Early Intervention and Prevention in Nottinghamshire Anthony May, Corporate Director for Children, Families and Cultural Services Nottinghamshire County Council

Early Intervention & Prevention Strategy Context - 1 National: Reducing public expenditure Increasing pressure on Children’s Social Care Changes in the roles of local authorities and how services are delivered A commitment to the early years and early intervention from the Coalition Government Nottinghamshire County Council

Early Intervention & Prevention Strategy Context - 2 Local – reflects the national picture: Unprecedented budget pressure across the public sector Review of services including the refocusing and increased commissioning of services Continuing high demand on Children’s Social Care Nottinghamshire County Council

Our approach in Nottinghamshire The challenge is to develop a whole systems approach to the issues facing our services: Continuing the improvements to safeguarding in Nottinghamshire made in the last 15 months Refocusing of Children’s Social Care as a service providing high quality Child Protection Services Continuing to improve the effectiveness of our early intervention and prevention services including: – Early Years – Targeted Support for young people – Health – The co-ordination of services & key processes such as the JAT & CAF Nottinghamshire County Council

Safeguarding Improvement Programme Significant improvements over the last year but pressure on Children’s Social Care remains: An average of 1300 contacts each month More than 50% of the contacts (680) do meet the thresholds for a referral to Children’s Social Care Only 90 CAF assessments initiated each month Only 60 referrals to Joint Access Teams each month NB all figures (October 2010 – March 2011)

The role of the Children’s Trust Executive Strengthened membership including health providers and representation from district councils Children, Young People’s and Families Plan – developing more effective early intervention and prevention services will be a key priority Future joint commissioning of services District Early Intervention Management Groups

Our Ambition...children, young people and their families will receive the most appropriate support to meet their needs at the earliest opportunity in order to ensure better outcomes and the cost effective delivery of services.... Nottinghamshire County Council

Our principles for early intervention and prevention work – 1 We will: Intervene at the earliest opportunity in order to secure the best outcomes for children, young people and families Target resources at the early years, in order to maximise the future life chances of children and young people Ensure that children and young people are effectively safeguarded by all of the agencies and staff that work with them Work together to reduce duplication in areas such as the assessments of need Nottinghamshire County Council

Our principles for early intervention and prevention work – 2 We will: Ensure children, young people and families will be supported to participate in key early intervention and prevention processes Ensure that the views and experiences of children, young people and families inform and influence the design and delivery of services Use evidence-based practice to inform planning for future service provision Adopt a whole family approach, whilst keeping the child or young person firmly at the centre of any intervention.

The Strategy’s key strands for development I.The provision of services to ensure the best start in life II.The development of language for life III.The engagement and support of parents and carers IV.The development of effective structure and processes V.The use and provision of management information Each strand has a number of priorities and detailed action plans Nottinghamshire County Council

Developing more effective early intervention & prevention services - 1 Implementation of the Pathway to Provision initiative Development of the CAF as the truly common assessment and referral process Fully utilising the capacity of the Joint Access Teams as the key mechanism for early intervention Refocusing of our early intervention and prevention services to meet the needs of children, young people’s needs appropriately and at the earliest opportunity

Developing more effective early intervention & prevention services - 2 The focus of the presentations from colleagues this morning will focus on this critical area Future services will need to: Make more efficient use of available resources Ensure more effective targeting of resources to children, young people and families with the greater need Ensure equitable access across the County based on need and local demography

Summary Covered this morning: 1.The national and local context and challenges 2.The need for a whole systems approach to ensure we identify and meet needs at the earliest opportunity 3.Our ambition, the principles and key development areas for early intervention and prevention services 4.In the following presentations we will be looking at the practical changes taking place in key service areas to achieve our ambition

The refocusing of the Early Years & Early Intervention Service Nottinghamshire County Council

OUR AMBITION We want children, young people and their families to have the opportunity to achieve their full potential by having the best start in life and access to services when they need them most. Nottinghamshire County Council

Coalition Government’s Vision for the Foundation Years – the core purpose of Sure Start Children’s Centres (draft) “Improve the child development and school readiness among young children and to reduce inequalities. This includes identifying, reaching and supporting the most disadvantaged families to improve their parenting aspirations and skills, and to promote health and well-being.” Nottinghamshire County Council

Key Priorities (1) Redefine the Early Years offer, targeting services where there is greatest need Ensure all early years provision is offered through a single point of access Ensure there is sufficient childcare provision that is accessible, sustainable, and of high quality Implement the Language for Life strategy to ensure the early identification of language delay Implement the Family & Parenting review findings by integrating and extending family support provision - delivering throughout school transitions and across tiers 2 and 3. Nottinghamshire County Council

Key Priorities (2) Use national and local evidence based programmes/practice that are proven to make a difference Support the work of the Joint Access Teams and the use of the CAF through multi-agency training/development programme and the development of a quality assurance framework Develop a whole-family CAF tool and use of eCAF Deliver the Pathway to Provision enforcement plan Develop district early intervention and prevention management groups Nottinghamshire County Council

Key Priorities (3) Consider workforce development needs in light of reshaped service. Secure efficiency savings - £3.25m. KEY DATES: Following a consultation period, recommendations to the County Council in December 2011 New management structure in place by March 2012 New commissioning agreements in place by September 2012 Nottinghamshire County Council

‘Enabling infants to become rounded, capable people results in great and lasting social benefits through a lifetime that includes happiness and security in childhood, achievement in education, readiness for productive work and, above all, successful parenthood’. ‘Early intervention: the next steps’. Graham Allen MP. Jan 2011 Nottinghamshire County Council

Developments in children’s health services and the wider NHS NHS Nottinghamshire County Public Health Children and Young People Team July 2011 NHS Nottinghamshire County

Presentation Picture of health (JSNA) NHS role in early intervention and prevention Developments in children’s health service The wider NHS Challenges and opportunities NHS Nottinghamshire County

Picture of health in Nottinghamshire 179,500 children and young people aged 0-19 years Average overall for most indicators of health Wide variation within the county –low birth weight, smoking in pregnancy, hospital admissions, teenage pregnancy rates, linked to deprivation Key health issues for Nottinghamshire: –childhood obesity, emotional health and wellbeing, sexual health, substance misuse, CYP with disability, vulnerable groups NHS Nottinghamshire County

Prevention and early intervention: the role of the NHS Universal services Antenatal care – midwifery The Healthy Child Programme: Health visitors School nurses Child health surveillance (GPs) Services contributing to ensuring the best start in life NHS Nottinghamshire County

Key national developments in children’s health services: The Department of Health is planning for the development of two initiatives nationally: –The Health Visiting Implementation Plan , (including revised core offer) –Family Nurse Partnership Programme NHS Nottinghamshire County

The wider NHS in Nottinghamshire ‘ Listening’ exercise now complete Clinical commissioning groups: 6 Public Health move to Local Authorities Health and Wellbeing Board PCTs in existence until 2013 (clusters) Transforming community services (TCS) complete –New providers of community children’s services NHS Nottinghamshire County

Challenges and opportunities Financial challenges within the NHS Loss of organisational memory, capacity Fragmentation of services Effective partnership working – –HWB, joint commissioning, Public Health move Clarity of purpose: e.g. EI&P Strategy Evidence based practice, cost effectiveness NHS Nottinghamshire County

Thank you! Children and Young People Public Health Birch House Ransom Wood Business Park Southwell Road West Mansfield Nottinghamshire NG21 0HJ

The development of a Targeted Support Service for young people Nottinghamshire County Council

Scope of Services From the age of 8 At risk of involvement in crime and ASB ASB linked Parenting Orders and Contracts Substance Misuse Missing children and “runaways” Youth homelessness Improving participation in ETE Outreach youth work in ASB hot-spots Young Carers Resettlement for custody leavers Nottinghamshire County Council Replaces YISP and Face-It services Will replace Connexions by March 2012 Replaces YSS Crime & Disorder Team and YOS RAP Team Replaces Mansfield / Ashfield Missing Children Project

Ethos Young person centred Minimum number of professionals involved in meeting needs Minimising number of plans and appointments and reducing repeat assessments Solution focused approaches involving families and carers wherever possible Nottinghamshire County Council

Team Structure 3 locality based multi-disciplinary Targeted Support Teams Co-located NCC, health and voluntary sector and police staff County wide Outreach and Open Access Team County wide Young Carers service delivered by Family Action Nottinghamshire County Council

Operation CAF based referrals and assessment Published eligibility linked to “Pathway to Provision” Individualised programme approaches led by a named case manager Direct links into CAMHS Nottinghamshire County Council

Children's Social Care, Sustainable and fit for the future: A new vision and focus Nottinghamshire County Council

Why a new vision and focus? Demand

Children’s Social Care vision and mission “To give the most vulnerable children and young people in Nottinghamshire the support and protection they need to be safe, secure, happy and to achieve their full potential”

Vision is underpinned by the following principles Children’s Social Care works to protect and support the most vulnerable children and young people in society We will keep children at home in their families wherever possible and where it is safe to do so Children should exit the care system by returning to their family or into alternative permanent placements, such as adoption, as quickly as possible

Immediate challenges; managing the demand on the Service Significant investment in; –additional front line staff (Including agency) –increased cost of placements for Looked After Children Inspection; –Positive Ofsted Unannounced inspection in February 2011 –Positive Peer Challenge in May 2011 –Full safeguarding inspection in the autumn

Transformation Programme 18 months – 2 years programme to develop a new operating model for Children's Social care Priority projects, including: –Multi-agency safeguarding hub –Locality based teams –Permanence team –Transition services for children with disabilities –Support to young people aged 16+ Implementing a sustainable, cost effective and efficient operating model that links to early intervention and gives clear support to JATs