Joined-up thinking, joined-up services, exploring coalface challenges for making services work for families with complex needs

Purpose – This paper aims to describe coal-face challenges to making services in the UK work to ensure the mental and physical health, safety and wellbeing of children. Design/methodology/approach – After briefly referring to some challenges to effective joined-up service provision, it describes examples from the first author's experience of problems, during 30+ years as an NHS clinical child psychologist, and some solutions. It then describes two challenges that underpin many of these problems: lack of understanding of, or training in, evaluating evidence for interventions and a more general lack of knowledge about effective behaviour change principles. Findings – The paper concludes with recommendations about how to achieve effective joined-up services. Common themes emerging from the research are discussed, including choosing evidence-based programmes, providing adequate training to staff, and increasing people's understanding of behavioural principles. Originality/value – Having effective joined-up services would mean better services for parents and their children, and would be more cost-effective for the NHS. The ideas presented in this paper could also be applied to other services within the NHS.