Abstract
Schools are a source of at-risk referrals to Children Social Care (CSC), contributing the second highest proportion of all referrals in the UK, behind the police. Since 204 schools were also associated with the highest increase in referrals.Social workers have the lead responsibility for assessing and safeguarding children. This research evaluated an intervention that integrated social workers into schools (SWIS) to support education colleagues, children and families. The SWIS study involved 29 secondary schools, and approximately 280,000 students across 2 local authorities (LAs) in England. The intervention and evaluation were co-designed from interviews with social care practitioners and senior managers, school staff, young people and parents, and observations of practice. It was piloted in three sites to inform learning about how the intervention worked.Mixed methods approaches for embedded evaluation included process and implementation evaluations of the intervention's mediators, enablers and barriers, and explored scale up. The evaluation extended to estimate the cost-effectiveness of SWIS on referrals to CSC and in reducing rates of child protection enquiries. Micro-costing and consensus building approaches were undertaken to address wide-ranging variability surrounding key unit costs. Disaggregation of economic outcomes in the form of a cost-consequences analysis identified costs associated with outcomes including child in need assessments and days lived in foster or residential care.Overall, SWIS was well received by social workers, school staff and students. SWIS activated frequent informal interactions, and increased opportunities for relationship building. Most students interviewed reported feeling positive about SWIS. SWIS influenced the CSC system, with SWIS teams taking on more referrals and assessments. There was no evidence of benefit from the SWIS intervention on the primary outcome however: the rate of child protection enquiries was estimated as 5.5% higher in the SWIS arm than in the control arm, but this effect was not statistically significant. The average total cost per SWIS school was pound;96,645.30 (95%CI: pound;9,065.20, pound;74,225.30) greater than per control school. No statistically significant differences between trial arms were identified for any outcomes, costs or cost-effectiveness over a 23-month follow-up period. The probability that SWIS is cost-effective was estimated for a range of willingness to pay values. At threshold values of pound;000, pound;0,000 and pound;20,000, probabilities of cost-effectiveness were estimated as .3%, .% and 6.%. This means SWIS had a low probability of being cost-effective.It is important to test interventions for impact before they are rolled-out at scale, the findings from this evaluation found no impact on outcomes, nor value for money. This study highlights a difference between the views held by those involved in delivering the intervention and the findings of the impact and economic evaluations. SWIS was well-received by professionals and families, but did not result in an impact on CSC outcomes. Reducing the need for child protection may be an outcome that is most likely to be achieved by tackling the known drivers of child abuse and neglect. Interventions designed for broader societal determinants such as families financial stress may offer more promise for improving CSC outcomes.