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Coordinated service provision
This knowledge page describes the results of Eppi-Centre systematic reviews

One rapid evidence assessment (REA)[1] searched for studies in which the participants were families with multiple problems, spanned more than one generation of family members and included young people of secondary school age or above. It looked for evaluations of coordinated service provision, but there appeared to be comparatively few. Two higher quality studies suggest that such interventions improved school attendance and attainment. Positive reports were also found on self-reported anti-social behaviour and delinquency. However, the costs and benefits of such approaches do not appear to have been rigorously evaluated, nor is it clear how generalisable these findings are.

A second REA[2] investigated early interventions for youth at risk of poor outcomes. This included a review of multi-agency interventions for drug or alcohol abuse, poor mental health and anti-social behaviour, under-18 conceptions, therapeutic foster care and youth offending. Detailed conclusions can be found in the report.

In relation to gang-related crime and anti-social behaviour, a meta-analysis of nine studies identified from a systematic review [3] found that, overall, comprehensive interventions had a positive, but not statistically significant, effect in reducing crime outcomes compared to usual service provision (i.e. whatever was in place either in a comparison area or before the specific intervention). However, none of the studies included in the review considered the cost-benefit of any of the interventions. The analysis also suggested that comprehensive interventions may be more effective if they include: 

  • Case management/provision that was personalised to individual offenders
  • Community involvement in the planning of interventions
  • Community involvement in the delivery of interventions
  • Expertise shared between agencies
  • Delivery of incentives to gang members to change offending behaviour, as part of a wider comprehensive intervention approach; for example educational opportunities, tattoo removal, financial assistance, recreational activities.

A research study investigated joint commissioning [4]. Its broad aims were to:

  • identify research evidence on ‘commissioning’ or ‘public service purchasing’ in education, health and/or social welfare in the UK and other countries
  • investigate the impact of ‘joint commissioning’ of health, education and/or social welfare services
  • identify the factors which influence the impact of joint commissioning of health, education and/or social welfare services.

The evidence about the impacts of joint commissioning was considered inconclusive. The evidence about the factors that affect commissioning was judged to be of better quality. Synthesis of the results of these studies highlight the importance to successful joint commissioning of:

  • trusting relationships between commissioners, and how these are built up over time by continuity of staff;
  • clarity over responsibilities and legal frameworks, particularly in the context of any shared or pooled financial arrangements;
  • the importance of coterminosity between organisational geographical boundaries;
  • the development of clear structures, information systems and communications between stakeholders.

The study also produced a searchable database of research studies of commissioning in health, education and social welfare, which can be found at: http://eppi.ioe.ac.uk/webdatabases/Intro.aspx?ID=22.

References

1. A systematic rapid evidence assessment: interventions to improve the co-ordination of service delivery for High Cost High Harm Household Units (HCHHU) (2007)

2. Targeted youth support: Rapid Evidence Assessment of effective early interventions for youth at risk of future poor outcomes (2008)

3. Reducing gang related crime: a systematic review of ‘comprehensive’ interventions (2009)

4. Commissioning in health, education and social care: models, research bibliography and in-depth review of joint commissioning between health and social care agencies (2012)

  
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