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and unnecessary or uncoordinated visiting of families were obstacles to the achievement
of that integration and co-ordination of services and activities which was designed to
ensure that the fullest and most effective use possible was made of the special skills of
the individual workers. The need for a large number of specialist and semi-specialist
officers will continue for some time to come, but this does not preclude the possibility
that at some stage fuller co-ordination may be effected through giving major responsibility
to some one particular worker. The integration of services begun after 5th July,
1948, led to a revaluation of those services and to the examination of the need for fresh
means of co-ordination and co-operation. The position in London now is revealed by
a survey undertaken in June, 1956, by the Clerk of the Council in association with chief
officers of the departments concerned into the incidence of home visiting, based on samples
of problem families drawn from areas thought to be representative in social content of
the county as a whole and directed at the visiting of homes or interviewing of members
of the family in places other than the home, in which some 112 staff (representing
34 different grades) and 38 voluntary workers took part. Multiple visiting (in the sense
of the visiting of families by two or more workers during a defined period) occurred
in 45 per cent, of the families included in the survey, and 14 per cent, were visited
by three or more workers. In only 8 per cent, of the families in the survey were
the visits paid considered prima facie to warrant further study on the ground that
they were examples of a possible lack of co-ordination or an overlapping of duties,
and the results of these further enquiries showed that in the great majority of instances
apparent overlapping had occurred because of staff changes which had led to a break
in the continuity of contact with the family. It seems that so far as London is concerned
the incidence of multiple visiting is small and does not in itself connote material overlapping
of functions on the part of the workers.
Methods of co-ordination
Problem
cases
conference
Reference has been made earlier to the Problem Case Conference which is organised
by the education service and meets regularly in each education division to consider
the treatment and education of school children presenting behaviour, etc., problems
in relation to their home circumstances and environment, and is attended by representatives
of the divisional medical officer and the education officer and the children's
care committee organisation. These conferences receive reports from the head teachers,
the school inquiry officer, the social worker or voluntary worker in the children's
care committee service, the child guidance clinic workers, the school medical officer
and the health visitor as appropriate.
N.S.P.C.C.
conference
Another formal conference concerned with casework is the education divisional
N.S.P.C.C. conference. This is attended by representatives of the education officer
and the National Society for the Prevention of Cruelty to Children for the division,
the area children's officer and of the children's care committee organisation. Oral or
written reports are made to the conference by the local inspector of the N.S.P.C.C.,
the social worker or voluntary worker in the children's care service, and the health
visitor, as appropriate, about those children or families in whose case intervention by
the N.S.P.C.C. has been or is considered desirable.
Problem
family
register
More recently, special action has been taken to intensify the efforts that can be made
to deal with problem families and with neglected or ill-treated children. A central
register of problem and near-problem families is now kept in each of the nine health
divisions and the officers of the various statutory and voluntary agencies have been
asked to notify the divisional health office of those families with which they are dealing
which present special problems and to ascertain by reference to the register whether
any family which they contemplate assisting is already receiving attention from some
other body. Each voluntary organisation retains full discretion whether information
at its disposal should be passed on and the register does not involve building up a dossier
of confidential matters relating to the family but rather tends to encourage consultation
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