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Key worker services for disabled children: what characteristics of services lead to better outcomes for children and families?
- Authors:
- SLOPER P., et al
- Journal article citation:
- Child: Care, Health and Development, 32(2), March 2006, pp.147-157.
- Publisher:
- Wiley
Research has shown that families of disabled children who have a key worker benefit from this service and recent policy initiatives emphasize the importance of such services. However, research is lacking on which characteristics of key worker schemes for disabled children are related to better outcomes for families. A postal questionnaire was completed by 189 parents with disabled children who were receiving a service in seven key worker schemes in England and Wales. Path analysis was used to investigate associations between characteristics of the services and outcomes for families (satisfaction with the service, impact of key worker on quality of life, parent unmet need, child unmet need). The four path models showed that key workers carrying out more aspects of the key worker role, appropriate amounts of contact with key workers, regular training, supervision and peer support for key workers, and having a dedicated service manager and a clear job description for key workers were associated with better outcomes for families. Characteristics of services had only a small impact on child unmet need, suggesting that other aspects of services were affecting child unmet need. Implications for policy and practice are discussed, including the need for regular training, supervision and peer support for key workers and negotiated time and resources for them to carry out the role. These influence the extent to which key workers carry out all aspects of the key worker's role and their amount of contact with families, which in turn impact on outcomes.
Care co-ordination and key worker schemes for disabled children: results of a UK-wide survey
- Authors:
- GRECO V., SLOPER P.
- Journal article citation:
- Child: Care, Health and Development, 30(1), January 2004, pp.13-20.
- Publisher:
- Wiley
Investigated the prevalence and nature of care co-ordination and key worker services for disabled children and their families with a postal survey of 225 children with disabilities teams. Of 159 questionnaires returned (70%), 35 (22%) reported having a care co-ordination scheme, with 30 (19%) providing key workers for families. Most had multiagency and parent involvement in setting up and overseeing schemes. However, multiagency funding was less common and funding for many schemes was short term. Different models of key working were apparent. Five schemes employed full-time key workers. In 21, professionals key worked with a few families as part of a large case load, and in 3 both types of key workers were employed. Most schemes provided initial or ongoing training for key workers, but a few provided neither. The proportion of areas having care co-ordination or key worker services is consistent with findings on research with parents of disabled children, which reports that less than one-third of families have a key worker. The extent of multiagency involvement in planning and overseeing the operation of the service was positive but joint funding was more problematic. There was considerable variation in service models and, as yet, little is known about whether or how such variations relate to outcomes. Further research will investigate these issues.
Involving disabled and chronically ill children and young people in health service development
- Authors:
- SLOPER P., LIGHTFOOT J.
- Journal article citation:
- Child: Care, Health and Development, 29(1), January 2003, pp.15-20.
- Publisher:
- Wiley
Aimed to investigate the extent and nature of involvement of physically disabled or chronically ill children and young people in local health service development using a postal survey of all 99 health authorities and 410 NHS Trusts in England: 76% and 59% responded respectively. Identified 27 initiatives involving chronically ill or disabled children and young people in consultation regarding service development, over half in partnership between health services and other agencies, usually local authorities and/or voluntary organisations. A variety of consultation methods included child-friendly methods such as drawing, drama and making a video. Seventeen initiatives reported that children's involvement had resulted in service changes, but only 11 went beyond consultation to involve children and young people in decision-making about service development. Only a third of organisations had someone with designated responsibility for children's involvement. Such involvement is at an early stage. The failure of policy documents on user involvement to identify children and young people as a group for whom methods of consultation need to be developed and the lack of people with designated responsibility for developing involvement may be a reason for slow progress in this area. Initiatives identified show that such involvement is possible and can have a positive impact on services.