Early intervention leaders' debate

The general consensus remains intact: it makes sense to provide support to children, young people and families early and address root causes of social problems, thus preventing the need for costlier services further down the line. However, putting that essential principle into everyday practice is becoming increasingly challenging for local authorities in a period of sustained and severe budget reductions, rising demand for social care and pressures from regulators. New challenges and opportunities are also arising in involving partner agencies and in delivering what works. CYP Now hosted a debate with directors and assistant directors in central London on 23 September to thrash out these issues. The debate took place in partnership with Capita One, which supplies management information systems to local authorities to manage data on children and families.

Despite the challenges, the desire and the resolve to prioritise early help among those present remains as strong as ever.

Sheila Lock joined Norfolk County Council as interim director of children's services last year after inspectors judged its child protection system to be inadequate and school support ineffective. "Going to a place deemed inadequate across the whole of the children's estate is a challenge in itself," she said. "There's definitely an inextricable link between inadequacy in children's social care and inadequacy in schools, and a poorly developed early help offer, so it's had to be a priority for us to develop that. A lot of my time has been taken up developing a strategy that will allow us to disinvest up here (in social care) and reinvest down here (in early help)".

She said the inspections system was undermining innovative practice across the board. "In a system so highly regulated, where judgments are made about practice all the time, there's a big question about what that does to the confidence and empowerment of people at the front line working with families."

Sandwell director of children's services Simon White said: "It's very difficult to prove to anybody's ultimate satisfaction that the money you spend on prevention reduces demand on social care. But what you can be absolutely sure of is if you deal with those problems in social care, you will end up with more children in care, more on the child protection register and more classed as children in need - because that's what they do. If you do the work somewhere else you will inevitably get less in the social care space, and that's been my experience.

"The more goes through that sausage machine, the more sticks on the sides. If we think of it not as prevention, but as an alternative to put your resource into providing and responding to the needs of those children and families in a different place - the early help space - you will get less business in social care. This raises the question, is that dangerous? Potentially, but it's much better for the children, it's more cost-effective and it starts to make your numbers work in driving down demand. The alternative is no less dangerous. Capturing children so you've got too many to keep an eye on and caseloads that are unmanageable doesn't keep children safe.

It just puts the risk elsewhere.

White added: "The only child and family-centred way to change within the regulatory framework is to do as little of that work in children's social care and as much as possible in the space called early help, which is a multi-disciplinary, multi-agency space. In Sandwell we've seen a reduction in our 'children in need' numbers by about a half because of taking that approach."

Others pointed out that excessive bureaucracy was soaking up resources in social care. Most agreed that social workers are spending around 70 per cent of their time on meetings and bureaucracy and only 30 per cent in direct delivery.

Pressures on demand

Felicity Roe, assistant director in Hampshire, said: "We've got to bring down the costs of social care in order that we can continue early help. We're beginning to look at how we might completely innovate across social care and change the way we do it, full stop, end of story. That is the only way we will get enough money out of the system to keep the early help going." She added that Hampshire has begun a partnership with Capita One to devise a better social care technology system that will "enable that change in practice".

Demographic and social factors are also putting intense pressure on the capacity to provide early help. Barking & Dagenham's corporate director for children's services Helen Jenner said: "The next two years is okay but in year three we won't have any early help under the current models because we've got huge growth in the child population, we've got increasing deprivation and poverty so our statutory services use up more, and I'm being asked to make cuts."

Representing the voluntary sector, National Children's Bureau director of evidence and impact Enver Solomon expressed concern about the opportunities for smaller local charities, and the "extent to which commissioning frameworks will enable them to play an active role." Roe said Hampshire had opted "not to have a local solution here and a local solution there because we'll commission in 11 different ways. It's too expensive and we can't do it. So we're moving back to a single commissioning look across the county". For example, it will have one contract to support domestic violence, and the provider would be expected to adapt where it reasonably can to suit more localised circumstances. On involving smaller local charities she revealed: "We've tried to tip the playing field far enough so that bigger charities don't win and the smaller, local charities can."

Schools

Given the enormous financial pressures, there was a strong call around the table for schools to do more around early help. Lock said: "In Norfolk we have a real standards issue in many of our schools. I'm having conversations with schools about the readiness of children entering the classroom to learn, which is quite a catalyst for the debate around where schools fit into early help."

Roe revealed that schools in Hampshire have made a "really significant step" in together putting £2m into early years services and an additional £1.5m into "early help hubs" consisting of professionals from a wide range of partner services.

But nationally she said the message needed to come from government that a school must be "thinking about its whole community".

The pupil premium presents a clear opportunity for schools to help narrow the attainment gap between disadvantaged children and their peers, and help prevent other problems from arising. Gail Tolley, who joined Brent Council as director of children's services four months ago from Milton Keynes, said: "Having been DCS in Milton Keynes for five years, the pupil premium was seen as part of the early help offer. It isn't yet in Brent - schools have not been challenged and engaged around their contribution to early help through that particular resource. Colleagues at the local authority aren't thinking like that. The two words 'pupil premium' don't feature anywhere in our early help strategy. It needs to be explicit." Tolley added: "The introduction of the early years pupil premium means this is an opportune time to ensure collaboration with schools."

White said the rapid emergence of academies independent from council control made it more difficult to get schools to embrace their role in securing children's wider wellbeing. "When you have a more atomised system in governance terms - particularly standalone academies, which have a very parochial attitude - it creates a problem in getting all schools to step up for all children who have particular needs, particularly around deprivation." He also said that "the coalition government's deliberate decision to focus on attainment" was "not always helpful". NCB's Enver Solomon agreed, saying: "An overarching framework around the principles and values that are critical for early help would enable agencies - schools, health, early years - to actually coalesce in a more effective way."

Nevertheless, there was some evidence of genuine engagement by schools. Jenner said: "In my borough the Healthy Schools London initiative has made a huge difference in emotional health and wellbeing and resilience. It has involved a lot of parents. Schools are generally very ready to take those things up."

Beyond schools, White called for a family-centred approach to early help, given, he said, that "adults are completely central to children's wellbeing and a source of danger and certainly a source of protection, nurturing and development."

In Norfolk, Sheila Lock revealed that "one of the things we decided to do with our restructure is to have an early-help post in adult services that will mirror exactly what we're doing in children's services with the intention that they will lead on the 'Think Family' strategy".

With local authorities now responsible for public health, Solomon said this was "a great opportunity for integrated commissioning. You could say there is going to be more resource available to try and get this right." Rose Collinson, until recently interim director of children's services in Walsall, said: "The public health money relatively speaking isn't huge bucks but Clinical Commissioning Group (CCG) money is much bigger. We need to help CCGs commission well because there's a positive kick-back (in health outcomes and savings) if CCGs can see their current role in early help."

Participants stressed that early help must never be conflated with the early years. Solomon said: "It's actually about early intervention right across the age range, particularly for those older children who are often perceived as being more challenging, more troublesome, rather than troubled themselves, and who aren't always identified as being in need in the same way as younger children."

Indeed, youth work emerged as a key part of several authorities' work around early intervention. In Barking & Dagenham, Jenner said: "Our most effective bit of early help is around our youth services. We have good networks, a youth forum that works well, buy-in from the voluntary sector, schools and local community groups, and an infrastructure around it. My concern is we soon won't be able to afford it because it isn't statutory." Sutton's head of integrated services for young people Claudette Brown said it was able to maintain its service by "aligning our community and youth workers to locality teams".

Mel Meggs, assistant director in Derbyshire, explained that it has integrated its personal advice service and youth workers into the early help team. "They still deliver open-access universal services in targeted communities," she said. "They have been transformative in how we respond to our vulnerable young people. Youth workers have been brilliant at being able to broker with families. They're fundamental to our early help offer."

Meggs added that for youth workers, the integration had required some retraining and "cultural change around intervention models, management and accountability", but also cultural change among other professionals who might previously have been dismissive of youth work: "There is a lot of judgment about what other professionals do."

Community resilience

And, as several around the table observed, whatever their ilk, "sometimes professionals don't have the solutions". Sharon Moore, commissioner for families in Staffordshire, said: "We should be giving the community the power and resource to self-determine what the solution might be, and build community resilience.

"In Staffordshire we allow parents to use our children's centres to set up self-support groups, things we don't need to commission and that are self-sustaining."

But Jenner said: "One of the problems in Barking and Dagenham is that although we have a mixed community in terms of ethnicity, we don't in terms of income generation so we don't have any children who come from families in the top 30 per cent of wage earners in the country. I envy places where you've got much more mixed communities and that allows more to be done."

Solomon said it was crucial to "give equal weight and authority to community voices".

He said as part of NCB's successful "Better Start" Big Lottery Fund bid with Lambeth, it would "genuinely share power with local communities".

"Having an open mind to change your decisions based on what the community says to you can be scary for all of us because it challenges our authority."

To help the sector ensure services improve outcomes, the Early Intervention Foundation was set up last year. One of the authorities it is working with is Staffordshire. "They're helping us analyse what we're commissioning around early years," explained Sharon Moore. The county is currently undertaking a public consultation on its provision for under-fives.

Jenner pointed out that a programme that works in one authority might not elsewhere. "Family Nurse Partnership in my previous borough of Tower Hamlets was fabulous. I brought it into Barking and it hasn't worked. In Tower Hamlets the young parents were much happier to be compliant. They're feistier in Barking & Dagenham so we've had to develop a different programme. It hasn't got the same fidelity but it appears to be having a better impact."

Lock said such differences can also exist within the same authority. "The nuances of communities are very different in the south of Norfolk to what they look like in the north. You can't just take a model and necessarily replicate it. It requires a lot of preamble and community engagement because people receive services in different ways."

Indeed, NCB's Solomon warned there is no "magic bullet" to achieve impact. "It's not just about what works, but what works for whom and in what circumstances," he said. "We get hung up on fidelity, models and randomised control trials, we roll out programmes and find not surprisingly that Functional Family Therapy might have worked in the US with kids in the youth justice system but it's not necessarily going to work very well for children here who are on the edge of care.

"We need to recognise where the gaps are in evidence, particularly around systems change. We know much less about what works when it comes to systems change in children's social care. You can take all the programmes you want in the world but if you haven't got wider systems change practice in place about leadership, culture, assessment, data collection and data analysis, then you're not necessarily going to get the outcomes and we need to have a better understanding of that."

AROUND THE TABLE

Claudette Brown, head of integrated services for young people, London Borough of Sutton

Ravi Chandiramani (chair), editor-in-chief, Children & Young People Now

Rose Collinson, ex-interim director of children's, Walsall Council

Helen Jenner, corporate director, children's services, London Borough of Barking & Dagenham; and Greater London chair of the Association of Directors of Children's Services

Sheila Lock, interim director of children's services, Norfolk County Council

Mel Meggs, assistant director, universal and targeted services, Derbyshire County Council

Sharon Moore, commissioner for families, Staffordshire County Council

Phil Neal, managing director, Capita One

Felicity Roe, assistant director - access, performance and resources, Hampshire County Council

Enver Solomon, director of evidence and impact, National Children's Bureau

Gail Tolley, strategic director, children & young people, London Borough of Brent

Simon White, director of children's services, Sandwell Metropolitan Borough Council

Roundtable debate held in partnership with Capita One