Early Help: Policy context
Tuesday, January 2, 2018
Amid rising demand for child protection services over the past decade, early help support for children and families with emerging or less severe problems has been largely left on the political, policy and funding sidelines.
A combination of these factors has resulted in decisions being taken by local and national government that has changed the nature of early intervention and seen the closure of some of the services and facilities that delivered support.
However, as recognition has grown recently of the need to reduce demand on children's social care services, new approaches to early help are emerging resulting in a wider range of organisations becoming involved.
Early help and its origins
Early help is a public policy approach that encourages preventative intervention in the lives of children or their parents, to prevent problems developing later in life. Interventions can be targeted at children deemed to be at higher risk of disadvantage, or can be universal in scope.
As well as the political and social benefits of preventing poor outcomes in later life, such as mental health problems, low educational attainment and crime, advocates of early intervention also cite economic benefits to the approach. This is based on the argument that preventative policies cost less to implement than reactive ones.
Early intervention is a policy approach often targeted at young children, but many organisations, such as the Early Intervention Foundation, have adopted a broader definition that covers conception to early adulthood "because intervention is also about preventing adolescents and young adults from developing problems".
Early intervention as a policy approach took hold under the New Labour government of the late 1990s. A range of policy programmes, such as Sure Start children's centres, the Healthy Child Programme and the Early Years Foundation Stage, were introduced to tackle health, education and social problems earlier.
The government also created a ringfenced grant for councils to spend on early intervention services, worth £2.48bn annually by 2010.
When the Coalition government came to power in May 2010, it quickly implemented a 10 per cent cut in the early intervention grant for councils in 2011/12. It was the start of a gradual but enduring tapering off of early intervention funding from central government.
Analysis of data from the Department for Communities and Local Government shows that in 2017/18, real-terms government funding for council early intervention services was £1.1bn - a fall of 65 per cent from the 2010/11 level of £3.2bn. This is set to fall even further over the next two years (see graphics).
In Turning the Tide, published in November 2017, analysis by the National Children's Bureau, Action for Children and The Children's Society showed that by 2015/16, the proportion of children's services funding spent on early interventions had fallen to 25.7 per cent from 36 per cent in 2010/11.
Further analysis of section 251 "outturn" figures published by the Department for Education in late 2017 shows that local authority spending on Sure Start children's centres and early years services fell £670m between 2010/11 and 2015/16.
In 2010/11, councils spent £1.5bn on children's centres and early years, but by 2015/16 this had fallen to £844m - a reduction of 44 per cent. This saw the share of children's services budget spend on children's centres and early years drop from 15 to nine per cent in total.
The analysis, by consultants Aldaba, also reveals that spending on a host of other early help services has fallen from £2.5bn to £1.6bn over the same timescale. This includes support services for care leavers, child asylum seekers, young people and struggling families. Councils' projections of spending plans for 2017/18 suggests this downward trend will continue, with potentially dire consequences (see ADCS view).
The impact of funding cuts
The extent of the funding cuts has been seen most starkly in reductions to children's centres provision. CYP Now's own analysis found that between May 2010 and February 2017, nearly a third of all children's centres were closed or had downgraded in terms of the range of services offered. More recent analysis by the Labour Party based on Freedom of Information responses from councils found that the number of children's centres had fallen from 3,632 in June 2010 to 2,390 in April 2017.
The changes have taken place at a time when local early years and early child development services have been reorganised as a result of the transfer of responsibility for public health services for under-fives from the NHS to councils. This has seen local authorities undertake strategic reviews of their early years and child development offer, with many developing new organisation structures for delivering early help services.
Many areas have reduced their number of children's centres and turned those that remain into children and family hubs that focus more on targeting support at the most disadvantaged families instead of offering universal provision. The move to more targeted support has helped centres such as Hudson Children's Centre in Sefton to develop a support programme for parents with emerging mental health problems (see case study). This early help has seen the number of referrals to specialist mental health services fall significantly.
An issue exacerbating the problems is the lack of a clear government policy on the role of children's centres. A consultation on the future of children's centres - pledged in 2016 before the last election - is yet to happen, and Ofsted inspections have been suspended since early 2015. A parliamentary answer before Christmas by children and families minister Robert Goodwill suggested the government is wavering over its commitment to running a consultation.
"I am aware of the previous commitment made to consult on the future of children's centre services," said Goodwill. "However, we rightly want to take some time to gather evidence and consider what steps would be appropriate. Local councils continue to have a duty to ensure there are sufficient centres or other settings such as family hubs to meet local need and to consult where they plan to make changes to local provision."
It is not just children's centres that have been the victim of cuts. Council youth services have been significantly reduced, with universal provision being particularly badly affected. A standalone government policy statement on youth services was scrapped at the end of 2017, with this now being incorporated into a consultation on a wider civil society strategy.
Meanwhile, evidence gathered through the Turning the Tide report reveals that spending on a range of other early intervention children's services has fallen over the decade. This includes short breaks for disabled children, teenage pregnancy support and family advice services.
The Aldaba analysis of children's services spending shows that between 2010/11 and 2015/16, council spend on children in need and looked-after children rose by £400m and £150m respectively. This has coincided with record numbers of care applications being made and children being taken into care. Some have suggested the cuts to early help services and spending and rise in crisis interventions are linked.
Tony Hawkhead, chief executive of Action for Children, said: "Funding cuts have left local authorities with no option but to close early help services designed to spot signs of abuse and neglect, and move to a fire-fighting model."
Matthew Reed, chief executive of The Children's Society, added: "While more children are reaching crisis point, local authorities have found themselves less able to respond."
Turning the Tide shows that the gap between early and late spending grew from £2.1bn in 2010/11 to £4bn in 2015/16 (see graphic).
Policies post 2010
While central government funding for early intervention has fallen since 2010, a range of new early help programmes and initiatives have been created.
The Troubled Families programme
Launched in 2012, the Troubled Families programme was a flagship initiative of the Conservative and Liberal Democrat coalition government. An initial cash injection of £448m was given to councils to identify and then work with 120,000 of the most disadvantaged families in England. Councils created dedicated teams of troubled families workers to provide intensive support to workless families and those involved in crime, antisocial behaviour and whose children were persistently absent from school. A portion of the payments for working with families are linked to the outcomes achieved.
The government claimed that by March 2015, the lives of nearly all families that participated in phase one of the programme had been "turned around". But a 2016 evaluation by the National Institute of Economic and Social Research concluded that there was little evidence that the programme "had any significant or systemic impact" across most of the outcomes.
Despite this, the programme has been expanded to work with 400,000 families with a wider range of problems, including children with mental health problems who have been assessed as a "child in need" and living in families affected by domestic violence. The Department for Communities and Local Government (DCLG) has allocated £920m to the programme up to 2020. Early DCLG findings from phase two of the programme suggest the number of children in need among families involved in the initiative fell 13 per cent.
The expansion has seen the Troubled Families programme become an integral part of many council's early help offer.
Social mobility opportunity areas
Towards the end of 2017, the Department for Education published its social mobility national plan, Unlocking Talent, Fulfilling Potential. This sets out five core ambitions to boost the life chances of children in disadvantaged areas. This includes measures to improve literacy levels in pre-school children; teachers' skills in areas with lower academic attainment; post-16 technical education; closer partnerships with businesses; and a more even spread of career opportunities across the country.
The approach will initially be targeted at 12 deprived communities that the government hopes to turn into "opportunity areas". Each area has developed its own delivery plan with specific targets for improving attainment for children of all ages.
Improving Lives: Helping Workless Families
This Department for Work and Pensions policy document, published in May 2017, sets out a series of innovative objectives aimed at helping parents who experience worklessness and other disadvantages to improve outcomes and future life chances for their children.
A key focus of the policy is the importance placed on supporting and strengthening the quality of inter-parental relationships, whether parents are living together or not. It will draw on lessons from the DWP's Local Family Offer trial, which supported 12 areas to link parental conflict support into other local services for families. It is underpinned by research that shows children's emotional success is influenced by their parents' relationships.
The department is providing £30m to fund proven projects and train staff to identify the signs of conflict.
The Early Intervention Foundation
Launched in July 2013, the Early Intervention Foundation (EIF) is the brainchild of Labour MP Graham Allen. It is a charity and one of the government's "What Works Centres". Its work focuses on gathering evidence on early intervention and providing advice for tackling the root causes of social problems for children.
It has established a network of local places to implement early intervention approaches across a range of services and providers, including health, education and police bodies, reflecting the growing multi-agency nature of early help work (see expert view). It has provided local places with access to the latest evidence and/or potentially effective practice, and opportunities to share experiences with areas facing similar challenges.
There is little sign of extra government funding for early intervention being forthcoming. However, there is growing urgency to find ways to reduce the number of children coming into the children's social care system. Joining these two things up in a strategically coherent way is the challenge for policymakers.
ADCS View: We must all sign up to early help vision
By Alison Michalska, ADCS president and DCS at Nottingham City Council
Meeting rising levels of need against a backdrop of falling budgets is an ongoing challenge for local authorities. As resources continue to diminish, the need to rethink how we can work with partners and communities to support children and families becomes more pressing.
In 2008, Nottingham City Council endorsed a 20-year vision to give children the best start in life and shift outcomes for residents of all ages via early intervention.
One example of our efforts to try to break intergenerational cycles of under-achievement and deprivation is the network of locality hubs across the city. Our hubs bring together schools, health, children's centres, youth and play services, family support workers and social workers to build capacity in families and communities by encouraging them to look after each other. They are the cornerstone of our efforts to manage demand in children's social care, which has remained steady in recent years.
The benefits of well targeted early years programmes in improving progress and achievement at school are widely known and underline the need for investment earlier in a child's life.
Children's services leaders need to work with partners in health, police and education to offer help and support to children and their families earlier and in a way that empowers them. However, we cannot do this while we are spending our limited resources on acute interventions too late in a child's life. We cannot tip the balance without bringing together our combined expertise, capacity and resources with the strength of communities.
A proactive, truly multi-agency approach to early intervention via family support and high-quality education for all children will improve resilience and, if effective, reduce the need for higher cost, more intrusive interventions.
Financial pressures in other public agencies, especially the NHS, police and education, are all taking their toll on our communities. More and more families are reliant on food banks, yet Brexit is taking up much of the focus in government and among the general public. Not enough attention or resources are being prioritised on preventing these or other issues that children and young people face from escalating further.
There is a clear and urgent need to do things differently and this must start with all relevant government departments reaffirming their commitment to building a country that works for all children and young people.
Providing help and support earlier is the only way to reduce demand for high-end statutory services and health and social care in the long run.
EIF View: Better evidence vital on what works best
By Donna Molloy, director of dissemination, Early Intervention Foundation
Improving support for vulnerable children and families is a multi-agency responsibility, and we need to understand which are the most effective multi-agency systems. Greater integration of services has long been seen as a solution to the challenge of rising demand and shrinking budgets.
This kind of "whole-system thinking" is relevant to the provision of early help services aimed at reducing vulnerability. No single agency can deal with vulnerable individuals and communities alone. Schools, health professionals, police and other frontline public services all have a role to play. Building a local system to identify and provide support to vulnerable children and young people might allow us to spot emerging problems sooner, increase the likelihood that a person is able to access the right support more easily, and reduce the risk that they are simply "passed around" from agency to agency.
However, recent work by the EIF highlights the dearth of evidence about the impact of multi-agency integrated systems for vulnerable young people. We know very little about whether integrated models are more effective than other models of delivering services or if some models work better than others. The evidence that exists is often qualitative, involving staff or service-user perceptions.
Many systems currently being delivered and developed are not well evaluated. EIF's survey of 28 integrated children's early help systems across England found 11 were evaluating their systems, and just four said that their evaluations were showing improvements.
Evaluation is increasingly crucial for integrated early help systems because, despite a general consensus that multi-agency working and greater integration is a good thing for professional relationships, efficiency and effectiveness, there remains limited evidence that greater integration improves outcomes for children and families. There is also a lack of clarity about the essential components of multi-agency working, and how much integration is necessary to make a positive difference for children and families.
Multi-agency systems are set to play an increasingly large part in early help delivery, and if they are to be successful in achieving positive impact on people's lives, more support for evaluation at the local level is needed.
- Unlocking Talent, Fulfilling Potential, Department for Education, December 2017
- Turning the Tide report, NCB, The Children's Society, Action for Children, November 2017
- Improving Lives, Helping Families, Department for Work and Pensions, April 2017
- National evaluation of the Troubled Families programme 2012-15, Department for Communities and Local Government, October 2016
- Early Intervention: the next steps, Graham Allen for the Cabinet Office, January 2011