ICS0028

Written evidence submitted by National Children’s Bureau

The National Children’s Bureau (NCB) is a leading charity that champions the rights of children and young people. We bring people and organisations together to drive change in society and deliver a better childhood for the UK. We interrogate policy, uncover evidence and develop better ways of supporting children and families.

The health of babies, children and young people is one of NCB’s key priority areas. NCB runs the Children and Young People’s Health Policy Influencing Group (HPIG), a coalition of over 70 leading voluntary organisations, Royal Colleges and professional associations engaging in advocacy, research, practice development and service delivery to improve babies, children and young people’s health.

HPIG’s work on the Health and Care Act

HPIG played a crucial role in ensuring that children would be at the heart of the new Integrated Care Systems (ICS), advocating for children throughout the parliamentary process and spearheading the efforts that saw a number of important amendments made to the Health and Care Act, ensuring children’s needs would be met in the new system. These included:

ICBs will now be required by the Act to set out the steps it will take to address the needs of children and young people under the age of 25 in their five-year forward plans. Children and young people are one of only two groups singled out by the primary legislation in this way.

Statutory guidance, being produced by NHS England, will require ICBs to nominate an executive children’s lead, responsible for ensuring the ICB sets out clearly the steps it will take to address the needs of those aged 0-25.

ICBs will also be required to report annually on how well they are delivering their duty to safeguard children. This is one of the single most important responsibilities that they hold and it will have to be delegated to an executive lead.

Recognising serious and distinct challenges with sharing relevant information about children, the government committed to laying a report before Parliament setting out its policy regarding improvements to multi-agecny information sharing and the introduction of a consistent child identifier.

We worked closely throughout this process with a number of Parliamentarians including Baroness Tyler, Baroness Walmsley, Baroness Meacher, Baroness Hollins and Baroness Finlay.

Early evidence from local systems

While it has only been three and a half months since the new ICSs were put on a statutory footing, NCB’s work with local systems earlier this year highlighted huge variation in the sense of ‘ICS readiness’ when it comes to their responsibilities relating to children with SEND and safeguarding.

Under the old system, each Clinical Commissioning Group (CCG) provided a Designated Medical Officer (DMO) or Designated Clinical Officer (DCO) for SEND. The DCO/DMO played a key role in implementing and embedding the SEND reforms and in supporting joined up working between health services, local authorities and other SEND partners.

In February this year, NCB’s Health team conducted a poll with DCOs and DMOs across the country. They were asked how confident they felt about the move to statutory ICSs. 42% said they did not feel very confident, 23% said they felt neutral, 8% felt slightly confident and only 26% felt very confident

A further question focused on the specific concerns DMOs and DCOs had about the move to ICSs. 25% said they were concerned about retaining sufficient capacity in key SEND and leadership roles. 23% and 19% said they were concerned about the visibility of SEND within ICBs and ICPs, respectively and 15% raised a concern on how the changes will affect collaborative working with key partners, such as local authorities.

In a more recent, but smaller, poll of the wider SEND workforce on 28 September 16 out of 23 professionals polled said that they had not been meaningfully involved in the development of their ICS.

Monitoring ICS implementation and how NCB can assist the inquiry

We are now monitoring the establishment of ICSs and, in our role as convenors of HPIG, are planning to undertake a piece of work that will systematically analyse how well the new systems are meeting the needs of babies, children and young people.

We will be doing this, in partnership with HPIG members, by assessing publicly available strategies and plans (notably the Integrated Care Strategies, due to be published by ICPs by December 2022 and the Joint Five-Year Forward Plans, due to be published by ICBs by April 2022) against a co-produced framework.

We have shared the inquiry’s call for evidence with our 70+ HPIG members, as we’d be happy to do with further inquiry developments.

NCB would also be happy to provide further evidence, both written and oral, on how well ICSs are meeting the needs of babies, children and young people as we learn more from systems.

NCB would also be happy to offer members of the inquiry the opportunity to attend a meeting of HPIG to gain first-hand insight from our members, who will also be closely monitoring ICSs across the country.

October 2022