ntc prevention and early intervention strategy 2013 …...resilience and by giving people knowledge...

Received Cabinet approval 14.10.13 09 February 2016

Children, Young People and Learning

Prevention and Early Intervention Strategy

2013 – 2016

Date: October 2013 Version: Final Author: Jill Baker

Review Date: April 2016


Prevention and Early Intervention Strategy

2013 – 2016

Introduction

Welcome to the North Tyneside Children and Young People and Learning Partnership’s Prevention

and Early Intervention Strategy. The partnership wants to establish prevention and early

intervention at the heart of the borough’s family and children’s services. Shifting resources towards

prevention and early intervention is central to reducing inequalities and will transform the lives of

our most vulnerable families, while also addressing the critical challenges of rising demand for

services and reducing resources.

This strategy is integral to the partnership’s vision of a borough where all children and young people

are healthy, happy, respected, protected from harm and able to realise their potential. It also

contributes to the objectives of the North Tyneside Strategic Partnership.

The Purpose of this Strategy

This strategy will ensure partners achieve a more sustainable balance between preventative / early

intervention services and remedial provision. Families will receive integrated preventative universal

services with the provision of additional support and interventions to those who are vulnerable at

the point where it can have the greatest impact upon their life chances.

1. What do we mean by prevention and early intervention?

North Tyneside Children Young People and Learning Partnership define prevention and early

intervention as:

Prevention – happens when risk factors are reduced by building on strengths, building

resilience and by giving people knowledge about how to access services themselves.

Many families access preventative services already – often known as universal services

Early intervention – happens when issues are identified and action is taken quickly, before

things get worse

Prevention and early intervention can be employed at any time during a child’s life, as problems

emerge and our services will work with children and young people aged from 0 – 19 years. However

we will have a particular focus on the early years of a child’s life (0-3 years) and in some cases,

before they are even born, because the early years are not only critical for life chances, improving

experiences in early years is also central to reducing inequalities in childhood and in later life.

Support services can have the greatest impact during the earliest years of a child’s life.

The table below summarises the characteristics of preventative universal services and additional

support / early intervention services:


Preventative Universal Services Early Intervention and Additional

Support

Scope Services available to every child,

young person or family.

Services are targeted at families where

risk factors are present, such as:

• Early signs of neglect.

• School attendance / behaviour

issues.

• Parenting capacity.

• Domestic violence

• Child poverty

• Worklessness

• Mental health problems

• Substance misuse

• Poor housing condition

• Poor health behaviours (e.g.

smoking, poor nutrition)

• Homelessness

• Disabilities or special educational

needs.

• Additional educational needs.

• Health needs.

• Sexual health issues

• Risk taking behaviour.

• Crime / anti social behaviour.

Early intervention can occur at anytime in

a child’s life but there will be a particular

focus on the crucial early years (0-3

years)

Aim To build the capacity of children,

young people and families, so they

are able to stop problems from

arising in the first instance.

To identify families requiring

additional support at the earliest

opportunity.

To address emerging problems or

existing risk factors.

To supporting families at the earliest

opportunity, in order to prevent

problems from escalating.

To build the capacity of families to tackle

or manage underlying risk factors.

Access /

Assessment

No formal assessment usually

undertaken

Maternity Assessment Framework

Early Help Assessment

Health Visitor assessment

Individual education plans

Integrated Disability and Additional

Needs assessment

Drugs and alcohol

Worklessness

Youth crime


Response Services are usually delivered in a

dedicated setting and often have a

single focus.

Integrated packages of services are

tailored to meet the needs of the wider

family. This may include

1:1 support and personalised provision.

Services can be delivered in locations

that best suit the needs of the family.

Delivered by • Children’s Centres

• Health Visitors

• Midwives

• Schools

• School nurses

• Further Education Providers

• GPs

• Youth Provision (universal)

• Range of community and

voluntary sector providers

• Parenting Programmes

• Parent Support

• Family Nurse Partnership

• Teenage Pregnancy Support Services

• Behaviour Services

• CAMHS

• Youth Offending Service

• Youth Service (targeted)

• N2L

• Job Centre Plus

• Substance misuse support

• Domestic violence interventions

• Family Partners

2. Why are we doing this......and why now?

National Context

A series of Government commissioned reviews and reports have established early intervention

and prevention at the heart of the Government’s children and families policy. Appendix One

provides more detail of those key national documents which have shaped the current policy

context, however the recommendations they make can be summarised as follows:

• The Munro Review of Child Protection: A child centred system

o Local Authorities and their partners have a duty to ensure sufficient early local

support for children, young people and their families

o Effective mechanisms are needed to identify children and young people at risk of

abuse or neglect

• Allen Review: Early Intervention

o The period between 0 – 3 years is crucial in determining lifelong outcomes but early

intervention is important throughout childhood

o Effective parenting is the single biggest determinant of a child’s future

• Field Review: The Foundation Years: preventing poor children becoming poor adults

o Children’s life chances are most heavily predicated on their development during the

earliest years of life

o Key factors in improving outcomes for children include health pregnancy, good

maternal mental health, secure bonding, love and responsiveness as well as high

quality services and childcare

• Flexible Free Entitlement for eligible Two Year Olds

o Up to 570 hours of free, quality early learning for children from families on low

incomes

• The Marmot Review: Fair Society, Healthy Lives

o Disadvantage starts before birth and accumulates throughout life.


o The early years is the foundation for future health and wellbeing.

• The Bercow Review: Services for Children and Young People with speech, language and

communication needs (SCLN)

o In addressing SCLN, the value of early intervention is best exemplified by the effects

of its absence

o Speech, language and communication should be a priority for all Children’s Centres

and a primary focus for measuring their success.

• Best practice for a Sure Start: The Way Forward for Children’s Centres

o Children’s Centres must effectively ‘reach’ families with children at the earliest

possible opportunity, in order to have the most significant positive impact.

o Working with families from pregnancy onwards can help support and promote key

parenting behaviours.

• Health Visitor Implementation Plan: A Call to Action

o The Health Visitor workforce will be expanded, with 4,200 full time equivalent posts

created.

o Families will receive a core offer of evidence based protective health care.

o Additional care and support for those who need it.

• More Great Childcare: Raising Quality and Giving Parents More Choice

o Rigorous training and qualifications for early years workforce

o Drive up quality through inspections and incentives for providers

• Health and Social Care Act

o New commissioning arrangements including GP led commissioning.

o Greater autonomy for health care providers.

o Restructuring of public health, including an enhanced role for local authorities.

o Establishment of Health and Wellbeing Boards.

• Housing

o Strong evidence base in relation to poor housing condition and the impact on

children’s development, health and wellbeing (Shelter 2006)

A clear message emerges from the national drivers: early intervention and support is fundamental to

delivering improved outcomes for children.

There is also a strong economic imperative for prevention and early intervention. Social problems

and intergenerational disadvantage place a significant financial burden on society. Youth

unemployment alone is estimated to cost the economy in excess of £10million a day. Tackling the

underlying causes of social problems, through prevention and early intervention, could realise

significant savings for the public purse. Studies have shown that every £1 spent on prevention and

early intervention can realise savings of up to £10+. Shifting resources to prevention and early

intervention has the potential to combine improved outcomes with greater efficiency.

A collaborative approach is essential for delivering children’s services focussed on prevention and

early intervention. Not just because integrated services are better able to change lives and realise

greater efficiencies, but because the benefits may not necessarily accrue to those organisations

investing in prevention and early intervention. For example early life interventions may realise

savings and improved performance for the justice, health and education sectors in later years. A

shared strategic approach will ensure partners remain focussed on prevention and early

intervention’s potential for transforming outcomes for all parties in the long term.


Local Context

The majority of young people in North Tyneside are happy, healthy and are able to realise their

potential. However there is a social gradient and some children and young people consistently

experience poor outcomes compared to their peers. These vulnerable children and young people

are frequently part of an intergenerational cycle of deprivation and poor outcomes. North

Tyneside’s challenge is to tackle the underlying causes of disadvantage within our most vulnerable

families and to transform their life chances by offering preventative universal services with

additional support and intervention that is proportionate to need. Appendix 2 sets out additional

detail on our local evidence base.

A significant minority of the borough’s children and young people do not receive the appropriate

care and support within their family. Neglect is the single biggest cause of children becoming ‘at

risk‘ in North Tyneside, with 59% of Child Protection cases initiated for reasons of neglect as of the

31st

March 2013. North Tyneside has also experienced a sustained rise in the number of families

requiring specialist support. Over the past 5 years North Tyneside has seen the number of looked

after children increase by 29% and a 19% increase in children subject to child protection plans.

Child poverty levels in North Tyneside are below the national average, yet 1 in 5 of the borough’s

children are raised in poverty. This figure rises to 2 in 5 children, within our most deprived wards.

Material deprivation exacerbates other risk factors and increases the risk of poor outcomes.

Risk taking behaviour remains an ongoing issue for a minority of the borough’s young people. North

Tyneside has significantly higher incidences of substance and alcohol misuse resulting in hospital

admissions. Teenage conception rates are improving but the borough remains above the national

average. Young people who are already vulnerable are more likely to engage in risk taking

behaviour. Children and young people raised in our most deprived households are also more likely

to experience poor health outcomes. They have a lower life expectancy at birth, are at greater risk

of becoming very overweight and are more likely to be admitted to hospital.

The current economic climate means that it is more important than ever for children and young

people to realise their educational potential. North Tyneside is successfully raising the educational

attainment of our most vulnerable children and young people. For example the achievement gap

between pupils eligible for free school meals and their peers at Key Stage 2 and 4 is reducing.

Measures such as the Pupil Premium and extended remit for the borough’s Virtual Head will

accelerate this improvement. However the gap in educational attainment between vulnerable

learners and their peers remains significant. Our most vulnerable learners are less likely to achieve 5

A-C GCSE’s, a higher level qualification at 19 or enter Higher Education. Young people in our most

deprived neighbourhoods are also at increased risk of becoming NEET (Not in Education,

Employment or Training). Young people with poor skills and qualifications are in a particularly weak

position within the current and future labour market. This is particularly true in North Tyneside,

where the youth unemployment rate continues to exceed the national average.

Welfare reform and low economic growth will further increase pressure on the borough’s most

vulnerable families. These factors combined with a rising birth rate will intensify and prolong

demand for high level children’s services. In an environment of constrained public expenditure, the

existing approach to children’s services is unsustainable in the long term. It is important that we

work with partners now to manage future demand for specialist services, by addressing the

underlying causes of disadvantage and vulnerability.


3. Our Vision and Principles

Families will be offered preventative universal services which will identify children and young

people who are vulnerable to poor outcomes at the earliest opportunity and they will be supported

to manage and reduce risk factors. The most vulnerable families will receive targeted, personalised

support for each family member, designed to build their resilience and capacity to provide a caring

and nurturing home environment.

Intervening early to improve the lives of vulnerable children, young people and families will make a

significant contribution to the Children, Young People and Learning Partnership’s vision of a borough

where:

• Children and young people are respected, valued and listened to;

• Childhood is nurtured;

• Children and young people are happy, healthy, confident and safe, and develop as

enthusiastic learners and tolerant, compassionate individuals who are challenged and

supported to be the best they can be; and

• The power of learning is harnessed to transform the lives of individuals and regenerate our

communities.

The partnership’s work is underpinned by ten principles that will inform all aspects of our work.

Children and young people:

1. Come first.

2. Have a right to be recognised as people with views and interests.

3. Have a right to be protected from harm and discrimination.

4. Have a right to develop as curious, enthusiastic and autonomous learners.

5. Have a right to the best health possible and to medical care.

6. Have a right to live and play in a safe healthy environment.

7. Have a right to an identity.

8. Should have the opportunity to grow up in a family and a community with equality of access

regardless of their sex, gender, age, sexual orientation, ethnicity and background.

In addition:

9. Parents, carers and communities need to be supported in promoting the interests and

welfare of their children and those in their communities.

10. We never give up on a child or young person - no child should be viewed as a lost cause.


4. What we will do

We have a clear vision for improving the lives of children, young people and families, based upon the

national and local evidence base, our existing knowledge and experience of what works already. The

Prevention and Early Intervention Strategy will focus on five key objectives:

1. Preventative universal services are provided in an integrated way in the borough and offered

to all families

2. Vulnerable families are identified and supported at the earliest opportunity

3. Sustainable improvements in vulnerable children’s outcomes are achieved by addressing the

needs of the family as a whole.

4. Services to tackle the underlying causes of poor outcomes for children and young people are

developed

5. Every child enters school ready to succeed

6. Children and young people flourish both in and out of school

1. Preventative universal services are provided in an integrated way in the borough and

offered to all families

Strong universal services help our children, young people and families to help themselves to find

solutions to problems or prevent problems developing; through building resilience. Universal

services are those that are routinely available to all children, young people and families, which can

help to provide services that are delivered in a non-stigmatising way. Universal services and settings

are often the places where emerging issues/difficulties are first identified, or where families may

first ask for help.

Universal services are delivered through existing universal services such as, Midwifery/Health

Visiting/School Nursing/Primary Care, Children’s Centres, Early Years Settings, Schools, Universal

Youth Services, Police and the Voluntary and Community Sector.

Making improvements in the integrated delivery of universal services is critical in ensuring that it is

easier for children and families to access and get the support they need. This will require new and

innovative ways of working, making the effective use of shared resources and improved information

sharing.

2. Vulnerable families are identified and supported at the earliest opportunity

The benefits of early support are clear, so it is important that partners identify vulnerable children

and families at the earliest opportunity. North Tyneside is developing an early identification

infrastructure to ensure families receive timely and appropriate support, particularly during the early

years of a child’s life. The Common Assessment Framework has been redesigned to provide a

streamlined and family focussed assessment framework, which will be known as the Early Help

Assessment. It will be used to assess the child’s need within the wider family and will form the basis

for subsequent support packages. A new ‘Front Door’ Service will provide dedicated customer

services call handling functions for all children’s services inquiries and referrals. Notifications


involving vulnerable children and young people will immediately be referred to a Multi Agency

Screening and Coordination Team, who will assess notifications and referrals. Where there is a

safeguarding concern regarding a child or young person, the Social Work Assessment Team will

undertake an assessment and identify the appropriate level of support. The Multi Agency

Screening and Coordination Team will then ensure families receive the timely support they need

from the appropriate agencies.

3. Sustainable improvements in vulnerable children’s outcomes are achieved by

addressing the needs of the family as a whole.

Families are the single greatest influence on a child’s life. The effectiveness of support is therefore

greatly enhanced when it reflects the needs of the family as a whole. North Tyneside will ensure

integrated support services are tailored to the specific needs of families.

Partners will commission the Family Nurse Partnership and Health Visitors to support vulnerable

parents from early in the pregnancy and through the critical early years of a child’s life. An Early

Help and Coordination Team will provide additional assistance to families experiencing low level or

more straightforward issues. The team will agree, with the family, the expectations and

responsibilities of both parties, based on the Early Help Assessment. They will then work alongside

the family to address specific issues and coordinate their integrated support package.

Families with more complex issues including poor housing condition, domestic violence, alcohol and

drug problems and mental health problems will be supported by the Family Partner Team. A Family

Partner will work with a family, to understand their circumstances and deliver practical hands on

support. They will also coordinate and shape the family’s integrated support package, to maximise

its effectiveness. Where families are not meeting their commitments, the Family Partner will

provide assertive challenge, with recourse to a sliding scale of sanctions where appropriate.

Securing housing that meets the decent homes standard will be a priority when working with the

most vulnerable families.

4. Services to tackle the underlying causes of poor outcomes for children and young

people are developed

Tackling the causes of poor outcomes significantly improves the life chances of our most vulnerable

children and their families. Partners will focus resources on addressing the causes of poverty,

deprivation and vulnerability, rather than treating the symptoms. Children’s Centres will be at the

heart of this approach. A review of the children’s centres’ core offer and the development of a

commissioning framework will provide a clear vision for the future. Children’s Centres will work with

families ‘at risk’ from the early stages of pregnancy to promote key behaviours, including breast

feeding, secure attachment and positive relationships, responsive parenting and smoking / alcohol

cessation during pregnancy. Improving child and family health will be central to children’s centre’s

work. Partners will establish a health and wellbeing offer for children that will be delivered through

our children’s centres. Partners will also explore the potential to locate all perinatal services within

children’s centres, including midwifery, health visiting and children’s centre functions. Partners will

also develop a framework for the delivery of Health Visiting, which will become the responsibility of

the Council in 2015 and pursue innovative approaches to such as oral health, health education and

nutrition advice. Families will be supported to lead more healthy lives with local access to family


activities, healthy cooking, community growing, stop smoking services, alcohol and drug services and

mental health support.

A review of parenting support will be carried out to ensure a robust focus on early intervention,

particularly during the first three years of a child’s life. The Early Help Assessment will be used to

identify needs and secure appropriate parenting support. Parenting support will encourage the use

of effective parenting styles and foster strong attachments between parents and their children.

Parents and carers will be able to shape services, become volunteers and where appropriate, receive

support to develop employment skills. Additional informal support for parents will also be

developed. The Oaktrees Parenting Centre will provide families with preventative health, care and

education support, which improves outcomes for children and their families. The centre will be

open 6 days a week throughout the year, including school holidays. Oaktrees will also offer 15-20

hours of free childcare to the most disadvantage parents.

5. Every child enters school ready to succeed

Partners will work to raise the aspirations and attainment of vulnerable children and young people.

Partners will help families to provide a good home learning environment and strengthen parents’

capacity to support their children’s learning. The Language for All programme will continue to

supports children’s early language development. Parents will also be supported to improve their

own literacy and numeracy. We will also deliver the extended free nursery places for the most

disadvantaged 2 year olds. Partners will continue to provide support to vulnerable children once

they enter school. The remit of the Virtual Head Teacher has been extended to incorporate priority

groups and a Vulnerable Learners Team will provide dedicated support. The team will track

vulnerable learners’ progress, identify early indicators of risk and target resources accordingly. Their

main focus will be on academic support for children, advice and training for schools, and information

for other professionals. They will also work with partners to support schools on issues of challenging

behaviour. North Tyneside’s Emotional Wellbeing Programme will continue to be delivered across

schools. Children with disabilities and additional needs will be supported by an Integrated Disability

and Additional Needs Service, which will bring together key partners to deliver integrated

educational, health and care support.

6. Children and young people develop outside of school

Partners have agreed to develop a joined up local offer for young people aged 10-19 years. Young

people will be able to access positive activities beyond the school day in every locality. An

accompanying capital investment programme will transform youth facilities in North Tyneside. The

Youth Support Service has been reshaped in light of Ofsted recommendations and feedback from

young people. The service is now focussed on providing targeted support to the most vulnerable

young people and communities with high levels of risk taking behaviours. Work with the voluntary

and community sector will help to deliver preventative universal provision across the borough. A

multi agency Youth Provision Board has been established to drive forward the youth agenda in North

Tyneside.


How will we know it is working?

Objective Outcome

1. Preventative universal

services are provided in an

integrated way in the

borough and offered to all

families

• Proportion of parents accessing children’s centres increased

• Increased breastfeeding rates

• Decrease in number of women smoking in pregnancy

• Excess weight in 4-5year olds and 10-11 year olds is not

increased

• Proportion of children deemed ready for school increased

2. Vulnerable families are

identified and supported

at the earliest opportunity

• Referrals to Children’s social care per 10,000 population is

reduced

• Number of early help assessments undertaken

• Percentage of early help cases closed due to achievement of

satisfactory outcomes

• A reduction in medium and high risk domestic violence

incidents

• Positive feedback from families

3. Sustainable improvements

in vulnerable children’s

outcomes are achieved by

addressing the needs of

the family as a whole.

• Achievement gap reduced between pupils eligible for free

school meals and their peers achieving at Key Stage 2 (Eng and

Maths)

• Achievement gap reduced between pupils eligible for free

school meals and their peers achieving at Key Stage 4 (5 A*-C

inc Eng and Maths)

• Rate of permanent exclusions from school reduced

• Under 18 conception rate reduced

• Less spend on reactive and crisis services

• Number of parents achieving the National Certificate in Adult

Literacy and/or Numeracy

4. Services to tackle the

underlying causes of poor

outcomes for children and

young people are

developed

• Proportion of children in poverty reduced

• Reduction in the number of workless households

• Integrated budgets provide integrated services


• Increase in community/locality led initiatives are developed

• Number of family dwellings improved to decent homes

standard

5. Every child enters school

ready to succeed

• Achievement of at least 78 points across the Early Years

Foundation Stage with at least 6 in each of the scales in

Personal Social and Emotional

• Narrowing the gap between the lowest achieving 20% in the

Early Years Foundation Stage Profile and the rest

• Increased take-up of formal childcare by low-income working

families

6. Children and young people

develop outside of school

• First time entrants to the Youth Justice System aged 10 – 17

reduced

• Reduction in young people aged under 18 admitted to hospital

with alcohol specific conditions (rate per 100,000 population

aged 0-17 years)

• Reduction in young people aged under 18 admitted to hospital

as a result of self-harm (rate per 100,000 population aged 0-17

years)

• Reduction in emergency hospital admissions caused by

unintentional and deliberate injuries for young people aged under 18 (rate per 100,00)

Case Study

The children were registered as child in need, there was poor school attendance, poor parenting, a

lack of boundaries, a lack of ability to keep children safe, Anti Social Behaviour (ASB) and

worklessness

The worker, a ‘Family Partner’, held a family meeting where all members were given an envelope

containing all daily tasks/ personal wishes/ what was important etc written on slips of paper. The

family were encouraged to discuss importance and all family helped to add these to a large piece of

paper which was displayed and referred to as a visual aid with the aim to ‘sticking to changes’

The Family Partner developed routines in the home- prioritising bedtime routine/ getting up in the

morning and late and early visits and had regular telephone contact. Visits and telephone contact

were both planned and unannounced to ensure the changes were implemented, which enabled

focus to be very intense. As a result the Family Partner was able to develop a positive relationship

with the family. A comment Mum said early on was ‘don’t give up on us like everyone else has’.

When she got fed up with the Family Partner regularly chasing her up to do things she was reminded

that ‘this time we weren’t going to give up’.


One of the primary reasons why the role of the Family Partner has been successful for this family is

due to the flexibility/ time available to attend regularly and offer a hands on approach to support the

family whilst giving opportunity to develop their skills by role modelling/ practising scenarios etc.

This has equipped the family to deal with every day issues effectively and appropriately.

The agreement to have ‘one worker, one plan’ has enabled the Family Partner to support the family

with ALL the issues they face and not just have a focus on one thing leaving other professionals to do

their part. It has enabled the Family Partner to have a clear picture of the families strengths and

weakness and enabled regular support to be offered to address issues as they arise before they

reach crisis point. As the Family Partner has worked openly and honestly with the family and had a

clear understanding of the family there is a reduced the risk of them ‘trying to avoid changes’. They

are also looking toward achieving future aspirations and the importance of education which is

something they said they have not done in the past.

Outcomes

• Children are no longer subject of ‘Child in need’- the Family Partner now has key

responsibility

• All three children have had 100% school attendance this half term- this is the first time all

children have attended school regularly

• Reports of ASB and Child Care Notifications have reduced significantly with no reports at the

time of writing in past 10 weeks

• The parent has fully engaged to implement appropriate boundaries/ routines which have

had a positive impact on the children’s school attendance and overall well being. The three

children present as happier, achievements in school have risen, and family functioning has

improved. The children have been part of the action plan and have been actively involved in

how they want this to look and what they would like to see changed. Mum is able to manage

the ever changing needs of her children more effectively.

• Mum has accessed training and development- this is very positive as Mum would avoid

group sessions/ training as her self confidence/ esteem was very low. She has now

volunteered to enrol on further training and is working toward developing skills to aid

employment. Mum has never had employment as an adult.

• Youngest child- feels happy enjoying school’ I am happy all day’.

• Eldest and middle children- Feel everything is going well

• Mum- feels everything is going well and she is more confident/ motivated to continue to do

well

• Concerns from other professionals have reduced with no further role identified for social

work intervention.

• YOT/ N2L have seen significant positive changes in presentation of eldest child and her

maturity of managing her behaviour appropriately and making the right lifestyle choices.

• School have reported positive progress re the children achievements and attendance

Next Steps

This strategy will be reviewed and refreshed through an ongoing process of consultation and

refinement with partners, families, children and young people. A comprehensive Delivery Plan,

based on the objectives and outcomes set out in this strategy will be developed. It will reflect the

shared commitment, resources and governance we are developing with our partners. This will

include a suite of performance measures that allow us to monitor our progress against the 5

objectives. A quality assurance framework will also be developed for each service area.


Governance

The Children, Young People and Learning Partnership have overall responsibility for the Prevention

and Early Intervention Strategy. An annual progress report will be presented to the Children, Young

People and Learning Partnership Executive Commissioning Board, with exception reports provided

as appropriate. North Tyneside’s Health and Wellbeing Board and the Children’s Health and

Wellbeing Board will provide oversight and ongoing challenge and scrutiny of the strategy and

delivery plan, however, it is our intention to create a PE & I Sub Group of the Health and Well Being

Board specifically to monitor progress and to incorporate within that the current governance

arrangements for the ‘Troubled Families’ programme. All boards will receive quarterly progress

reports and annual performance reports.


Appendix One

The National Policy Context

1. The Munro Review of Child Protection: A child-centred system

The final report of the Munro Review of child protection sets out proposals for reform which, taken

together, are intended to enable professionals to make the best judgments about the help to give

children, young people and families.

The report found that preventative services can have a greater impact on reducing abuse and

neglect than reactive services. Munro identified a need to identify and secure support for those

families experiencing difficulties but who do not meet the criteria for receiving children’s social care

services. It recommended that local authorities and their statutory partners should have a duty to

ensure sufficient local early support for children, young people and their families. Within

preventative services Munro also identified a need for effective mechanisms to identify children and

young people at risk of abuse or neglect.

2. The Allen Review: Early Intervention

Allen concluded that many of the costly and damaging social problems in society are created

because we are not giving children the right type of support in their earliest years, when they should

achieve their most rapid development. His reports identified the period between 0-3 years as of

crucial importance in determining lifelong outcomes but also found that early intervention was

important throughout childhood. Intervening later to address established problems is more costly,

and often fails to achieve the improvements in outcomes that early intervention delivers. The

importance of effective parenting is also highlighted and is described as the biggest single

determinant of a child’s future than wealth, class, education or any other common social factor. The

report then considers how best to deliver early intervention and identifies the most effective early

intervention programmes and approaches. The report also recommended the creation of an Early

Intervention Foundation, which is now in place.

3. Field Review: The Foundation Years: preventing poor children becoming poor

adults

The final report found overwhelming evidence that children’s life chances are most heavily

predicated on their development during the earliest years of life. The review concluded that it is

family background, parental education, good parenting and the opportunities for learning and

development during the crucial early years of a child’s life that were key determinants of a child’s life

chances. A number of key factors in improving outcomes for children are identified, including a

healthy pregnancy; good maternal mental health; secure bonding; love and responsiveness of

parents along with clear boundaries, as well as opportunities for a child’s cognitive, language and

social and emotional development. The report also identifies an important role for high quality

services around health, children’s centres and childcare.


4. Flexible Free Entitlement for Eligible 2 Year Olds

The Flexible Free Entitlement for Eligible Two Year Olds is part of the Coalition Government’s agenda

to improve outcomes and narrow the gap in educational achievement between disadvantaged

children and other children in the local authority area. It also aims to increase the take up of the

flexible free entitlement for three and four year olds and to improve outcomes for parents by

signposting them to services as appropriate.

The offer provides up to 570 hours per annum of free, quality early learning that can be delivered

flexibly. It can be taken as:

• 15 hours per week over 38 weeks per year or

• Stretched over more weeks meaning fewer hours per week are taken.

To access the offer, families must be in receipt of one or more of the following benefits:

• Income Support

• Income-based Job Seekers Allowance

• Income-related Employment and Support Allowance

• Support under Part VI of the Immigration and Asylum Act 1999

• The Guaranteed element of State Pension Credit

Child Tax Credit, provided that families are not also entitled to Working Tax Credit and an annual

gross income of no more than £16,190, as assessed by HMRC.

Those delivering the offer - approved childcare providers - must be able to offer high quality early

learning and they must demonstrate a commitment to working in partnership with children’s

centres, family partners and health services. Provision operated by both the Local Authority and the

PVI sector will be used to deliver the entitlement whilst additional support services will be provided

by a range of partner agencies.

For families who access the offer, the benefits include:

• Two year old children meeting the eligibility criteria will have access to up to 15 hours free,

high quality early learning over 38 weeks per year.

• Parents will have increased access to children’s centres and the services that they provide.

• Parents will be able to seek additional support with their own learning and training.

5. Marmot Review

The Marmot review calls for a ‘second revolution in the early years’, to increase the proportion of

overall expenditure allocated there. This expenditure should be focused proportionately across the

social gradient to ensure effective support to parents (starting in pregnancy and continuing through

the transition of the child into primary school), including quality early education and childcare.

The review found that:

• Early interventions during pregnancy and ongoing support in early years are critical to the

long-term health of the child and other long-term outcomes.

• Universal and proportionately targeted interventions are necessary.

• Emerging evidence shows that Sure Start Children’s Centres have a positive impact on child

outcomes.

• Intensive home visiting is effective in improving maternal and child health.

• Good parent–child relationships in the first year of life are associated with stronger cognitive

skills in young children and enhanced competence and work skills in schools.


• Good quality early childhood education has enduring effects on health and other outcomes.

These outcomes are particularly strong for those from disadvantaged backgrounds.

6. The Bercow Review

The report makes recommendations to Government about the steps it should take to transform

provision for and the experiences of children and young people with speech, language and

communication needs (SLCN) and their families. The Review set out recommendations to address

five key themes, which need to be addressed for real change and improvement to happen:

• Communication is crucial;

• Early identification and intervention are essential;

• A continuum of services designed around the family is needed;

• Joint working is critical; and

• The current system is characterised by high variability and a lack of equity.

7. Best practice for a Sure Start: The Way Forward for Children’s Centres

Children’s Centres must effectively ‘reach’ families with children at the earliest possible opportunity,

in order to have the most significant positive impact. Centres that are working with families from

pregnancy onwards can help support and promote key parenting behaviours which are increasingly

recognised as important for future development. These should include:

• Smoking and alcohol cessation during pregnancy

• Breast feeding

• Secure attachment and positive relationships

• Responsive parenting

• Talking and communication

• Good nutrition in early years

• Dental health promotion

• Physical activity

8. Health Visitor Implementation Plan: A Call to Action

The Health Visitor Implementation Plan was published in 2011 and provides the detail to support the

Coalition Government’s commitment to develop the health visiting service and to recruit an

additional 4,200 health visitors by 2015. The plan set out a vision for the future of health visiting

services, a call to action for the stakeholders involved, the pathway to achieving the 2015

commitment and information about the work programmes that will support the implementation.

The plan was refreshed in April 2013 to reflect changes to the NHS. The revised plan describes

progress made so far, and explains who the new bodies are in the health and care system, and their

roles in delivering the health visitor plan.

9. More Great Childcare: Raising Quality and Giving Parents More Choice

The Plan sets out the Coalition Government’s proposals to build a stronger and more professional

early years workforce, and to drive quality through everything it does. It details how the

government will achieve its vision of a dynamic childcare market, delivering high quality early

education. It incorporates the government’s response to Professor Cathy Nutbrown’s independent

review. Key points include:


• Building a stronger, more capable workforce with a greater focus on training and

qualifications.

• Driving up the quality of childcare provision by improving the regulatory regime via more

rigorous Ofsted inspection.

• Reducing the duplication of local authority inspection and the costs involved in order to

enable more money to get to the ‘frontline’.

• New childminder agencies which will recruit and train and support new childminders and

provide more choice for parents.

• Freeing high quality providers to offer more places.

10. Health and Social Care Act 2012

The Health and Social Care Act 2012 puts clinicians at the centre of commissioning, frees up

providers to innovate, empowers patients and gives a new focus to public health. The key policy

developments include:

• Clinically led commissioning New clinical commissioning groups will directly commission

services for their populations, supported by the NHS Commissioning Board.

• Provider regulation to support innovative services Patients to be able to choose services

which best meet their needs, as long as they meet NHS costs. Providers, including NHS

foundation trusts, will be free to innovate to deliver quality services. Monitor will be

established as a specialist regulator to protect patients' interests.

• Greater voice for patients The Act establishes new Healthwatch patient organisations locally

and nationally to drive patient involvement across the NHS.

• Greater accountability locally and nationally The Act sets out clear roles and

responsibilities, whilst keeping Ministers’ ultimate responsibility for the NHS. It gives local

authorities a new role to join up local services.

• Streamlined arms-length bodies The Act removes tiers of management to release resources

to the frontline.


Appendix Two

North Tyneside’s 0-19 Population

The North Tyneside population aged between 0 and 19 in 2011 was just under 45,000. The

Office for National Statistics has estimated that by 2021 it will have increased by 6.4% to just

under 48,000. When split by age group, the 5-10 age group will see the biggest gains rising by

18.6% by 2021. The only age group projected to go down is the 17-19 year olds. An increasing

0-19 population is likely to result in greater demand for children’s services.


Child Poverty in North Tyneside

1 in 5 of North Tyneside’s children live in poverty. This is lower than the average figures for

statistical neighbours, the North East and Nationally. Child Poverty varies greatly across the

borough from 2.6% in the North East of the borough to 40.3% in the South of the borough.


North Tyneside’s Looked After Population

The number of children in care has risen significantly over the last 5 years and the North East as well

as North Tyneside has seen the gap with the rest of the country widen, putting pressure on

children’s services across the region. Whilst the national numbers are stabilising North Tyneside and

the North East region as a whole continue to see an increase in the numbers of children in care.


The map below shows the density by ward of the Looked After Population. The majority of the

children in care come from Riverside, Chirton and Howdon but they still only make up a very small

percentage of the 0-17 population. The spread across the borough follows a similar pattern to the

Index of Multiple Deprivation with the coastal strip being the least deprived showing the smallest

numbers of children in care, with the exception of a small area in Whitley Bay.


Children Subject to a Child Protection Plan in North Tyneside

As with the children in care numbers the number of children subject to a Child Protection Plan have

also seen significant increases in recent years. North Tyneside hit a peak figure of 47.7 in 2011, well

above the National figure but in line with the North East pattern. In 2013 North Tyneside’s figures

dropped to 32 per 10,000 population (aged 0-17). The North East region remain well above the

rates seen nationally, adding to the pressure on Safeguarding services in the region.


Youth Justice – First Time Entrants in North Tyneside

The graph below shows that over the last five years North Tyneside has significantly reduced the

number of first time entrants to the Youth Justice System. In 2011-12 we performed better

than the England, North East region and our Statistical Neighbours and were ranked in the top

quartile across the country. In year figures show this decrease is being maintained.

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