Do you know the most expensive word in children’s services?

This blog addresses how interest groups may include (or exclude) significant costs in an analysis to influence placement choice.

Have you noticed a move towards the monetisation of language in relation to children’s care? 

Are we slipping, uncritically, into a period where children’s care is not protected from economic, political and cultural influences?  

Leave that with you to think about while we explain how the title of this blog came about.

Dr Pip Thornton, now a Chancellor’s Fellow in the Edinburgh University’s School of GeoSciences, has spent the past decade examining the power held by tech giants as mediators of information. In an article What are our words worth in the digital age? – Edinburgh Impact | The University of Edinburgh she explains how she found out that search engines change search terms. Maybe you might have searched and found that the results looked different to what you asked for? She realised the power a search engine has in manipulating and contextualising the words that you put in.

Linguistic capitalism 

Dr Thornton started researching the topic and soon came across Frederic Kaplan’s concept of linguistic capitalism and found out that platforms make money by selling the actual words users put into the search engine.

Revenue comes from the adverts, product listings and service offerings across the search engine’s network to web users. Every time you search for something each word is priced and auctioned in a fraction of a second. The flow of information is manipulated by market forces. Some search returns get boosted up the list.

How a search engine looks at Wordsworth’s ‘I Wandered Lonely as a Cloud’.

Dr Thornton says: “The word ‘cloud’ is really expensive … the value of it isn’t Wordsworth’s cloud, the host of golden daffodils and Cumbrian springtime – it’s cloud computing/technology”. She examples printed receipts.

So, have you thought about the most expensive child care word? 

Here’s a clue – the most expensive web search word is ‘mesothelioma’, a type of cancer that develops in the lining that covers the outer surface of some of the body’s organs. Why expensive? Because if someone is searching they are usually looking for a clinical service

So, the most expensive words in children’s services? 

If we did some research into PRFs for high-cost low incidence needs we might find commonly used words.

The Nuffield Family Justice Observatory has done just that – see page 18 and 19 Children subject to deprivation of liberty orders (nuffieldfjo.org.uk)

NCERCC is a strong supporter of the NFJP’s work and sees it as a start in ensuring a substantial basis for future planning of provision.

The needs in these lists are undoubtedly intensive and expensive.

However to create the data for accurate responsive calculations of the care necessary and the cost to provide we need the acuity of detailed depiction.

It is accurate assessment of clinical needs, and accurate description of the care response, setting, provider, that are required for decision making.

This is the primary task for commissioners and providers.

The primary task = that which cannot be compromised.

Matching needs to services/staffing/expertise/experience, the Impact Risk Assessment, on these things relationships and outcomes are based.

Placement making needs accurate assessment of clinical need.

This is something that joins providers and commissioners

• We should not be using ‘premium’ words to imply an intensity of provision.
• We should not be using words to reduce or remove the potential risks in meeting the needs of a child. Ofsted research recently quoted a commissioner ‘…you could be over-describing the child’s needs and no one will offer a place for them”.

If we act in this way we potentially compromise the response to children’s needs.

• We think we have what is required as the providers describe their settings in ways that imply high level clinical meeting of needs
• We do not have the data of commissioners unsuccessful matches that would provide the clinical and financial basis for developing high level provision

These are examples of the ways we can slip into the monetisation of language in relation to care.

The expense would then be in the life of the child.

A Quality Adjusted Life Year (QALY) is a measure of the quality and quantity of a life lived as a result of an intervention.

Here is an example of monetisation

Costs are often combined with QALYs in cost-utility analysis. This can be used to develop a cost-effectiveness of an intervention. This is used to allocate resources.

It is such cost effectiveness of Residential Child Care that is holding us back from having the provision of the right child in the right place at the right time, as local as possible and specialised as necessary.

Cost-benefit – a way out of monetisation?

Cost-benefit analysis (CBA) estimates the strengths and weaknesses of alternatives. A CBA may be used to compare completed or potential courses of action, and to estimate or evaluate the value against the cost. In terms of a QALY cost can be calculated as the effect of doing something or not.

Yet there is still more to be done for us to necessarily re-evaluate our current thinking regarding Residential Child Care

It is often cited as having lesser outcomes. What is commonly left out of such evaluation is that a child has arrived at a residential setting having had many sequential changes of ‘home’ as they move up the placement hierarchy. As Martin Narey advised 3 placement is enough to determine that a residential setting is required. In one paragraph we have seen that what is described as having a lesser outcome is actually the outcome of decisions not being taken.

Effective and efficient use of funds is a decision on an intervention whereby a child receives the right care at right time.

It is clear that one aspect of critiquing the monetisation of language in child care decision making is appreciating, asserting, Residential Child Care can be clinical work in a social care setting.

See Appreciating Residential Child Care Workers as Attachment makers changes everything – NCERCC and Attachment and the Stages of a Placement – NCERCC