health consultants working for NHS London and the Greater London councils. They will be aided by colleagues in housing, the probationary service, youth offending and the voluntary sector. Representatives of these organisations recently attended a MASH conference in London to discuss how they were developing their partnership programmes. Most of the initial partnerships involve child protection, although some have set up adults and children's MASH partnerships simultaneously.

Detective Superintendent Richard Henson of the Metropolitan Police explained to the conference how many people had tried to build integrated teams as far back as the 1940s, with little long-term success. He was critical of past and current failings of agencies to protect vulnerable adults and children and believes that MASH will be a genuine breakthrough in interagency co-operation.

How MASH speeds up the referral process

DS Henson's views were echoed by Briony Ladbury, who runs Safeguarding First and is an independent health consultant for the NHS. She told the conference that agencies were not intervening early enough. "If you look at the Munro review, the same messages were coming out. The same with the Laming review. It's about earlier interventions to stop the abuse happening," Ladbury said.

"We know from many years of evidence, including the Soham murders, that timely information is a factor. In fact, it was that failure to share information that is a key part of most of the serious case reviews I look at. Information is sitting in places where it is not being shared and that has prevented early interventions for families."

Quicker response to children's needs

"We shouldn't just do what we did before," she said. "We should be thinking about doing the right thing this time. To health professionals this does not threaten existing NHS systems. It's not a takeover. It's there to get a quicker reaction to the children's needs coming through the MASH. If a health professional has a query about whether there is a risk to a child or a need to a child that has to go through the multi-agency risk assessment planning process, then they can exercise their own professional judgment; use their designated and named professionals for the advice they would normally have and then it goes into the MASH system."

Innovation, integration and improvement

Ladbury agreed with DS Henson that the integrated teams approach had been tried before: "I set up an integrated team many years ago in Croydon. But they were never sustained. But this approach by our partners to get this working in the form of the MASH is really important. Reforms are about innovation, integration and improvement."

How the pan-London MASH model will work  

The pan-London MASH is colour-coded red, amber, green and blue, so screening methods are consistent across the different agencies. This colour-coding system has been dubbed the "London Continuum of Need". Henson said some 50% of referrals in MASH come through the police side, with the other 50% through the local authority.  "Every notification that comes in is screened and the first thing that's decided on is; is this case open to the local authority, to children's services? If that is the case then that goes without delay to the team or the social worker who is dealing with it."

The benefits of analysis

DS Henson emphasises the benefits of collective problem solving: "Analysis allows us to identify repeat victims and have proper interventions and profiling. Who is that person who seems to be moving around the place? Wherever they are there seems to be more risk and harm. "Some individuals are victims, some are offenders and some are both and will swap between the two. We all need to think of the wider context of the domestic situation they live in and their peer group. This will give people the confidence that they are making decisions with the fullest information available. We focus our limited resources on where the need is and where the harm is. We get the resources to the people who need it most."

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