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Suzanne Watts joined the Department of Psychology, Social Work and Public Health at Oxford Brookes in 2011. Her thesis title is 'Exploring Referrals from Primary Health Care to Child Protection Services.'
Embarking on a PhD mid-career can be daunting, challenging and at times may seem out of reach. However, the Doctoral Training Programme Studentship in Children and Young People has given me the opportunity to undertake a full time PhD to investigate the complex and sensitive issue of child protection. The central philosophy of the Doctoral Training Programme is multi-disciplinary research, drawing from psychological, educational and health perspectives. Coming from a professional background in health care, where the inclination is to concentrate attention within your own discipline, this programme has challenged my previously narrow disciplinary viewpoint.
The focus of my study is the inter agency communication that occurs between primary health care professionals and child protection social workers. More specifically it explores the early stage of the statutory process when primary health care professionals refer or notify child protection services of their concerns about the safety and well-being of a child or young person. From the outside this would appear to be a simple task, however from reviews of fatal child abuse inquiries it is apparent that this communication process is not straightforward and is beset with problems and difficulties. The consequence of ineffective communication is that families remain unsupported and children remain at risk of harm and further abuse.
In order to explore this communication process in depth, a qualitative multiple case study approach has been adopted. The unique aspect of this study is that it explores the referrals from the perspectives of both health and social care professionals. Additionally, the narrative written on the referral form is analysed as a function of the communication process. Therefore each case is made up of three elements, in-depth interviews with a health care professional and a social worker and a content analysis of the referral form.
Health care professionals, who make a child protection referral during the period of data collection are invited to participate. The inclusion criteria being that they work in either universal child health services (for example, health visitors, family nurses and school nurses) or general practice (GPs). It is acknowledged that these professionals are well placed to identify children at risk of harm and to refer them to child protection services. Once the health care professional consents to be interviewed then the social worker who has taken up the referral is invited to participate, and the referral form is anonymised, thereby making a case for the study.
There are a number of ethical concerns within the design of this study namely confidentiality, privacy and data protection. To overcome these issues the support of an administrator, acting as an information gatekeeper within social services, has been crucial in identifying the cases and recruiting participants to the study. The administrator is an employee of social services and has access to social service IT case management systems as well as the contact details of the professionals involved with the referral. As the investigator of the study, I cannot approach potential participants directly, nor am I able to access any identifiable personal information until they agree to participate. The administrator has a key role in inviting participants and providing anonymised data for case selection and analysis.
Recruitment to the study is dependent on the goodwill and enthusiasm of health and social care professionals. Unfortunately high workloads, staff shortages and the prioritisation of vulnerable children’s needs are issues that have impacted on recruitment to the study. Data collection is on-going and in order to increase the pool of potential participants, two more study sites, both inner city boroughs, are being used for recruitment in addition to the first county wide study site.