This document provides an introduction and literature review on the topic of multi-agency working. It begins with an introduction that outlines the policy context in the UK promoting integrated youth support services (IYSS) delivered through multi-agency collaboration. The literature review then examines definitions and models of multi-agency working, highlighting that there is no agreed definition and models vary in their level of integration. Influencing factors on effectiveness are discussed, including the importance of clear aims, shared vision and resources, as well as pre-existing relationships and cultural capital between agencies.

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A critical evaluation of the effectiveness
and efficiency of an example of multi-
agency working: a literature review.
Julia Everitt
Student
Staffordshire University
Final version submitted: January 2010
Produced as part of MA Education
Julia can be contacted via Academia.edu or via juliaeveritt@yahoo.co.uk
Keywords: extended schools, extended services, social capital, cultural capital,
partnership working, collaboration, collaborative advantage, social inclusion,
collaborative capacity

2. Julia Everitt 2 of 18
Introduction
The Every Child Matters (DfES 2003) White Paper aimed to improve children’s life
opportunities and Youth Matters (DCSF 2009a) extended this vision to include 13-19
year olds aiming to address poverty, health, low aspirations and school absence (DfES
2007). This Targeted Youth Support (TYS) (DfES 2007) (Appendix 1) is to be
delivered by a range of organisations (Appendix 2) through a model of integrated
working (Atkinson et al. 2007) entitled the Integrated Youth Support Service (IYSS)
(VCS 2009). This ‘joined up provision’ should be in place by 2008 (DfES 2007:1-3)
aiming to replace ‘organisational or professional silos’. French (2007: 56) informs
this and other policies from the 1990s have taken a ‘children and family centred
approach’ which meant that various agencies would have to work together to provide
services; in the right time and place; signalling a significant shift towards a multi-
agency approach (defined below). This essay will be used to review the literature
surrounding the topic of multi-agency working and will then investigate and critically
evaluate the effectiveness of the development of the IYSS within the local area;
identifying barriers and enablers, resulting in recommendations for practice.
It is clear that when attempting to define the concept of multi-agency working the
matter is ‘complex’ (Atkinson et al. (2007: 13-14) exacerbated by the breadth of terms
utilised to describe an activity detailed as multi-agency (Appendix 3); resulting in
commentators who avoid a definition (Balloch and Taylor (2001). French (2007: 47-
48) informs it embraces the concept of partnership seen as the working relationships
between multi-agencies; requiring a level of integrated working to provide ‘effective
service provision’. This offers the potential to achieve outcomes through integrated
work (Milbourne et al. 2003) but various factors hamper the approach. It requires
more than labelling the relationship a partnership (Powell and Glendinning 2002) for
frustrations and barriers might overwhelm (Hudson and Hardy 2002) and extinguishes
the collaboration without achievement (Huxham and Vangen 2005). There is
conflicting evidence (Atkinson et al. 2007) with regard to the demands made on
agencies; with reports of both positive and negative aspects and barriers which can
also bring reward (IDeA 2009) and thus essential to success (Huxham and Vangen
2005), but these need to be reflected upon. This suggests that for the IYSS to offer
‘joined up provision’ these factors will need to be taken into account.
Literature Review
Rationale
There is documented research on the links between inter-connected problems
including poverty, unemployment, low achievement and children’s life opportunities
(French 2007, Payne 1998). These were inherited by New Labour and worsening
trends (Milbourne at al. 2003) fuelled their argument for a multi-agency approach,
resulting in the promotion of partnership as the ‘panacea’ (Dhillon 2007 :504),
through policies in various arenas (Milbourne at al. 2003) with ‘cross-cutting
outcomes’ (Lowndes and Sullivan 2004 :53) like social inclusion. This is (Political
Dictionary 2003) the strategy to combat social exclusion; where individuals ‘suffer
from a combination of linked problems’ OPDM cited at Breckland Council 2009) or
joined-up problems, that require joined-up solutions (Milbourne at al. 2003).

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However, the call for sectors to work collaboratively to provide integrated services is
not new (Powell and Glendinning 2002) or unique to New Labour (Siraj-Blatchford et
al. 2007); but a combination of previous political approaches (Milbourne et al. 2003)
assumed to be more inclusive (Lowndes and Sullivan 2004). The rhetoric of
partnership is seen as essential to locate solutions to complex problems (Dhillon
2007), with policies focusing on the socially disadvantaged (Tett et al. 2003).
However, Dhillon (2005) argues that this thrust of partnership activity in different
arenas and contexts highlights the terms’ ambiguity and despite the increased political
interest (Dhillon 2007: 505) partnership remains ‘fuzzy’. Powell and Glendinning
(2002: 2) agree that it is the ‘indefinable in pursuit of the unachievable’ and despite
the optimism of official documents there is an array of issues including the definition
of partnership itself (Dhillon 2009). This suggests that despite the increase in the
political arena the concept is not new or clear.
There is an unspoken assumption (Dhillon 2009) that partnership working, can
achieve more, than organisations working independently. Dhillon (2005: 215)
conceptualised this idea as ‘1+1+1= more than 3’ to demonstrate achievement of
more than the sum of parts. Rawson (1994) cited in Leathard (2003) entitled this the
multiplicative effect of interprofessional work, which Leathard (2003: 94) informs
provides a ‘mathematical justification to support interprofessional collaboration’.
Organisations are not limited by their own resources and that in principle, almost
anything is possible, an achievement entitled ‘collaborative advantage’ (Huxham and
Vangen 2005:3). This appeals to policy makers (Dhillon 2009) who automatically
assume the benefits and underestimate costs (Tett 2005) or realise that it can be a slow
painful experience filled with frustrations, which might expire without achieving
anything (Huxham and Vangen 2005). This suggests that multi-agency working has
the potential to achieve more together than individually, but may bring
underestimated costs or unachievable aims.
Atkinson et al. (2002) inform that agencies work together for different reasons;
however, there is a distinction between internal and external rationales (Powell and
Glendinning 2002). Internal are the good reasons to work collaboratively including
meeting a specific group’s needs or pooling resources (Huxham and Vangen 2005), as
opposed to government initiatives and statutory requirements (Atkinson et al. 2002,
Audit Commission 1998, Huxham and Vangen 2005) through an overpowering
pressure to collaborate (Dowling et al. 2004). Powell and Glendinning (2002)
question the success level such compulsory partnership working can achieve and
indicate (Audit Commission 1998) they might not be compatible with a concept
which requires relationships based on trust. This suggests that forced partnerships
might not achieve the same level of success.
Models
Multi-agency activity takes many forms highlighted by the range of models in the
literature (Atkinson et al. 2007), which hinders classification; but similarities were
identified, including the extent that partners work together or how teams are
organised. The extent or progression on the ‘journey towards multi-agency working’
(p16) is depicted in a hierarchal manner with lower levels of communication to higher
levels depicting co-located teams (Leathard 2003) (Appendix 4), highlighting
collaboration layers which may suggest that some individuals work closer than others

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(Dhillon 2009). The organisation of the multi-agency activity (Atkinson et al.
2007:18) includes operations teams, decision-making groups, steering groups
(Appendix 5a) or whether the integration appears at strategic, operational, service
level or professional identity (McGowan et al. 2009). The literature suggests there
needs to be commitment at senior levels, otherwise lower levels become marginalised
(Hudson and Hardy 2002). However the demanding nature of multi-agency teams
can draw the focus towards to structures as opposed to improving outcomes (Duffy
and Marshall 2007). This suggests there are various models, with some indicating the
possibility for higher levels of collaboration, but the model should not be the focus.
The IYSS model’s development is challenging, as the concept lacks a universally
agreed definition and depends on what is understood by the term ‘integrated’
(McGowan et al. 2009). Successful implementation was highlighted (DfES 2007) as
requiring collaborative working, however pathfinders (DCSF 2009b) utilised various
structures (Appendix 5b). VCS (2009) cite Watts et al. (1999) to illustrate achievable
integration levels (Appendix 6); however there is a reassertion (McGowan et al. 2009)
that recognizes the value of discrete professional areas of expertise with authorities
not depicting integration as the end result. This suggests this could inhibit the ability
for collaboration, as higher levels are linked to integration.
Influencing factors/challenges
Research suggests (Tett 2005) that to facilitate collaborative working clear aims,
allocated time and shared ownership are required (Atkinson et al. 2007, Dhillon
2007), which combined with a shared vision, goals, and resources; are the ‘building
blocks’ of success (IDeA 2009: 5). Effectiveness can be achieved through concern
for quality, but shared objectives had the biggest impact (Poulton and West 1999),
similarly if individuals have worked together previously (Lloyd cited in Milbourne et
al. 2003) or have a history of team ethos (Clarke and Rummery 2002) effectiveness
can be increased. This subscription to common values (Sullivan and Skelcher 2002)
can result in individuals creating their own collaborative culture or way of doing
things. These previous contact or networks are found to form ‘cultural capital’
(Clegg and McNulty’s 2002: 588) a resource that contributes to partnership success
and taken forward from previous experiences (Milbourne et al. 2003). This suggests
that clear and shared aims are important and effectiveness can be increased if
individuals have previously worked together.
The degree of collaboration (Hudson and Hardy 2002) the partnership can sustain
before loss of commitment is called collaborative capacity; seen in the form of skills
and attributes which enable individuals to work across boundaries; however, this is
not easy. Barriers are deeply rooted in organisational culture and practice; with
informal behaviour patterns, dress code and language, serving as obstacles. These
identity issues highlight the complexity of multi-agency working with ‘turf warfare’
(Canavan et al. 2009: 380) and conflict manifesting when crossing boundaries (IDeA
2009), causing conflict and inhibiting success (Clegg and McNulty 2002). The need
to recognise (Tett 2005) each agency’s contribution and learn from each other is
important and marginalisation is reduced if individuals identify an acceptable team
place (Milbourne et al. 2003). However, lack of clarity over role demarcation
(Atkinson et al. 2007) is a concern, with status issues resulting in tensions and low
morale from blurred boundaries. Insecurities are felt (Stanley 2007) when agencies do

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not appreciate each other’s abilities, resulting in crossing domains, which can threaten
partners (Hudson and Hardy 2002). This highlights the identity barriers to multi-
agency working, which can inhibit success.
Working relationship issues are at the core of multi-agency activity (Atkinson et al.
2007), with the need for understanding, communication and mutual respect.
Furthermore the importance of personal views, feelings and attitudes (Richards and
Horder 1999) are more significant, than systems and structures. Differences may arise
(Milbourne et al. 2003) which need to be actioned; otherwise tensions arise that
inhibit integration. To build (Sullivan and Skelcher 2002) and maintain collaborative
relationships individuals will need specific capabilities, such as the reticulist
(Appendix 7). This new ‘hybrid’ professional type (Atkinson et al. 2002: vi) has
certain knowledge and experience that is essential for successful collaboration.
Achievement (Hudson and Hardy 2002:59) could relate to having the right person, in
the right place at the right time and highlights the destructiveness of having the wrong
person there. Selecting the right person can be through careful selection but equally it
can be down to ‘luck’. This indicates the importance of having the right individuals
involved in the IYSS.
Building relationships upon trust, mutual respect and understanding (Atkinson et al.
(2007) are important to effective working relationships; engendered through sharing
skills, best practice, resources; and a common language to facilitate decision making
(Lowdnes and Sullivan 2004). Trust appears to be ‘by-product of personal
connections and friendships’ (Tett et al. (2003:47) and although partnerships can exist
(Hudson and Hardy 2002) without trust, its presence forms the basis for the closest
and enduring relationships. Sharing priorities, goals and working together (Clarke
and Rummery (2002) can overcome inter-professional issues and past mistrust.
Furthermore (Sullivan and Skelcher 2002) lack of trust results in less effective
collaborations; overcome if organisations agree parameters which aim to promote
fairness, account for behaviour and are important in building trust (Hudson and Hardy
2002). One set of parameters seen as beneficial to partnerships are the Nolan
Principles (Anderson 2009: 40) and assist with building strong partnerships. This
indicates how important trust would be with regard to the IYSS.
Leadership is an important resource for collaboration (Sullivan and Skelcher 2002,
Atkinson et al. 2007). However, effective leadership of integrated teams requires a
‘special mindset and skills’ (IDeA 2009: 10) including capacity to draw others in,
motivation, passion, social skills, reflection and a commitment to own learning and of
others (Sullivan and Skelcher 2002, Duffy and Marshall 2007). A reticulist (Sullivan
and Skelcher 2002) (Appendix 7) may be able to lead a multi-agency team, however,
the idea of a lead agency and hierarchal relationships, where agencies could exercise
more power (Powell and Exworthy 2002), may be challenged (Sullivan and Skelcher
2002). To work collaboratively organisations will need to surrender power and
resource control (Tett 2005), as this can inhibit progress (Canavan et al. 2009).
Furthermore (Atkinson et al. 2007) individual’s roles should be clarified so they
understand how they can contribute utilising a clear framework of responsibility. An
‘unequal power balance’ (Lowdnes and Sullivan 2004: 61) can exist; partners
contributions (Sullivan and Skelcher 2002) should be valued consummately, however
less powerful partners can be treated with inequity, or excluded from partnership

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practice including the voluntary and community sector, who despite encouragement
often feel inferior (Milbourne et al. 2003).
Evaluation
An intended gain (IDeA 2009) is the ability to respond effectively to the needs of
children and young people and although integrated working (Frost and Stein 2009:
315) is ‘intimately connected’ to improving outcomes, this proposal has been
challenged. The mechanisms of partnerships (Powell and Glendinning 2002) have
rarely been scrutinised and gains are difficult to realise in practice, with impact
evidence being difficult to locate. The pressure to collaborate does not appear to be
based on clear evidence it can work, with a literature search (Dowling, Powell and
Glendinning 2004) finding little evidence of improved outcomes. Organisations
cannot learn from partnership working (Clarke and Rummery 2002) unless evaluation
takes place and the results are fed back, however, there is no distinctive success model
(Powell and Glendinning (2002) against which to measure. To achieve the intended
results, individuals would need to understand the required ingredients for a successful
partnership in terms of the concept of success (Dowling et al. 2004); however the
majority of partnerships were concerned with the process of undertaking partnerships,
highlighting the lack of clarity regarding whether to measure process or outcomes.
Despite refinement of models there is a lack of links to evidence and the outcomes to
service users; with any documented positive impacts referring to the professionals
involved (Atkinson et al. 2007). Agencies learn from each other and inform practice
by sharing differing perspectives of services; however (Stanley 2007) informs this is
simple notion of learning from each other and it is questionable why multi-agency
working requires national initiatives to endorse it. This highlights the importance of
evaluation to the IYSS, to determine if outcomes have been achieved, however it is
clear that determining success is a difficult process.
To determine the effectiveness of the IYSS this literature review has highlighted the
need to investigate what the locally understood rationale is for the IYSS, what are the
aims, if evaluation is seen as important and the range of agencies involved. To
determine the efficiency it will be necessary to identify what model of multi-agency
working has been selected, whether leadership is recognised as important and whether
there are any barriers or challenges which appear to be affecting the development of
the service.

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Appendix 1 – Seven key elements
DfES (2007) inform that a success factor of the targeted you support pathfinder was
the delivery of seven key elements for vulnerable young people.
Fig 1: Seven Key Elements (DfES 2007)
No Key element
1 Strengthen the influence of vulnerable young people and their families and
communities, and their ability to create positive change
2 Identify vulnerable young people early, in the context of their everyday lives
3 Build a clear picture of individual needs, shared by young people and the
agencies working with them, using the common assessment framework (CAF)
4 Enable vulnerable young people to receive early support in universal settings.
Help all agencies to draw in extra help on behalf of young people, through
better links with other agencies and organisations
5 Ensure vulnerable young people receive a personalised package of support,
information, advice and guidance, and learning and development opportunities,
with support for their parents or carers as appropriate. This should be
coordinated by a trusted lead professional and delivered by agencies working
well together
6 Provide support for vulnerable young people across transitions, for example
moving on from school or from the support of one service to another as their
needs change.
7 Make services more accessible, attractive and relevant for vulnerable young
people

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Appendix 2 – Organisations involved in targeted youth support
DfES (2007) informed the organisations involved in targeted youth support include
but are not limited to, the following: youth services, schools, health services, social
services, voluntary and community sector agencies, Connexions, education welfare,
behaviour support, drugs and alcohol services, sexual health services, teenage parent
support workers, special educational needs coordinators (SENCOs), child and
adolescent mental health services (CAMHS), counselling services, information advice
and guidance providers, housing and housing support, youth offending services and
the police.
While the key stakeholders vary depending on local circumstances, choices and
models, there are a number of services and organisations which are essential to the
successful delivery of targeted youth support in every area.
Fig: 2 Key Stakeholder values and benefits
Organisation Value and benefits
Youth Work Key to identifying young people in need and gaining their trust.
Health services Many young people’s problems require their expertise.
Social services Bring extensive expertise in supporting and identifying needs.
Voluntary and
community sector
Bring experience and expertise in engaging and supporting
vulnerable and disadvantaged young people
Connexions Substantial experience of developing tailored multi-agency
support and ensuring the engagement of young people in service
design. Connexions have a central role in delivery of TYS.
Parenting Support Stakeholder value – Positive parenting is one key to resilience:
helping to protect young people from poor outcomes.
Schools Stakeholder value – Schools should be actively identifying,
supporting and, where necessary, referring on young people.
Motivation and a positive bond with school, together with good
attainment, can help protect young people from poor outcomes.
Post 16 education
providers
Many of the young people targeted will be over 16 and it is
important that learning provision services, and other services for
this group, are engaged.
Housing and
housing support
Stakeholder value – Housing services are often an initial point
of contact for vulnerable young people. Some vulnerable young
people, for example some teenage parents, may need help to
find and retain independent accommodation with support.
Police Stakeholder value – Neighbourhood policing can help to
identify young people engaged in anti-social behaviour. The
police work with schools through safer schools partnerships to
identify young people at risk.
Youth offending
services
Stakeholder value – Youth offending teams offer substantial
experience of providing multi-agency support to vulnerable
young people and run a number of evaluated targeted
preventative programmes for young people and their parents.
Related programmes include: extended services in and around schools, positive
activities for young people (PAYP), and the young people's development programme
(YPDP), positive futures, youth inclusion programmes (YIP), neighbourhood policing
and local authority/PCT teenage pregnancy strategies.

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Appendix 3 – Definition of multi-agency working
Atkinson et al. (2007: 13) found that an activity which could be characterised as
‘multi-agency’ is referred to, by a vast quantity of different terms. Selections of these
are listed below. This they inform has ‘implications for researching multi-agency
activity’ as the confusing and/or conflicting nature of some of the terms can result in
more complex research and can lead to comparison difficulties, between studies.
Fig 3: Definition of terms relating to multi-agency activity
Multi-agency working
Multi-agency activity
Partnerships
Partnership working
Interprofessional collaboration
Interprofessional work
Interprofessional consultation
Co-operative practice
Joint-working
Multi-disciplinary working
Integration
Interagency working
Interdisciplinary working
Transdisciplinary working

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Appendix 4 – Models of multi-agency working
Leathard (2003: 96) cites various examples of multi-agency collaboration including
an example by Hudson (1998) which pins down collaborating under four different
levels of collaborative involvement.
Fig 4 - Models of inter-professional collaboration
Communication Interactions are confined to the exchange of information
Coordination Individuals remain in separate organisations and locations but
develop formal ways of working across boundaries
Co-location Members of different professions are physically located
alongside each other
Commissioning Professional with a commissioning remit develop a shared
approach to the activity

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Appendix 5a– Multi-agency structures
Atkinson et al. (2007) indicate that some commentators use models to depicts the
organisational structure of the activity, with frequent models including operations
teams, meetings or steering groups or whether the integration appears at strategic,
operational, service level or professional identity (McGowan, Watts and Andrews
2009).
Fig. 7: Decision making Groups (Atkinson et al. 2007)
Decision making groups
Education Social
Services
Health Other

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Appendix 5b – Multi-agency structures
DfES (2007) inform that the successful implementation and operation of targeted
youth support needs to be underpinned by multi-agency structures and workforce
development that support early intervention and flexible collaborative working.
Fig 5: Different Multi-agency structures (DfES 2007)
Multi-agency teams
Many pathfinders have developed frontline multiagency, locality-based, targeted
youth support teams. These teams are usually based in community settings and
schools.
Multi-agency teams may be maintained by devolved planning and commissioning
arrangements and have control of devolved/delegated budgets, controlled
through pooling or aligning arrangements.
Higher-level panels or boards
Some of the pathfinders have established panels with a wider geographic remit than
locality-based teams. This is often to maximise the contribution of more specialist
services. The panels generally receive complex cases from locality-based teams and
provide support (or draw in support from colleagues) for local teams and in
universal settings as needed. The panels can also act as the first point of contact for
agencies not directly linked to a locality team or members of the public.
The panels may have control of devolved budgets. Their membership varies, but they
may, for example, include representatives from educational psychology, police and
community safety, speech and language therapy, community paediatrics and social
care or housing services.
Allied Services
Some less central services may not be formal members of teams or panels, but may be
linked to these structures, with practitioners joining a team working around a young
person as needed. Formal protocols, joint training and other arrangements to develop
working relationships, such as hot-desking, are being established in the pathfinders to
strengthen links.
Supporting multi-agency structures
 Building on existing partnerships
 Clear scope where they work
 Clear governance – fitting into hierarchy of accountability in local authorities
and services
 Seven key elements at the core
Workforce development
 Clear lines of management and supervision –
 Integrated training and staff development
 Opportunities to build close relationships

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Appendix 6 – IYSS and the nature of integration
Fig 6:- The Nature of Integration - A Five Stage Model
VCS (2009) refer to the Five Stage Model of Watts, Hughes & Haslam, (1999):
Integrati
on
Cross-
fertilisation
Co-ordination
Co-operation
Communication
5. Characterised as the development of
cross-fertilisation, boundaries between
services disappear altogether
4 Where services share and exchange skills
working across professional boundaries in
ways that are likely to redraw the boundaries
themselves.
3. Where two or more services alter
their working patterns to bring them
closer into line with another, while
remaining within their professional
boundaries.
1. Working patterns remain
unchanged but efforts made
to help services to
understand what other
services offer. E.g. to cross
refer clients effectively
2. Where two or more services co-
operate on joint task

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Appendix 7 – Required skills and attributes of reticulists
Sullivan and Skelcher (2002: 101) indicate the required skills and attributes of a
reticulist.
 Understanding different organisational contexts
 Knowing the role and playing it
 Communication
 Networking
 Negotiating
 Conflict resolution
 Risk-tasking
 Problem-solving
 Self-management