The Common Assessment Framework (CAF) and lead professional (LP) working are part of a government strategy in England and Wales for earlier intervention and more integrated services for children and families. A national government evaluation studied the early piloting stage of implementation of CAF and LP working in 12 English trialling group areas. Initial findings suggest a number of interlocking factors, which seem to either help or hinder the process of implementation. Where there is enthusiasm for the work and a clear structure, which is understood and internalized by practitioners, CAF and LP are promoting better multi-agency working, helping agencies to come together much faster and enabling more rigorous follow-through of services. Hindrances include the lack of a local history of successful multi-agency working, which seemed in turn to breed professional mistrust and fuel anxiety. Anxiety is also generated by fears about change and lack of confidence in new skills. For many practitioners aspects of this work are new and the emotional impact of the work needs to be acknowledged in support and training. The task of local implementation would be easier if there were firmer national guidance about CAF and LP roles and processes, for example a single nationally approved CAF form.

Background: Many U.K. medical schools have patient contact in the first two years of the undergraduate course. Aim: To compare the purposes and organization of early patient contact in UK medical schools and to relate these arrangements to the schools' curricular objectives. Methods: A telephone survey of lead educators in UK medicals schools. Categories of contact were plotted against phases of the course to discern patterns of organisation. Results: The quantity of contact varies considerably (four to 65 days). There is a pattern, with learning objectives around the social context of health and illness preceding skills based work and integrated clinical knowledge for practice coming later. Schools fall into three categories: close adherence to the preclinical/clinical split, with limited early contact acting as an introduction to social aspects of health; provision of substantial patient contact to maximize the integration of knowledge and skills; and transitional, with limited clinical goals. General practice provides between one third and one half of early patient contact. Conclusions: Arrangements meet the objectives set by each school and reflect differing educational philosophies. Change is toward more early contact. There appears to be no national guidance which supports a minimum quantity of patient contact or specific educational purpose in the early years of U.K. basic medical training

Early, integrated patient contact was both feasible to organise and acceptable to patients. The curriculum model was perceived by all parties to be educationally effective. The indications are that this model will be sustainable but will need consistent intensive support.

The common assessment framework (CAF) and lead professional (LP) working are being introduced into all local authorities in the next 2 years as part of the Every Child Matters agenda. This article describes some elements of an evaluation of 12 pilot trials. It was found that schools and pastoral staff in particular played a major part in the trials. The majority of the research participants thought that this was a worthwhile initiative and examples were collected of successful implementation of the scheme. However, issues of missing skills, lack of time and limited practical support for staff in schools were highlighted. It is suggested that these issues may be magnified in the full‐scale implementation of CAF and LP work. Considerable effort by pastoral staff and education managers will be required if this ‘good idea’ is to deliver improved outcomes for children in need.

This article discusses the issue of 'making the invisible visible' from a methodological and a substantive viewpoint. The ideas emerged from a doctoral research study into individual target setting with middle ability students in an English secondary school. The students involved had been identified by assessments as 'average' and by their teachers as quiet, unnoticed children. It is suggested that the methods used by the researcher to elicit the students' perceptions could also be used by teachers in order to engage these quiet students in a learning discourse.