Extend mandatory role of health visitors, urges children's commissioner

A report by the Office of the Children's Commissioner (OCC) found that there are 15,800 babies under the age of one considered by local authorities to be vulnerable or highly vulnerable and at risk of harm, but still living at home.

Families currently receive five mandatory health checks from health visitors - one before birth, one when the baby is born, one when the baby is between six and eight weeks old, one when they are between nine and 12 months old, and one when the child is between two and two-and-a-half years old. 

But Longfield wants the number of mandatory visits to be increased for families where children are deemed to be "at risk".

"There is insufficient information about which interventions help parents whose children are at risk," the report states.

"But one visible safety net is health visitors - who may be the only professionals to see a baby regularly in the vulnerable early months.

"The OCC recommends increasing the number of mandatory visits for families where known risk factors are present; improvement in referral pathways from health visitors to health professionals and children's services; and close monitoring of the adequacy of provision of health visitors now that funding for them has transferred to local authorities."

The report, titled A Crying Shame, also recommends that the government gives councils more money to cope with demand, stating that children's services departments are currently unable to help all children that need support due to lack of resources.

"It is clear that local authority children's services departments at present are not sufficiently well-resourced to offer help to all children who need it," states the report.

"This urgently needs to be addressed by the government in the Budget this autumn and in next year's spending review."

The report also found that 50,000 children aged up to five, including 8,300 under one-year-olds, are living in households with a "toxic trio" of domestic violence, drug dependency and severe mental ill health. 

But the report adds that council "children in need" data for March 2017 shows only 18,500 children aged four and under can be expected to be on child protection plans, including 5,000 babies under the age of one.

"This suggests there are likely to be over 30,000 young children (aged 0 to 5) living in extremely high-risk households but not on child protection plans, including 3,300 babies under one," states the report.

Other recommendations in the report include ensuring that new multi-agency safeguarding arrangements, which are due to replace local safeguarding children boards, make an assessment of likely levels of need in their area and draw up strategies to identify and support vulnerable children.

In addition, adult services working with those affected by domestic violence, mental ill health and substance abuse, should automatically ask whether there are children in the household and report concerns to children's social care.

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The report also calls for the government to identify and spread good practice among councils regarding tackling repeat removals of babies from the same families.

The children's commissioner also wants to see the annual publication of NHS and children's social care data to identify levels of need.

Anntoinette Bramble, chair of the Local Government Association's children and young people board, backs the report's call for the government to invest more in children's services.

"These worrying figures underline the huge number of children and families in need of help and support, and emphasises the colossal challenge facing councils and their partners as they try to address growing levels of need with rapidly diminishing resources," she said.

"While it is absolutely vital that councils are able to support families and help children who are at risk of significant harm, they also need to be able to intervene before problems escalate to that point.

"But this is being put at risk by the significant financial pressure that children's services across the country are now under, with many councils being pushed to the brink by unprecedented demand.

"This has seen a record number of children entering care at a rate of 90 a day; councils starting 182 child protection plans every day, and a child referred to children's services every 49 seconds.

"Despite councils' best efforts to protect spending on children's services, they have too often been forced to reduce or stop the very services which are designed to help children and families before problems begin or escalate to the point where a child might need to come into care."

Charlotte Ramsden, chair of the health, care and additional needs policy committee at the Association of Directors of Children's Services, said: "For local authorities protecting children and young people from harm is most important work and we work with a range of partners to do this including schools, health, the police and the voluntary sector.

"We know that children are best brought up within their families, this is a core principle of the Children Act 1989; local authorities are working hard to support families in times of crisis to better manage the challenges they face but the government's current approach to funding is not conducive to this goal.

"Children's services are facing increasing pressures as the report states; austerity continues and the cuts local authorities are having to make are becoming increasingly tough and counterintuitive as we are forced to scale back services that help tackle the root causes of the problems families face not just the symptoms.

"We urge the government to seriously rethink its current approach to funding children's services, ad-hoc, time-limited grant funding that only benefits a handful of local areas does not offer a sustainable, equitable solution. We hope the government is not silent on the issue in the forthcoming autumn Budget."

A study by the Nuffield Foundation published last week found that of the 173,002 children in care proceedings between 2007/08 and 2016/17 in England, 47,172 (27 per cent) were under the age of one. The number of newborn babies - those less than a week old - subject to care proceedings more than doubled from 1,039 in 2007/8 to 2,447 in 2016/17.

A Department for Education spokesman said: "Every child deserves the best start in life, so it is vital vulnerable children who may face barriers to success, such as those affected by mental health, alcoholism and domestic abuse receive the care and support they need, when they need it.

"We are working to tackle these issues through our landmark Domestic Abuse Bill to better protect and support victims, as well as reviewing the outcomes for children in need.

"We are also investing up to £270m in children's social care programmes to improve the lives of vulnerable children, we have pledged £8m to support children who are exposed to domestic abuse and £500,000 to expand helplines for children of alcoholics."