Assessing the Early Impact of Multi Agency Safeguarding Hubs (MASH) in London
The failure of agencies to work together effectively to safeguard children and young people has been highlighted in numerous serious case reviews of child protection cases. The Munro Review of Child Protection (2011) recognised the key role of the Local Safeguarding Children Boards (LSCBs) in fostering multi agency working and the same year the London Safeguarding Children Board (London SCB) began to roll out Multi Agency Safeguarding Hubs (MASH) in boroughs across the city. There are now 26 MASH operating in London. They follow a model developed by the LSCB in Devon and focus on the point at which child protection referrals are initially received.
Aims and methodology
A review of the implementation of this method of multi-agency working and its impact on safeguarding services to children was carried out in five London boroughs in order to assess how effectively it is being put into practice. One of the boroughs investigated had a relatively established MASH and the other four boroughs developed their MASH teams over the course of the review allowing the collection of data both pre- and 2 months post implementation.
A mixed methods approach was used including: pre implementation MASH site visits, a pre and post implementation snapshot audit of referrals to MASH, a pre and post implementation qualitative interview study of MASH professionals and a post implementation qualitative interview study of referrers to MASH.
A number of challenges were encountered in the collection of data from the five boroughs including delays to the implementation of MASH which reduced the time available for data collection and the difficulty of finding times when professionals were free to participate in interviews. These difficulties meant that amendments had to be made to the data requested and collected and to some of the analyses conducted.
The findings from this review provide early evidence that the MASH approach has the potential to address some of the issues highlighted in serious case reviews in the past. MASH appears to facilitate more effective multi-agency working and there are signs that the professionals working together in MASH teams were developing their own MASH culture as distinct from single agency cultures. This demonstrates the potential for improvement in partnership communication and information sharing.
The benefits of this improvement are already being felt in some of the boroughs under review. One of the most significant findings was the reduction in turnaround time of referrals to safeguarding services at all levels of risk (RAG (Red, Amber, Green) Ratings). The mean turnaround time for cases initially assessed as level 3 (high or complex needs) nearly halved from two and a half days to slightly over one and a quarter days and the turnaround time for referrals initially assessed as level 2 (low to vulnerable) halved from more than four and a half days to less than two and half days.
Professionals interviewed pre implementation had questions about how MASH would work, but in general people felt it would bring benefits to safeguarding. It was expected that this form of multi-agency working would lead to a better mutual understanding of the various roles involved in child protection and that faster information sharing would lead to more effective decision-making.
Professionals interviewed post implementation were generally positive about MASH working and the impact on services to children. There was evidence that more children were receiving services appropriate to their needs following referral. The main areas of concern arose from heavy workloads, poor staffing levels and frustrations with inadequate information technology resources.
The introduction of MASH has necessitated structural changes and a shift in cultural attitudes. It is therefore perhaps not surprising that at such an early stage in their development, some boroughs perceived themselves as being more operational than others and the site visits found a degree of variation in the ways they met the five core elements of the MASH model. These core elements of the London MASH were based on elements of the first MASH which was set up in Devon.
Both MASH professionals and those referring to MASH recognised that further work was needed to educate professionals (such as those responsible for making safeguarding children referrals) about the role and responsibilities of MASH. Many professionals outside of the MASH team appeared to be unfamiliar with the MASH process which could result in a reluctance to provide information when requested, particularly information that was regarded as confidential.
Furthermore, some non social care or police professionals within the MASH teams felt somewhat marginalised and complained of a failure to fully utilise their skills and experience, feeling that they were only used to provide information and did not take part in discussions or make decisions about children. Referrers to MASH complained about the failure to communicate feedback about the outcome of referrals.