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The future of safeguarding children: the Munro Review

Alison Foster
Independent Medical Writer

After the deaths of Victoria Climbie and Peter Connelly, the Munro Review was commissioned to address some of the inconsistencies in care that led to such neglect and improve safeguarding of children for the future

In June 2010 the Secretary of State for Education, the Right Honourable Michael Gove MP, asked Professor Eileen Munro, Professor of Social Policy at the London School of Economics and Political Science, to undertake a comprehensive review of child protection across England. 

This decision was made as, despite recommendations made by Lord Laming following the death of Victoria Climbie in 2000 and a further progress report completed several years later in 2009 after Peter Connelly, or 'Baby P', died from neglect and abuse meted out by his carers, much still needed to be done to increase the safety and wellbeing of children.1,2

Since the coalition government took power in May 2010, ministers have been keen to evaluate the impact of regulatory systems. The proposed Independent Safeguarding Authority (ISA), for example, has been put on hold to determine the best way to avoid over-regulation and ensure that systems deliver the desired outcomes and, most importantly, are child-centred. The Munro review was commissioned as part of this philosophy of streamlining systems, to look at the possibility of simplifying processes to ensure that the child remains the central focus.

First report: a systems analysis
The initial report, published in October 2010, looked at why the previous reforms have not resulted in the intended improvements to child protection.3 The review has successfully involved a broad stakeholder response and Professor Munro has drawn on the views of a wide range of users, service providers and commissioners of children's services. She also used the expertise of a personal reference group and drew on the evidence provided to both Lord Laming and the Social Work Task Force.6  

This report adopts a systems approach, which analyses how the various systems in place interact with frontline services. It highlights that the needs of children were difficult to address adequately and quickly due to overcomplicated tick-box assessment processes. Professor Munro points to duplication of assessments between services and the way that uncertainty in safeguarding was being managed. Services are so risk averse that lengthy assessments are performed, without achieving key outcomes for children and young people. Services are geared towards producing inspection reports as an end in itself, rather than operating more flexibly according to children's varying needs.

This analysis makes reference to the Taylor-Russell diagram, which is a really interesting way to view risk.7 It illustrates the way that trying to achieve a balance in assessing risk results in either increasing or decreasing the rates of false positives and false negatives. When attempting to identify actual abuse and thresholds for intervention, a low threshold results in a higher rate of false positives (cases with no abuse) to high thresholds where a high number of false negatives are obtained (missed cases of abuse). 

Interim report: the child's journey
The second report, published in February 2011, moved from a focus on systems to that of the 'child's journey from needing to receive effective help from problems arising from family and social circumstances'.4  A number of local authorities - Cumbria, Gateshead, Hackney, Knowsley and Westminster - were involved in the investigation, trialling a flexible assessment system. The report makes the following key recommendations:

  • Unannounced inspections should replace announced inspections of provider organisations.
  • Ofsted evaluations of serious case reviews are to end eventually.
  • Guidance such as Working Together to Safeguard Children should be separated from professional advice.8
  • The role of Local Safeguarding Children's
  • Boards (LSCBs) should be strengthened.
  • Efforts should be made to improve family support services, such as Sure Start children's centres and health visitors.
  • Supervision practices, which provide the space for critical reflection, should be strengthened.

The review is broken down into four main areas:

  • Getting help early.
  • Child and family social work.
  • Managing frontline social work.
  • Procedures.

Three other reviews were taken into account and reinforced the importance of early intervention: Frank Field's report from December 2010 that child poverty was a key target to address;9  MP Graham Allen's report, which highlighted 19 programmes with proven effectiveness at helping to break the intergenerational transfer of disadvantage and underachievement;10 and Dame Clare Tickell's review of the Early Years Foundation Stage, with the aim of focusing more on a child's learning and development.11  

This interim report looks at the skills and competencies social workers need, and draws on the work done by the Social Work Task Force. Tower Hamlets undertook a major review of its integrated computer systems in 2010 and recommendations were made as a result, suggesting that the existing format is not 'child friendly'. With regard to procedures, Munro calls for a more adaptable system to be put in place that is capable of providing learning for its practitioners.

The final report: a child-centred system
The final report firms up the recommendations made in the first two reports. Munro calls for a review of statutory guidance, an inclusive inspection framework that examines the effectiveness of all local services, and a new benchmarking system of performance data.5,8 Munro explicitly requests that the government should work with medical and local authority bodies to research how the proposed health reforms will affect partnership working.

A large section of the report concentrates on the importance of the right skills and competencies for social workers, stressing the need for social work students to receive training in child development and to implement a system of continuing professional development.

Analysis
Professor Munro's review should be welcomed by all who have a responsibility to protect children and young people. She proposes really sensible changes to an over-bureaucratised  system, with recommendations, for example, to simplify Working Together.8  This document is 55 times longer than it was in 1974. The recommendation to strengthen family support is consistent with the government's drive to recruit extra health visitors.12

Munro stresses the importance of supervision, which allows time for reflection, and avoidance of collusion, which can result in a loss of clear focus on the child. Essentially, this review is about a move from a management focus to a leadership model: from a 'doing things right' approach (following procedures) to 'doing the right thing'.5 

The recommendation to adapt systems and streamline procedures seems positive, but there should also be a note of caution. If systems are too flexible, without the rigidity of strict timeframes, for example, with initial assessments, there is a real risk of a culture of drift, indecision and delay. Munro does stress that 'timeliness' is an important principle that should be applied throughout the whole process. This is really important and a timeframe should be set to achieve an accountable framework.

There is much to applaud in the three documents - the acknowledgement of the need for early intervention, the importance of simplifying regulation and procedures and the links between adult services and public health.

However, we must remember that these proposals come at a time of severe budgetary restraint. We know that services are being cut across the health service, so it will be a major challenge to identify resources to meet all these recommendations.

The review only covers England, so it may be that services and ways of working will differ across the UK. Vulnerable families are often mobile and may experience significantly different services and ways of working across the UK.

There is a recommendation that the government should research the impact that health reforms will make on partnership working, but it can be argued that this does not go far enough.  Perhaps the review should have considered the present and future roles of commissioning groups in child protection.

The final report stresses the importance of education and training; but the focus is on social work. All agencies must look at provision of training and education and, in particular, look at the clarity of the role of the health visitor. Safeguarding is all about partnership across agencies, so all those working with children should be included. It was to be expected from the remit that Eileen Munro would predominantly focus on social workers, but she fails to acknowledge the vital roles that the other agencies play in the work of safeguarding children. 

Conclusion
This review is to be welcomed and all three reports make excellent observations and recommendations. The next stage is to consider the review and for responses to be developed by all the relevant stakeholders. Both health and social care professionals should study the recommendations and keep abreast of current thinking around the best way forward. No change from the present system is not an option. Too many referrals are overwhelming already over-stretched services. The government seems serious about its commitment to change; let us hope this takes place for the benefit of all our children and young people.

Box 1. Review summary

  • The two initial reviews provide the evidence for the final report and its recommendations. The first report concludes that professionals are constrained by rigid and demanding inspection and regulatory systems.
  • The second report looks at the challenges faced by social workers in their work to protect children, the gamut of rules and procedures and lack of training in child development in the social work course.
  • The final report ties all the work together and makes firm recommendations, mainly concerning social work practice. Eileen Munro is clearly in favour of greater flexibility and adaptability around individual cases and a learning culture where risk is managed by a team of workers, with a senior social worker acting in a consultant role.

References
1.    Lord Laming. The Victoria Climbie Inquiry: Report of an Inquiry by Lord Laming. London: DH; 2003.
2.    Lord Laming. The Protection of Children in England: A Progress Report. London: The Stationery Office; 2009.
3.    Munro E. The Munro Review of Child Protection. Part One: A Systems Analysis. London: Stationery Office; 2010. 
4.    Munro E. The Munro Review of Child Protection. Interim Report: The Child's Journey. London: Stationery Office; 2011. 
5.    Munro E. The Munro Review of Child Protection: Final Report - A child-centred System. London: Stationery Office; 2011. 
6.    Department of Health (DH). Facing up to the task: The Interim Report of the Social Work Task Force: July 2009. London: DH; 2009.
7.    Taylor H, Russell J. The relationship of validity coefficients to the practical applications of tests of selection. Journal of Applied Psychology 1939;23:565 -78.
8.    Department for Children, Schools and Families (DSCF). Working Together to Safeguard Children: A guide to inter-agency working to safeguard and promote the welfare of children. London: DCSF; 2010.
9.    Field F. The Foundation Years: preventing poor children becoming poor adults. London: Stationery Office; 2010.
10.    Allen G. Early Intervention: the next steps. London: Stationery Office; 2011.
11.    Tickell C. A Review of the Early years Foundation Stage (EYFS). London: Stationery Office; 2011.
12.    Department of Health (DH). Health Visitor Implementation Plan 2011-2015: A Call to Action. London: DH; 2011.