Services provided to children and young people are often described as fragmented. To meet this challenge different forms of collaboration between sectors and services have been established.
Family centres, inspired by the Family centre model, have been established in many Norwegian municipalities to provide better holistic services for children, youth and their families.
The Family’s House is based on a family centre model providing coordinated municipal services for children, adolescents and their families. Through co-locating and coordinating health, social and educational services the family house enables municipalities to offer parents and children comprehensive and readily available support within their communities. The family centres include services from different health and social care sectors but provide holistic family support. The collaborative practices within the family centres that were studied were both intersectoral and interdisciplinary.
In the Family’s house model, the house is both a tangible building where different municipal services are co-located, and an abstract house, a way to illustrate the different levels of initiative and interventions. Services that are recommended to be included are; pregnancy care, healthcare service for children and youth, preventive child welfare services and pedagogical psychological services. Tailoring the centres to the local conditions is one of the main principles at the heart of the model resulting in a single particular organisational structure.
In a qualitative study of three Family centres located in different parts of Norway, we found that differences in management structures in the centres had implications for the extent of services integration within the centres.
Ambition & goals
The aim of the study was to explore intersectoral collaboration in Norwegian family centres and the impact of organisational and management structures on the level of service integration.
This study provides insights into the construction of intersectoral collaboration in family centres and is relevant for municipalities considering establishing such organizations, actors working in family centres, and other practitioners and service managers involved in joint work across organizational and sectoral boundaries. The findings may also be of interest to other community stakeholders who have an interest in services for children, youth and families.
Evaluation - lessons learned
The study showed that the organisational structure influenced the level of service integration the centres were able to achieve. Two of the centres had flat management structures with a set of managers each of whom was in charge of one aspect of the centre’s activity, and one had a designated director that led a team of service managers.
The flat management structure seemed to hinder the development of integrated services. In these centres the managers did not have collective responsibility for the service delivery targets . Rather, each manager was accountable for fulfilling specific legislative requirements, reporting requirements, achieving deadlines and keeping within a specified budget for their part of the family centre. Deciding to implement a new initiative that involved resources from more than one of the services required negotiating agreement with the other managers. The management teams in the flat structure became the setting for the discussion and exchange of information, but they struggled to adopt or implement new practices.
In the family centre that was organised with a single director, where the centre was a single unit in the organisational structure of the municipality, the interaction between the managers was different. Being a unit with a common budget and a designated director made the services included in the centre interdependent and promoted collaboration across sectors. Managing the resources was seen as a common responsibility shared by all the service managers. When the interaction within the management team was based on interdependence and shared accountability they became more inclined to facilitate the development of new practices across the services throughout the family centre.
The findings in this study show that there are benefits to organizing the centres as a cohesive unit with a shared budget and a designated director with the authority to make decisions if there is disagreement between different services housed in the centre.
Organisational and management structures play a vital role in establishing and developing integrated services. This study illustrates that there is a need to address leadership and management structures in family centres. The absence of a centre director may undermine the opportunity to develop innovative and holistic interdisciplinary practice.
Exploring Family Centres- Creating Accessible and Integrated Family Support
The Family’s House Organization and Professional Perspectives