Public Services Committee
Uncorrected oral evidence: The role of public services in addressing child vulnerability
Wednesday 7 July 2021
Members present: Baroness Armstrong of Hill Top (The Chair); Lord Bichard; Lord Bourne of Aberystwyth; Lord Davies of Gower; Lord Filkin; Lord Hunt of Kings Heath; Baroness Pinnock; Baroness Pitkeathley; Baroness Tyler of Enfield; Baroness Wyld; Lord Young of Cookham.
Evidence Session No. 21 Virtual Proceeding Questions 146 - 150
I: Lee Golze, Assistant Director of Partnerships, Early Intervention and Localities, Doncaster Council; Dame Janet Trotter OBE DBE CVO, Gloucestershire Child Friendly Coalition; Andy Dempsey, Director of Partnerships and Strategy, Gloucestershire County Council; Karen Davison, Strategic Manager for Early Help, Durham County Council.
USE OF THE TRANSCRIPT
Lee Golze, Dame Janet Trotter, Andy Dempsey and Karen Davison.
The Chair: I welcome the witnesses to our next session. In this session we are looking particularly at local evidence and experience, and we are very pleased to have with us people from around England who are able to talk to us about the experience in their area. Our witnesses are Lee Golze from Doncaster, Dame Janet Trotter from Gloucestershire, Andy Dempsey from Gloucestershire, and Karen Davison from my home county of Durham. Welcome to all of you. Perhaps the witnesses would introduce themselves the first time they answer a question. The first questioner is Lord Filkin.
Q146 Lord Filkin: I welcome the four witnesses. We are looking forward to hearing from you. You have been described as people who to some extent have managed to overcome the many problems that we have heard inhibit effective early action for vulnerable children, such as siloed working in both central government and local government, poor co‑ordination by central government, lack of integration locally and data-sharing problems. I am sure you can add to the list, but those have been common themes.
We are very keen to hear whether you think you have overcome some of those problems and, if so, how. Later on, if there is time, I might come on to what you think could be done by central government to help others to do so. Maybe you could focus first on your own learning and evidence about overcoming such problems. Given that there are four of you, I will rattle through the list. I suggest that Dame Janet and Andy Dempsey do a double act, if they could bear it, because both are from Gloucestershire. Let us start with Lee Golze.
Lee Golze: Thank you for the invite. I am the assistant director for children’s services at Doncaster Council. I have a remit that includes a wide early help partnership offer and family hubs.
Lord Filkin: Would you care to address the question of what you have done that you think overcomes some of the problems and effectively addressing them?
Lee Golze: In Doncaster, we have 12 family hubs that we migrated from a number of Sure Start centres. We have retained a really strong family hub offer in Doncaster, which I think is a starting point. We have 12 with a significant budget that we work towards. I will identify perhaps two or three of the challenges. The first is about data-sharing agreement. I acknowledge that, while we have made some very good progress on that, some challenges still arise.
One of our benefits in Doncaster from the early help point of view is that partners from the local authority and our health colleagues use the same data system. The inputting of data happens through one early help module. That makes the sharing of information easier. It is all in one place, and colleagues across the partnership find it easier to access; and we have a robust data-sharing agreement that sits underneath it. That was a challenge. There are still some parts of it we would like to improve, but from the point of view of early years, early health, health visiting and midwifery, they are all inputting via that one system.
We also have a robust 1,001 days pilot where we brought together key services. For example, in one collocated integrated team there is a single line management structure, but it also reports back to its home team. We have family hub managers, midwifery, early help workers and health visitors. For want of a better term, they are a one-stop shop to support families pre-birth to 1,001 days. The emerging findings from the pilot are proving really positive. That is on data-sharing agreement. Shall I pause there?
Lord Filkin: Fine. There is a lot for us to explore. Maybe I can bring in Dame Janet from Gloucestershire. Dame Janet, to what extent do you think you have been able to overcome some of the problems and are getting better impact?
Dame Janet Trotter: Perhaps I can begin by saying that I do not want to claim too much, because we are in the foothills of all this. The child friendly coalition began when Gloucestershire had two poor Ofsted reports in different parts of the county, and there was a genuine desire to make change. I was asked whether I would chair a review.
The things that Dame Andrea came up with this afternoon were very much what we found: lack of co‑ordination of services; lack of involvement of the voluntary and charitable sector; the perspectives of young people were not fed into the debates when their services were looked at, and so on. The coalition developed from that sort of analysis of what was going on, and how people were finding the services. Most particularly, we had some really disturbing conversations with parents and young people about how they received and accessed some of the services.
The coalition, which took some time to develop, has statutory services, faith services, voluntary, charitable and business organisations, and it has had those from day one. It seems to me that that is very important. We accept that there is parity of esteem between all of them. There is no great hierarchy of organisations. We want to take the best from all those organisations in taking forward services for young children.
The coalition reports to the health and well-being board, which is another key issue because that board includes the main leaders for Gloucester and gives us a kind of mandate for moving forth. It has an independent chair, which is also novel and enables no one to be in any one camp or to own anything too much. I am supposed to be independent and seeing the best for everybody.
One of the things that is different about the coalition is that it really inverted the whole system. Whenever I look at a project that comes to us, I ask what young people are saying. How will young people be involved? How will it make things better for young people? We then build up the services from that. There are two things in the county that I will talk about later that help us to do that, to capture the young person’s voice and have a genuine dialogue with young people and seek to co‑create with them some of the services they think are important.
Lord Filkin: You are touching on several themes dear to our hearts. If time is limited, as it may be, it would be good to get a note from you about those. Can I turn to Andy Dempsey to speak for the local authority in Gloucestershire on the extent to which you think you are overcoming some of the factors that have inhibited effective early intervention?
Andy Dempsey: I do not know that I have a great deal to add at this stage, Lord Filkin. Janet has picked up on the points we needed to address in Gloucestershire. I think creating parity of esteem across the strategic partnership was the key to change in Gloucestershire, with the faith and voluntary sectors having a meaningful stake in the narrative.
From a local authority perspective on developing the coalition, multiagency coalitions themselves do not translate into multiagency practice. The key thing we have been able to do is establish a mandate to explore what business processes and infrastructure are needed to translate the strategic multiagency commitment into the sort of prosaic, clear business processes on the ground that translate into good outcomes for children and young people.
Listening to the debate this afternoon, as a DCS who has worked in a number of areas, and now in Gloucestershire, I would say that we pay insufficient attention to the layer between a strategic mandate and imperative and the business processes and the alignment and coherence of activity on the ground. That is all I would say. I agree with Dame Janet that it is very early days for us. It has taken 18 months to get to this point, to build the necessary trust and confidence across sectors to work in the way we want to work going forward.
Lord Filkin: Those are very important and different points. My very best wishes to you as you go forward.
Could I turn to Karen Davison from Durham? Karen, give us your perspective on the extent to which you think you have been able to overcome some of the inhibitors to effective early intervention.
Karen Davison: I think some of my colleagues have probably articulated a lot of the things I was going to discuss, but on a very practical level we have found that, when you are working across different organisations and services, it is a real challenge to understand each other’s culture and language. On the ground, you have to bring those organisations together and build up effective relationships, to make sure that we are talking the same language and that we understand each other’s culture, and each other’s thresholds and pathways. Until you do that, it is very hard to start developing integrated working arrangements. Understanding what we mean by early help and early intervention is a starting point. It means different things for different organisations. Having effective conversations has been really critical.
To help us do that, we have what we call the Durham way. We work right across lots of different services across County Durham. We make sure that we bring new staff to an induction session, which describes all our work, and all our interventions and resources, and helps to promote what we understand as whole-family outcome-focused work on the ground. It helps staff across adult services, criminal justice services and children’s services to understand each other’s roles and how those services bring in early help and access it from a single point. A key role for us in County Durham is to make sure that we all understand how to get early help, and what our services contribute to the early help agenda.
Lord Filkin: Thank you very much. Could I ask each of you to give a fairly crisp answer as to what you think central government could do to help localities better address the issues we are talking about? What can central government do—apart from more money, because that is too easy a question?
Lee Golze: It is a difficult question in some ways. Resources would have been my go-to answer, because they are still paramount. We need to keep an emphasis on the value and the importance of early intervention work and prevention work. I would suggest also a little bit of patience because, as we all know, evidence of outcomes from early intervention and prevention takes time, and certainly over the last 18 months that has felt a bit of a challenge. I guess my request would be that there remains a long-term commitment to it.
Lord Filkin: That is very clear. Dame Janet, do you have a couple of asks where you think central government could make a big difference?
Dame Janet Trotter: I have one ask, and that is not to have too prescriptive an outcome as to what to see on the ground. At the moment, in Gloucestershire, we have some really good local arrangements bubbling along. It seems to me that it is about providing local solutions that are right for a locality. For example, the Forest of Dean has very different travel accessibility and so on, and may need a different model from Gloucester city. There needs to be some prescription, but not too much, to allow local people to sort out how things might work with their community.
Lord Filkin: Thank you very much. Andy Dempsey, is there anything you would like to add?
Andy Dempsey: A very clear thing: if we acknowledge Working Together in 2018 as articulating a framework within which local agencies and actors deliver safeguarding responsibilities for children, why is there no similar articulation of the expectations of local agencies to deliver Section 10, which is our well-being duty? Without being prescriptive, I think the absence of that suggests lack of commitment—Lee has spoken to that—and lack of clarity, where some agencies are unclear, and in some cases unwilling, to acknowledge their role in promoting the well-being of all children, from pre-birth to 18, or 25 in some cases. Filling that gap and providing a framework to support the local solutions Janet is talking about would be most welcome.
Lord Filkin: Thank you very much. Karen, you have the last word.
Karen Davison: I definitely echo what Andy has just described. Having a shared outcome and inspection framework right across this particular agenda is critical. On the funding part, it is about sustainable funding—funding that is not year to year, or three year to three year. That is really important for local organisations to develop their services locally.
Lord Filkin: You cleverly got in funding at the end. Well done. Thank you all very much indeed.
Q147 The Chair: We have heard evidence, and we have seen, that what has been happening across the country is very much that the concentration has been on emergency crisis services, and, with the reduction in funding, that has pulled funding away from the well-being responsibilities that you were talking about, Andy, and certainly from the early intervention work, where the idea was always that it would reduce the amount of money spent on crisis work. Josh McAlister told us last week that the finance for non-statutory family help services had decreased by 35% since 2012, whereas the spend on statutory and high-need crisis intervention had increased by 26% over the same period.
Could you say something about your experiences, and whether and how, if you have been able to, you have protected early intervention services? Who will go first? Karen, I am going to the one I know a bit about.
Karen Davison: You do. I would definitely say that the Supporting Families programme has helped to drive our early help agenda in County Durham. It has recognised that to provide effective early help is a partnership and it is a system; it is not just a local authority responsibility. We have definitely invested in creating a very flexible and responsive workforce that responds to the needs of all children and families. We have talked a lot about early years today, but early intervention is also about intervening early at any age. Our family centres are for families with all-age children, because we know that problems arise later on with children.
By having that joint outcome framework for the early help system, we can demonstrate the impact of our work with children and families. We can demonstrate that we are reducing the number of children who are being looked after, and reducing the number of children who need a child protection plan, through really effective intensive family support in the early intervention space. It is really important that we are able to use that framework to demonstrate the “So what?” question. We are doing all sorts of different interventions: what difference does it make, for example, in getting children back into school, with good attendance, et cetera?
The Chair: Thank you, Karen. Let us go to Gloucestershire next, and Andy.
Andy Dempsey: I will build on what was said and follow up on the conversation earlier in the meeting. Some of this shift is driven by risk aversion in the system, and certainly as an authority, in intervention, that drives our partners and the system to become more risk-averse. It is not only about the totality of funding. It is about the behaviours and motivation of all actors in the system, and risk is a further component. The problem is that you start to see a greater number of children in the high-intensity high-cost part of the system—remember that this is not only social care; it is about education, health and care plan growth—with more children in tier 3 and tier 4 mental health settings and provision.
A corollary to that, and what the committee is exploring, is that it requires a whole-system response. It is not one agency pivoting from high end to early intervention. I agree about the distinction between early years as a sector and place, and early intervention across all ages. It is a difficult ask. It is about having collective discussions about risk. It is about acknowledging the problem that there will never be enough social workers if you carry on down this route, and that outcomes for children are not good.
Josh McAlister’s review highlights the lack of capacity in the system for accommodation and familial settings for children who come into care having its own compounding effect. There is a lot going on. It is not only about resources. It is about the interdependencies and interconnections. Perhaps I could give a local example. Our education, health and care plan growth is being driven in part by children who do not have a diagnosis and are unlikely to obtain one, which suggests to me that we missed an opportunity for earlier intervention that might have dealt with that before they got locked into an education, health and care plan that might not be the best solution to their needs, had we intervened earlier. That is not a solution, it is more a diagnosis, but I hope it is helpful.
The Chair: That is fine, and very helpful. Thank you, Andy. Dame Janet? I think we have lost Dame Janet for the moment. Lee, let us hear what Doncaster has to say on this.
Lee Golze: I echo what both colleagues have said, and add that the real challenge for us is to make sure that we provide support to children and families as early as possible, and before young people and children end up in higher levels, tier 3 or tier 4, be that an acute setting, social care or mental health. We need to get more of those young people and children seen lower down, which would reduce the number, in theory, in the higher levels of need.
From Doncaster’s point of view, we have a really strong commitment to early intervention and prevention with our DCS and politically. We have had that commitment over the last two or three years across the wider partnership. We have made significant investment. Throughout the last 18 months, we have invested a significant amount of money in early intervention services in particular, putting in family lead practitioners, who are predominantly able to support our educational settings in supporting children and families early, and any step-downs from social care. That is proving to have been a good decision. We know that some of our colleagues in education have had a really challenging year and are not always able to fulfil the lead practitioner role, for no other reason than the fact that they are absolutely snowed under.
The other bit for us is that we cannot afford not to invest in early intervention and prevention services. Our acute services are just going to buckle; their numbers are high, and the resources are not there. Not only do we have a moral obligation; economically, it is something we absolutely have to do. I am lucky that some of our senior executives share that opinion.
The Chair: You are. Very good. Can I come now to Dame Janet?
Dame Janet Trotter: There are two work programmes that we are involved in at the moment. One is related to early years—pre-birth to five years. What we have done there, quite clearly and importantly, is involve the faith communities, toddler groups and so on. We have gone beyond the statutory services to engage them in taking forward the work that we jointly want to do.
The other programme is related to mental health. There, we are deliberately drawing in the community and voluntary agencies, social prescribing and so on, to look at early interventions on people’s mental health, so that young people are not escalated when there are other solutions.
The Chair: Thank you. Could those of you from Gloucestershire say whether you think the child friendly coalition has reduced the pressures on statutory services, or whether the pressures are still there and you are just using money in a slightly different way?
Andy Dempsey: I think it is too early to say. What I would say with some confidence is that already the focus of the coalition has shifted away from the high-intensity high-end parts of the system that Lee and colleagues have alluded to. We will need them. There will be children, as colleagues have said, who will need those services, but already the conversation is more of an asset-based conversation about what we know about the broader group of children and families and young people, and how we engage them.
The example Janet gave is really powerful. Beyond our two, three and four year-old educational offer, there is a whole range of non-regulated parent and toddler groups in the county doing really good work. We have been able to extend the quality offer and the developmental and early years pedagogy into that space, in an entirely conversational and supported way. I would expect to see children then entering the two, three and four year-old offer better prepared and further on in their levels of development, which will, over time, translate into the system. That is the approach we are trying to follow across each of the domains of practice.
We are finding that we are having to do a lot of work to rewire the system. Without sounding pretentious, we have found that the power of the coalition is the meta narrative. What is the story of all these stories, and do they cohere into some purposeful activity? We are at a very early stage, so we cannot claim obvious impact at this stage, but the green shoots look promising.
The Chair: Good. Thank you. Karen, could you tell us a little bit about what you think the earned autonomy area and the Supporting Families programme have meant? The Early Intervention Foundation is worried that the evaluation of the Supporting Families programme is undermined by its lack of integration with social care, justice services and the NHS. Now that you have earned autonomy, are you able to handle that?
Karen Davison: All earned autonomy does for a local authority is allow us to have up-front funding. Other members might come in on that as well. We have to demonstrate our impact on children and families— absolutely we do—but we get the money up front. That helps us to plan better and develop our services in a much more planned way than the PbR—payment by results—method, which is not a great method for planning and developing effective early intervention services. It is too short term.
The Chair: As you can imagine, I would love to ask you loads more, but I need to make sure that other people get their chance.
Lee, I want to come to you about family hubs. We are really interested in family hubs. We want to know if you have evaluated yet, or you feel you really know, the contribution that family hubs in Doncaster are making to early intervention and prevention.
Lee Golze: The short answer is, in large part, yes, and we know that because we use a well-defined, continuous improvement cycle, which has four particular areas of focus. One is quality. That will include audits, supervision and assurance visits. The one that is really important to us is engagement with children and families, which is lived experience, voice and what children and families are telling us. We do evaluations through relationships and through conversations. We pride ourselves on the fact that we immediately try to respond to that feedback, and that helps to shape services moving forward. That works quite well.
We are really robust in our self-evaluation framework, with lots of self-evaluation and lots of learning. It is all underpinned by a robust performance framework. We have a valid and reliable dataset that we have been using for about two to three years. That gives us confidence, along with the other key areas, about outputs and outcomes. That is not to say that we are absolutely assured by all that, but we are delighted that we have just been successful at the two-year evaluation with the evaluation innovation fund. That was DfE funded and will bring external partners in to evaluate family hub service effectiveness, the outcomes and impacts, and value for money. We are really excited by that.
The Chair: Thank you. I am aware that I have taken more time than I was allocated and it is not good for the Chair to do that. We will move to the next questioner, and that is Lord Hunt.
Q148 Lord Hunt of Kings Heath: It has been a fascinating session and we are learning an awful lot. I want to relate the experience we have had. We have had a series of focus groups with children and families on their experience across a range of services. They have been fascinating but, at times, harrowing. An impression we have gained is that sometimes statutory services can be pretty unfriendly, and doors can be closed, whereas when people have come to the voluntary sector they found it much more accessible and open.
Could you reflect on that? To what extent do you think the statutory bodies could learn more from the way voluntary sector organisations work, or will the very fact of the rationing by statutory services always be a bar to the kind of accessibility that we want to see? Karen, could I come to you first?
Karen Davison: The way we work with children and families is absolutely imperative. The work of the Supporting Families programme has helped us to really understand how we need to be kind but firm sometimes. We need to listen instead of talking to families. We need to work with them and not to them. We need absolutely to listen to their lived experience. Very often, they tell us they have had poor experience of statutory services before. We need to ensure that we stop and listen to their experiences.
The other thing about the voluntary community sector in Durham, as Baroness Armstrong knows, is that we are a very large and diverse county, so our VCS partners can be very small organisations or they can be quite large. Working with a locality approach is really important. We know families want to access services in their local community. They want to access them locally. They trust their voluntary and community sector organisations.
We have done some work to bridge the gap and build trust between the voluntary and community sector and statutory services. A few years ago, we employed a number of staff to be a conduit or bridge between our local VCS organisations and, specifically, children’s services and our partners, such as health visitors, because we realised that we were not utilising the assets we had in communities. Talking with children and families, they wanted to access local voluntary and community sector services, but we were not using them very effectively.
Employing some staff to help to be that bridge has been highly effective for us. Now, for every family and child who comes into early help or requests early help, we always consider whether the family or the community can help first, before we think about offering statutory services, because we have built such a good relationship with our VCS organisations, and we understand them much better than we did a few years ago.
Lord Hunt of Kings Heath: Thank you. Lee, what is your experience in Doncaster?
Lee Golze: It is not dissimilar to Karen’s. I echo the fact that, generally, children and families are very keen to work with voluntary organisations. Within our family hubs, they form part of our core offer. They come under the umbrella of the family hubs. We do not necessarily distinguish between them and the other services there. They offer a range of things. During the lockdowns, we could not have managed without the large number of charities and organisations that provided support for families through clothing and food banks. It has been crucial.
We are trying to drive through more asset-based community developments, so that we are community facing. The first port of call is not that we bring them into a local authority or health service. We use community diamonds, and we use local resources, to provide the first level of support.
Lord Hunt of Kings Heath: Thank you very much. Coming to Gloucester, would Andy like to have a go first?
Andy Dempsey: I agree with Lee and Karen. I will not repeat what they said other than to attest that I certainly recognise it.
Coming back to the points about the negative view families sometimes have of statutory services, it may reflect the tendency we have to view the child or family through particular lenses. One day they are a pupil. The next day they are an anti-social behaviour perpetrator. The next day they are a potential young offender. The next day they are in need of early help. We lose sight of the fact that it is the same child or the same family; we are just changing the lens. We have noticed that. I agree with everything colleagues have said. I think there is a challenge for the statutory agencies.
My second point is that voluntary sector organisations have been pivotal during Covid, but in many cases they are commissioned by us as part of a holistic offer, and they are often the best intermediary with families, although behind and alongside them will necessarily be statutory services. I agree with what colleagues have said.
Lord Hunt of Kings Heath: Listening to you, there is strong consensus about the role and value that voluntary sector organisations can bring, and yet, the experience, I think, of many people is that that is not being used throughout the country. Perhaps, Dame Janet, I could come to you first. If we had to make one recommendation on the involvement of the voluntary sector, what could we say that would actually cause statutory bodies to reflect hard on the experience of the public who come to them and find in many ways a kind of unsympathetic, rather bureaucratic approach? What is the magic bullet, if you like, that we might be able to press on this?
Dame Janet Trotter: For me, it has something to do with the phrase that we use: parity of esteem. I do not think there is a hierarchy of professionalism in this particular world. I suspect that the voluntary sector is really misunderstood at the moment; there are some voluntary organisations that are sports clubs and so on, running small budgets, very often with no paid staff at all, and then there are other charities that are highly professional and doing some of the work that the statutory services used to do.
I chair a charity called the Nelson Trust, which looks after people who have suffered domestic abuse. My chief exec was in a room with social workers, and the social workers said, “We can’t possibly use volunteers”, not realising that he was much more qualified than some of the social workers there. I think there has to be greater understanding between the different sectors. We have to redefine who a professional is. For me, young children who have lived experience have a sort of credibility and professionalism themselves. They might not have been trained, but they have a right to be at the party. Other voluntary agencies have a right to be at the party and to be treated with respect, and as though they have something real to contribute. That would be my one plea.
Lord Hunt of Kings Heath: Thank you very much. Lee, what are your thoughts?
Lee Golze: Apologies, my screen froze. Can you repeat the question?
Lord Hunt of Kings Heath: We have had a fantastic exposition, and we have seen in the evidence we have received the way in which voluntary organisations, at their best, can provide much more sympathetic and often more accessible services. The key question for the committee, given that that is not uniform practice, is what recommendation we could make that would galvanise statutory agencies up and down the country to really recognise it, and to see what an asset voluntary organisations could be.
Lee Golze: The first bit for those of us who work in public statutory services is to have courage, and to have belief that our voluntary and community sector and faith-based organisations can actually do a really good job, and in some cases a much better job. Good examples of how that can be done are the Government’s recent holiday activities and food grants. There was a stipulation in them that the commissioners, in this case local authorities, should commission voluntary and community and faith sector organisations, with the aim of building sustainability, and helping to prop them up after the pandemic, and to allow them to form relationships with sometimes bigger VCS organisations and local authorities, to start to build sustainability and confidence in the system. I think that is a really good example.
Lord Hunt of Kings Heath: Karen, do you have anything to add?
Karen Davison: Certainly our holiday activities and food programmes would not go ahead without our fantastic VCS colleagues. They know their children and they know their communities. The other thing to add to what Lee said is that we have to remember that most of the voluntary and community sector organisations are local people who know their communities very well, and know the needs of those local communities.
Lord Hunt of Kings Heath: Thank you.
The Chair: We now come to Baroness Pinnock.
Q149 Baroness Pinnock: It has been a fascinating afternoon. Many thanks to the panel for such a powerful case about what is going on locally. I ought at this point to say that I am also a councillor in Kirklees, not far from where you are, Lee, in Doncaster.
We have talked a lot about how you have integrated services locally, but in a previous panel the Department for Education told us that there was no integrated government strategy on vulnerable children, and nationally it is much as you have described locally. If such a strategy were put in place, what would be your priorities, at both the national and the local level?
We heard earlier from Dame Andrea Leadsom about the review that she has done. Do you agree with the findings of the Leadsom review about family hubs? There is a lot there. I will start with Lee, because I am going to ask him an add-on question. To what extent have family hubs in Doncaster built on the earlier children’s centres and Sure Start? What is the difference?
Lee Golze: I will try to answer the broader question to start with, but leave space for my colleagues to come in on the back of it, mainly because it is a more challenging question than the second.
As regards an integrated strategy on vulnerabilities, clearly for me, as an assistant director with a focus on early health partnerships, the approach has to be around a focus on early years provision and early help. As I mentioned before, I am not sure that our acute services will be able to withstand it if we do not get that right. In Doncaster, that is it from a priority point of view.
On vulnerabilities, we have certainly seen that, generally, where children are living in households with existing vulnerabilities, the last 15 to 18 months have exacerbated them, particularly around domestic abuse, where there has been an exponential increase. It is the same with children’s well-being and mental health, and that has manifested itself at times with acute periods of crisis and A&E attendances. I will pause there on that.
As to the extent that Doncaster has built on Sure Start and children’s centres, we have 12 in Doncaster. They are a nought-to-19 or nought-to-24 SEND offer. They differ in that sense, because the universal offer is nought to five. It is very much support, as Dame Andrea said, for mental health, breastfeeding and midwifery, parental support and health visiting. We have a robust offer, and it works really well in each of the hubs. We also have a universal-plus service for age five and above, which includes services such as support for families that may have debt, for example, or housing issues, and certainly support for children’s mental health and well-being, so there is a broader offer.
The term we use in Doncaster for our family hubs is that they are the go-to place for children and families. Children and families can just walk in. There are no referral criteria. You do not have to meet a level of need or a threshold. They are places for people to go for support and advice, or just to access information.
Baroness Pinnock: Thank you very much. That is very helpful. Dame Janet, could you give us your views about the broader picture?
Dame Janet Trotter: I will have a go, but I do not think it will be complete. Andy will have to say something about family hubs.
I think there is a need for a change in culture. You can tinker with all sorts of systems, but it is still the same people trying to go forward. I would argue that there probably needs to be a change, or a training programme or something, in leadership on cross-sectoral working and working with civil society, because if the same leaders are there I do not think anything is going to change quickly.
Commissioning needs to be reviewed to ensure that it is helpful. I would probably build things into the commissioning process that required people to work in partnership, particularly with civil society, however we might envisage that, and certainly with the voluntary and faith communities, because they have so much to offer. Going into the future, I think we need the envisioning of community development to support its young people rather than just being atomistic.
Baroness Pinnock: Thank you very much indeed. Can I move to you, Andy, to say a bit about the family hubs that you have in Gloucestershire, and how that will work out?
Andy Dempsey: Our family hub approach is centred on our children and family centres, rather as Lee articulated. I would make a couple of additions. Ours are commissioned through two national charitable providers. What that highlighted during Covid was how little control we had locally over how they responded, so decisions were taken at a national level that impacted on local provision, and we had to reorder that.
The other thing to say about hubs is that we are developing a concept called Team Around the Locality, because we recognise that hubs can emerge in different places. Schools have done a magnificent job during Covid, and their appetite to enter into partnership on issues such as vulnerability and emerging problems with more vulnerable pupils and families has really re-energised that.
We are in the process of recommissioning our children’s and family centres. It is likely that we will have a family hub built on children’s centres, largely following the model we have been discussing, supplemented by Team Around the Locality approaches, where we have agencies clustered around schools to different levels of intensity.
A final point is that I was really interested in the debate on vulnerability. Five or six years ago, when I was in St Helens, we came up with the concept of the St Helens 100. I was the DCS then, and I said to agencies, “Do we know the 100 most vulnerable/complex children in the county?” What that highlighted was that we did not have the business processes across health, social care and criminal justice to know who those children were, let alone plan in a more preventive and co-ordinated way. I think we are relearning some of those lessons and, through Child Friendly, we have developed a particular process called the Resolution group, which is starting to put business processes and mechanisms in place. That is another aspect of the work we are doing.
Baroness Pinnock: Karen, it is your turn. We have heard from Andy that one of the missing links from the national perspective is that too many decisions are taken centrally, and there is a bit of a barrier in the way of local decisions and activity. Could you say a bit about what your asks would be from central government on a coherent co-ordinated strategy for vulnerable children?
Karen Davison: There is certainly a place for one, that is for sure, and I agree that we are best placed to understand who our most vulnerable children and communities are. Like the others, we have rebranded what were Sure Start children’s centres into nought-to-19 family centres, because we recognise that families have all-age children and problems can start at any age. We want them to be able to walk through the door and ask for help, or we might signpost them to a local community and voluntary sector organisation, or peer support group for the young person.
The holiday activities and food programme is another really good example. Yes, it is absolutely from central government focused on free school meals, but I think we are better placed to understand who our vulnerable children are. Some of them are not accessing free school meals. Leave us with some of the decisions and trust us to make the right choices and decisions about how we deliver those services to our most vulnerable children.
Baroness Pinnock: That is very helpful. Thank you for all those answers.
Q150 The Chair: I want to be a bit of a devil’s advocate. You have all talked about how important your offering is from family hubs or children’s centres, whatever you want to call them—I do not care about the name. My experience in all the Sure Start stuff was that yes, it needed to be universal, but unless there were methods whereby you targeted the most vulnerable, they were the ones who did not turn up, and the ones who did not return. In response, we developed what we then called progressive universalism. How have you overcome it?
We know it is true of all universal services that the people who are most in need are the least likely to access them at the time they absolutely should be accessing them and, therefore, often are the ones who come in when things have got a bit too bad. Can I very quickly ask if you are dealing with that in your own area? I will start with you, Lee.
Lee Golze: Yes, I will be as quick as I can. We are very much, as my colleagues said, developing a local solutions approach. The key for us is that we have relationships across professionals that are conversational, and we do it in place—for example, the pastoral support in a school is aware of a family and will have conversations with our family hubs and health colleagues. We really try to close the loops so that nobody falls between the gaps. It comes back to Andy’s really good point; we have a similar process in each of our four key localities on who are our top 20 vulnerable families and how we are proactively targeting support to them.
The Chair: And Gloucestershire? I do not mind who answers from Gloucestershire.
Andy Dempsey: Alongside the family-based approach Lee is speaking to, Chair, you have to mind the numbers. Let us say you have a 70% take-up of your two year-old educational offer. Who are the other 30%, who knows about them, and how are we engaging them? You match your knowledge of families with what your data is telling you about the shortfall and then you target engagement. Who is best to engage the family? We found that a good proportion of our children not taking up the two year-old offer were known to social care, so we mobilised social workers to say, “Let’s work with families, and promote that offer, and let’s get them engaged”.
The Chair: Thank you. Karen.
Karen Davison: It is at both ends. How do we ensure that the family hub, whether virtual or an actual building, is accessible, and that there is a universal offer, but at the same time we are able to deliver targeted and specialist support when it is needed? I think that is the crunch. How do we make sure that we are not stigmatising families that might be seen, as Angela Leadsom described, as troubled or resistant to offers of support, and services are not full of our well-educated parents who could seek support elsewhere from the community and voluntary sector, or local playgroups, et cetera?
We have to balance some of the work, making sure that there is a good universal offer, but that we have integrated pathways with our colleagues, such as health visitors and midwives, so that we can identify and target those who need additional support in and through the centres, and that where families are able and educated they receive support from within their own community.
The Chair: Thank you all very much indeed. It has been very good to hear some local examples of how you are dealing with things in the different localities. We really appreciate your giving up your time this afternoon. As I said to the earlier panel, if there is anything that you think we have missed, or anything else that you would like to let us know about, please do not hesitate to send us your ideas, or your experiences, whatever you think would be useful to us. We will be conducting this inquiry until September/October, so we have plenty of time to read anything else you have to send us. Thank you very much indeed.