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Creating a collaborative working culture across Health and Child
 Protection to support vulnerable pregnant women

Introduction: Annually, a small number of babies born at two Sydney hospitals are considered at risk of child abuse/neglect because of factors such as domestic violence, parental drug or alcohol addiction or unmanaged mental illness resulting in statutory child protection becoming involved. Historically, families’ first contact with child protection authorities would often be at the hospital following the birth of their baby.  Caseworkers would conduct an emergency assessment, sometimes immediately removing the baby from their parents’ care.  Such action traumatised parents, distressed staff and disrupted infant attachments. Short description of practice change implemented: The Pregnancy Family Conferencing (PFC) program is a cross agency and interdisciplinary program introduced to work with families early in their pregnancy to provide coordinated and integrated healthcare and support to reduce risk to their babies upon birth.  The program is a partnership between the health service responsible for the hospitals - Sydney Local Health District (SLHD) and the statutory child protection authority, Family and Community Services (FACS).  Aim and theory of change: The program aims to have transparent conversations with families through a series of meetings with healthcare professionals, child protection caseworkers and other services working with a family.  The meetings are run by an independent facilitator who helps participants agree on what needs to change for the safety of the baby and formulate case plans which support families to make these changes. Targeted population and stakeholders: The program is targeted at highly vulnerable families who are at risk of their babies being taken into care by the statutory agency. The key stakeholders include families and professionals from Health and FACS. Timeline: Initial discussions about piloting the program began in 2010.  Following consultation and negotiation between the two organisations the program commenced in April 2012.  Highlights: PFC has more than doubled its participation rates since its inception and outcomes indicate that the majority of families are retaining the care of their babies. There has also been a significant positive impact on the collaborative practice of professionals across organisations who have created a culture of shared responsibility when supporting vulnerable pregnant women. Comments on sustainability: A key driver of the program’s sustainability is the unique role of the program Coordinator- a jointly funded and supervised position.  The Coordinators conduct evaluation activities to ensure  program improvement and support practitioners from both organisations whenever difficulties arise. Comments on transferability: The success of the program in the Sydney district has led to it adaptation in other parts of the state. Conclusions: We will reflect on the challenging process of implementing a partnership program which has required both agencies to shift ingrained work practices, learn to share information and resources and build trust to provide coordinated and collaborative care to families in need of healthcare and support. Discussions  and  Lessons learned: Interagency and interdisciplinary collaboration is embedded within the PFC approach at every level and is dependent on trusting, genuine relationships with our colleagues across agencies and with families.