Contents

Enabling Information: A report on improving access and raising standards in information services for disabled people and their carers in Scotland.

4 Relationships Between Providers

4.1 Relationships between the statutory and independent sectors

An important aspect of community care is the encouragement of greater integration of services provided by the independent and statutory sectors. We can see evidence of this in the practice of some regional councils. The increasing emphasis on the division of responsibility between the purchaser and the provider of services, and the move from a grant-based culture to one based on contract and service level agreements will to some extent facilitate the fuller integration of the voluntary sector in statutory provision. However the importance of independent sources of information and advice being available must not be overlooked.

Characteristics of the present relationship between agencies in the statutory and voluntary sectors can be described in terms of:

Funding

The Working Group considers that local authority funding is extremely important and that many of the problems existing at present could be improved by a more effective use of existing funding. Funding may be given on an ongoing basis, or for particular short term projects such as the Carers Information Pack in Fife. The development of community care forums in Scotland demonstrates how the injection of funding can create "added value" in the voluntary sector.

Information sharing

The extent to which information is shared between the voluntary and statutory sectors is significant in terms of the information available to the end user.

The Devon Disability Information and Advice Federation, as part of NDIP, has consciously improved the sharing of information between the two sectors, to the benefit of both: voluntary sector bodies have access to the DLF database, while local authority staff have access to the information produced by local disability groups, and to the Community Care database produced by the federation.

Grampian Caredata has chosen to operate in a similar way. Their database is made freely available to agencies in the voluntary sector, thus saving groups the time needed to collect basic information.

Similarly groups in the voluntary sector can be useful sources of information to people in the statutory sector, either about specialised conditions, or particular client groups. Leaflets produced by Age Concern are preferred by one local authority's staff to the leaflets produced by their own authority. Professionals are frequent users of information from organisations such as Disability Scotland, Enable and the Scottish Association for Mental Health.

Referrals between the voluntary and statutory sectors

A successful voluntary sector organisation can attract considerable numbers of referrals, and the experience of SNIP in Edinburgh is that as health professionals and social workers have become more aware of the service offered, SNIP has received increasing numbers of enquiries from professionals.

The development of a network of agencies involved in providing information and advice to disabled people in Lothian has been prompted partly by a recognition of the importance of raising the level of awareness of what agencies in both the voluntary and the statutory sector have to offer locally.

The relationship between specialist and generalist services

This is a sensitive area. There can be a problem if a social work department contracts specialised services to agencies in the voluntary sector, as mainstream social workers may "offload" clients to that specialist service rather than provide the service themselves. The use of the "disability dustbin" may result in an extremely low level of awareness amongst local authority staff about disability issues. While it may frequently be desirable that people are referred to specialist sources of information and advice, this should not detract from the goal that general service providers should be able to meet the needs of all their clients, and that they should receive sufficient training to do this, and in particular, disability equality awareness training.

PSI has suggested in its final report on NDIP that one of the weaknesses of the Coopers and Lybrand report which shaped NDIP, was the failure to recognise that multi-agency working would lead to "tension, delay, and a lack of progress". PSI argue that the different organisational cultures of the statutory and voluntary sectors make it difficult to establish effective joint working arrangements, and this is compounded by the funding relationship between the sectors. As discussed in Part 1, section 3.6 above, this situation is unlikely to improve in the immediate future, with reorganisation of local government, but there is perhaps a greater degree of optimism in Scotland that it is possible to develop fruitful relationships between the statutory and independent sectors, as evidenced by some of the examples given in section 3.1 above.

4.2 Relationship between national and local providers

The relationship between national and local providers has changed in line with the developments within the disability movement as a whole, as described in Part 1, section 3. The traditional charitable bodies representing the interests of disabled people tend to be autonomous national bodies, relatively well funded by central government, and often with considerable capital reserves. In Scotland there are also several long-established locally based societies, for example societies for the blind and the deaf. Alongside these organisations, the emergence of local services, often provided by, or supported by local organisations of disabled people, has represented a challenge to these groups. Developments in this area have been piecemeal, and the lack of an overall structure has meant that the various players are not always clear about their role.

Work done by NDIP on the relationship between national and local providers showed that there was a lack of understanding between them, with local services often being unaware of what was available from national groups, and national groups often being unaware of what local services wanted from national groups (28). Overall provision of information for disabled people would be improved if activities at national level were more closely integrated with those at local level. This could possibly mean a greater degree of specialisation in what different bodies do.

The NDIP project team has suggested that a primary responsibility of national organisations should be in the collection and processing of information, with the main responsibility of dissemination resting with local groups. This division of responsibility is broadly accepted by the Working Group. It is, however, inevitable that there will be a degree of overlap. Disability Scotland, for example, receives around 8000 enquiries each year, and even if there is an effective network of providers operating in one area, Disability Scotland will continue to receive enquiries. The question is the extent to which a national organisation has confidence in local providers and is willing to refer enquiries on to local agencies.

Local information services use the services of national organisations in the following ways.

• As a source of information both computerised and paper based.
• Local organisations are typically members of national organisations, for example DIAL or RADAR, in order to have access to sources of information. Two members of one of the sub groups of the Working Group, both working in the occupational therapy area, were heavily dependent on the Disability Scotland database on aids and adaptations;
• To refer to for further information.
• While some local information services will approach a national body if it cannot answer a question, many local groups may turn first to other local groups especially if a network of providers is functioning eg in Lothian;
• To obtain information about services or facilities in other parts of the country.
• To obtain specialist or expert advice, for instance legal or medical advice, or for information about a specific condition or type of impairment.

In relation to existing use, the following problems were identified, both in responses to the group's statement, and in the experience of the members of sub group 3 who were primarily local information providers themselves.

• Difficulties in accessing national bodies.
  • opening hours may be shorter than those of local agencies
  • cost of phone calls

Problems with information products.

Local providers were generally satisfied with the quality of information provided by national bodies, but particular problems were identified with the use of Disability Scotland's database:

• the cost of subscribing to DS Data, and of on line phone bills;
• it is hard to use (one subscriber described being always on the phone to Disability Scotland to ask how to use it);
• little support in using DS Data is provided although initial training is provided within the cost;
• the service provided would be improved by the employment of an occupational therapist at Disability Scotland;
• the large sums of money invested in a system used at only 25 sites in Scotland; and a general concern that for the amount of money spent on it this database was just not good enough.

The Working Group is aware that Disability Scotland is looking at ways of addressing these problems, and has been piloting a disc based version of the database.

• Not enough training is provided to local services.
• National bodies are not good at speaking to local services about their needs.

There has been a proliferation of local services in recent years, often community-based and urban aided, but with funding from a range of sources including section 10 funding. There has also been a growth in organisations of disabled people offering information services, and there is evidence that some national organisations do not always feel confident that these local services can provide a high quality information service. This has led to a concern about quality standards in general, and the desire for a framework within which both local and national services can "place" themselves and develop effective working relationships in an atmosphere of mutual trust and respect.

4.3 Relationships between all agencies operating at local level

The focus of NDIP's work has been with the development and support of 12 pilot projects employing a federated approach to disability information provision. Coopers and Lybrand suggested that all information providers in a locality should, come together to "provide a coordinated approach to information provision and to improve the accessibility and quality of services... and should include statutory and voluntary agencies as well as groups of people with disabilities".

The experience of NDIP seems to suggest that this may to some extent have been putting the cart before the horse, and that if you do not have good quality direct service provision you will not necessarily achieve it by setting up a federation. This was the experience with the North East Yorkshire Information Service and with the Walsall Information Federation. In the draft final report on NDIP, the Project Team considers for each pilot project whether the value added by the federation is greater than the value which would have been added had the resources used by the federation been divided up between federation members. In some of the projects the Project Team suggest that the resources devoted to the federation could be justified because sufficient resources were already allocated to direct service provision (eg in Oldham). In six of the projects the outcomes of funding the federation have been better than increasing the funding of service providers. Four of the projects have not significantly added value, and in the remaining two it is unclear whether this is the case or not.

Extent of networking in Scotland

In Scotland there are no formal networks of disability information providers, but there are various examples of information providers getting together in informal networks to improve the sharing of information and referral of clients.

In Lothian, the Lothian Coalition of Disabled People has received funding from the Horizon project to employ someone to develop networking in Lothian. Two conferences have been held and many responses mention this as a positive development, although time-consuming for those involved.

In Grampian, a body called Grampian Information functions as an umbrella group for library and information services in Grampian. It organises training and provides networking possibilities. Its membership includes public librarians, CAB staff, social workers and, amongst other people, the manager of Grampian Caredata.

In Strathclyde, a report of the regional council's Poverty Officers Group in 1990 recommended that a strategy for information and advice provision should be developed and that it should be based on the establishment of local advice forums which would review existing provision, identify local priorities and develop networks of advice/information providers. Three pilots were set up to review existing advice services, in Cumnock and Doon Valley, Easterhouse, and in the East End of Glasgow.

The East End Information Services Planning Group was formed in March 1991 to research existing information provision as the basis for the future development of services in the area. In February 1992 they formed the East End Information and Advice Forum with representatives from various agencies and community groups such as CAB, libraries, Benefits Agency, Pensioners Action Group East, john Wheatley College, Poverty Advice Group, Community Education Service, Social Work Department and East End Community Information Project. The forum produces strategy for the development and coordination of information and advice services in the East End of Glasgow, and has also produced a variety of reports including a referral manual, and a report on developing quality of service in information and advice agencies.

Community care forums may provide the basis for some degree of networking, and councils for voluntary service in some areas are already well established and may be an alternative to specially created community care forums.

Advantages of networks

The structure of networks or federations can vary widely, as demonstrated by NDIP's pilot federations as well by the many federations not involved in NDIP. A network can be directly involved in information provision, or it may concentrate on developing resources such as databases for use by member agencies, or it may primarily be involved in support or development work. Some of the advantages of the existence of networks are that they may:

• encourage cooperation and information sharing between agencies;
• encourage effective referral to other members of the network;
• raise awareness of all members of the services provided by others;
• create the possibility of one stop;
• enable duplication and gaps to be recognised and addressed;
• raise awareness of disability issues in generalist services;
• give disability information a higher profile and increased influence and credibility; and
• facilitate joint initiatives.

The view was expressed in responses to the Working Group's statement that networks of informed people working in the field may be better sources of information than 'information professionals', and that a network may provide for "one stop" advice more effectively than a single source of information.

Disadvantages

Setting up and running a network may, however, be time consuming, and requires genuine willingness to work together. Existing groups may be possessive about their own information resources and feel that their funding may be threatened by a developing network. It is difficult to ensure that all the partners in a network make an equal contribution to that network. As already mentioned the strength of a network may depend on the strength of its members as well as on its funding and structure.



Experience of federations outside the NDIP project

There are many federations which are not part of NDIP, some of which appear to have been quite successful initiatives in improving the provision of information to people with disabilities, for example, the Oxford Disability Information Project (ODIP), which operated across 4 counties and 8 health authorities, and was coordinated by project manager, with each county having its own federation, one of which (Berkshire) had NDIP funding. The federation was funded by a hospital trust, the Department of Health and Oxford Regional Health Authority. In a recent report on its work the project manager describes how by the end of the project's 5 year existence, all four counties had multi-agency groups and on-going funding; all had county wide databases, a greater number of physical outlets and mechanisms for monitoring their performance. (29) The successes of the project, as described by the Project Leader, are put down to strong committed chairpersons, a paid worker in each county, high level representation form the organisations involved and clearly established and recorded arrangements between the agencies.