McKean, Cristina and Law, James and Laing, Karen and Cockerill, Maria and Allon-Smith, Jan and McCartney, Elspeth and Forbes, Joan (2016) A qualitative case study in the social capital of co-professional collaborative co-practice for children with speech

Background: Effective co-practice is essential to deliver services for children with speech language and communication needs (SLCN). The necessary skills, knowledge and resources are distributed amongst professionals and agencies. Co-practice is complex and a number of barriers, such as 'border disputes' and poor awareness of respective priorities, have been identified. However social-relational aspects of co-practice have not been explored in sufficient depth to make recommendations for improvements in policy and practice. Here Co-professional collaboration for children with SLCN 3 we apply social capital theory to data from practitioners: an analytical framework with the potential to move beyond descriptions of socio-cultural phenomena to inform change. Aims: Co-practice in a Local Authority site was examined to understand: 1) the range of social capital relations extant in the site╆s co-practice; 2) how these relations affected the abilities of the network to collaborate; 3) whether previously identified barriers to copractice remain; 4) the nature of any new complexities which may have emerged; and 5) how inter-professional social capital might be fostered. Methods & Procedures: A qualitative case study of SLCN provision within one Local Authority in England and its linked NHS partner was completed through face-to-face semistructured interviews with professionals working with children with SCLN across the authority. Interviews, exploring barriers and facilitators to interagency working and social capital themes, were transcribed and subjected to thematic analysis using iterative methods and a thematic framework derived. Results: We identified a number of characteristics important for the effective development of trust, reciprocity and negotiated co-practice at different levels of social capital networks : Macro ‒ service governance and policy; Meso school sites; Micro intra-practitioner knowledge and skills. Barriers to co-practice differed from those found in earlier studies. Some negative aspects of complexity were evident but only where networked professionalism and trust was absent between professions. Where practitioners embraced and services and systems enabled more fluid forms of collaboration, then trust and reciprocity developed. Conclusions & Implications: Highly collaborative forms of co-practice, inherently more complex at the service governance, macro-level, bring benefits. At the meso-level of the Co-professional collaboration for children with SLCN 4 school and support team network there was greater capacity to individualise co-practice to the needs of the child. Capacity was increased at the micro-level of knowledge and skills to harness the overall resource distributed amongst members of the inter-professional team. The development of social capital, networks of trust across SLCN support teams, should be a priority at all levels for practitioners, services, commissioners and schools. Co-professional collaboration for children with SLCN 5 What this paper adds╆ What is already known? Previous research has highlighted the need for collaboration between practitioners delivering services for children with SLCN. But a number of barriers to co-practice, such as 'border disputes' absence of clear collaborative agreements and a poor awareness of respective priorities between professionals, have been shown to affect such collaborations. What this study adds We employ social capital theory to show how effective collaboration can best be fostered at different levels (macro, meso, micro) within the educational and health systems and provide key messages for practitioners, schools and commissioners for the effective development of trust, reciprocity and negotiated co-practice. Clinical implications of this study A framework is presented identifying the dimensions of networks which are most relevant to co-professional co-practice relations and social capital. LAs, schools and external services could apply the framework to reflect on the nature of their collaborative networks. In this way they could identify specific goals to promote the development of the strong ties which are required for optimal co-practice.