For a rural community straddling two counties, the jigsaw pieces are hard to fit, writes Stephanie Northen

There’s a tidy profit to be had farming the Fens. But it’s rarely made by the people who dirty their hands with the rich dark soil of the flat lands.

Jobs are scarce, seasonal and usually poorly paid. In the isolated villages around the small town of Emneth, health is an issue. Young mothers can get depressed, with knock-on effects for their children. To add to their problems this is border country, with one foot in Norfolk and the other in Cambridgeshire. Bureaucratic boundaries create unintended gaps in public services through which whole families can fall.

But hopefully not any more. “We want the services families can access to be the same no matter which county they are in,” says Jill Wharton, head of Emneth’s nursery school and new children’s centre (see box, right).

Ms Wharton believes in “joined-up” services for families - the Every Child Matters agenda. She needs her faith because the business of joining up is mind-bogglingly complex, especially when two counties are involved. Take community nursing for example.

A community nurse is working with the Fenland Borders Sure Start project set up in 2002 to help families with young children in villages around Emneth. The project is funded jointly by the two counties and they were praised for putting babies before postcodes. Nevertheless, the nurse is used more by Cambridgeshire than by Norfolk because she is based at a Cambridgeshire primary care trust. Jill hopes that having her in the children’s centre will mean that Norfolk families get an equal slice of the community health cake.

But who pays this nurse? Not health: it has no money for such “additional”

services. Not education: the nursery school’s budget is for the nursery school. Whoever it is, it needs to be sorted out quickly because it’s hard to find community nurses in Emneth.

So a solution is negotiated. Until March the nurse will be paid by Sure Start. Then, as Sure Start’s funding across the country is redirected into children’s centres, she will be paid by the Emneth centre. But only for two years. After that Ms Wharton will have to bid for money to retain her nurse, creating another round of uncertainty for both of them.

There is another problem. She cannot afford as many hours as Sure Start provided, so the nurse will only work at the centre 2.5 days a week. (A midwife will cover the rest, but that’s another story.) But suppose the nurse can’t afford to work fewer hours? She might still get fed up and leave. That’s where Jo German comes in. Jo works for a charity, the Ormiston children and families trust. She has been seconded by Cambridgeshire to work on children’s centres. The headteacher and the woman from the voluntary sector represent “joined-up-ness” in action.

Ms German has joined up toy libraries, speech therapists, and home-visiting volunteers from the two counties who had never met before. She’s trying to get four professionals from four services to a meeting. Due to illness it has been cancelled for the third time. Now she will tackle the problem of the nurse’s missing hours.

“We’ll see if we can purchase those hours for a Cambridgeshire children’s centre. Then we will have a member of staff working between the borders. We don’t want to lose the cross-border working.”

Ms German admits to being passionate about breaking down barriers to work in partnership, though the challenge is enormous.

“We are dealing with two local authorities and they are both restructuring and they are both going at slightly different rates,” she says. “I’ve worked in this area for 11 years and I have never seen such anxiety about change before. It is impacting on the workers and we just hope it doesn’t impact on families.”

The pair resist an easy death by jargon and paperwork, and cling to the principle of putting the child and family first.

“We want to provide an integrated service,” says Ms Wharton. “How we get there is the hard bit. It’s going to be continually hard and continually challenging.”

Both have had to change their ways of working. The headteacher has come to terms with outreach work, with precarious funding streams that dry up every two years and with line-managing professionals from different services. The woman from the voluntary sector has learned to focus on what is actually happening inside the children’s centre.

“Jill’s used to being building based and I’m more used to managing a concept,” she says. “The concept of linking everyone up.”

`YOU CAN’T WAIT FOR GOVERNMENT GUIDANCE WHEN IT’S HAPPENING’

When Jill Wharton became head of Emneth nursery school three years ago it had a staff of six. Now she oversees the 25 employees of the town’s new children’s centre and the number is set to grow.

Emneth’s children’s centre received its official blessing from the Government late last year, in the first phase of a national programme to set up 3,500 by 2010. Every week 130 families use some services from this “one-stop shop” for the under-fives.

The nursery school, founded in 1949 to get women to work, is still there.

So is a neighbourhood nursery, the result of a 2001 government initiative with similar aims. And there are rooms for parents, toddler groups and child-minders, a JobCentre link, and a base for services such as a speech therapist, a Traveller support worker and a nurse.

Jill has got to grips with making integration work. “You can’t wait for government guidance when it is actually happening around you.” She’s the line manager of all the staff, whatever sector they come from. They will be part of the centre’s team and will train together. “It is a different way of working for some people and there is a lot riding on this model being successful.”

From the children’s point of view, the nursery school and the neighbourhood nursery are integrated. The three teachers work in both settings. But for Jill, the neighbourhood nursery presents a business challenge. “How do you provide high quality affordable child care that is self-financing in a rural area with high unemployment?”

Taking on the children’s centre has been an enormous change for her. “I’m on a nursery head’s salary, but I’m managing the finances of the neighbourhood nursery as well and I’m on site 48 weeks a year. It’s a huge remit.

“Traditionally nursery schools have always worked with health visitors and families, but this is at a different level. It’s about making it happen.”