Another report about integrating services, ‘It takes leaders to break down silos’

uk80"Leadership is the most important factor in enabling (or hindering) integration"

It takes leaders to break down siloes: Integrating services for disabled children by Amanda Allard, Andrew Fellowes, Anna Gardiner & Sarah Hart

Executive summary

Over the past decade, successive governments have brought in a range of legislation, policies and programmes in an attempt to deliver on a vision of coordinated, person-centred care and better outcomes for children and young people with SEND. However, despite this visible drive towards integration, services for children with SEND remain fragmented.

Following consultation with 76 education, health and care professionals and parent carers in three local authority areas, this report considers why the task of integrating the design and delivery of services around SEND is proving challenging. It also identifies the key factors enabling or hindering progress.

Local authority and NHS commissioners are compelled to integrate services by a range of legislation and national programmes. The desire to address the role of wider, external factors in determining our health and wellbeing, has additionally led to efforts to coordinate across whole ‘population health systems’ (Alderwick, Ham, & Buck, 2015). This approach is especially relevant to children and young people with SEND who, not only access a range of services across health, education and social care in relation to their SEN or disability, but are also more likely to belong to other vulnerable groups.

However, we know that in practice, the reality of integrated working between different services and agencies, such as NHS and local authority services, children’s and adults’ services and specialist and universal services, is challenging. The many services accessed by children and young people with SEND are subject to different legislation, funding models and accountability mechanisms that drive different organisational priorities. This means that in reality most initiatives trialling more integrated systems have focussed on adults where only health and social care need to be integrated.

Peter Limbrick writes: I hope to write a response to this during the next month or two. I welcome any comments about the usefulness of this report from TAC Bulletin readers. People who comment can remain anonymous if they wish. Send your comment to This email address is being protected from spambots. You need JavaScript enabled to view it.


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