Written evidence submitted by Norfolk and Suffolk NHS Foundation Trust

(FTDOOO4)

Response to the Call for Evidence – The first 1000 days: a renewed focus

Responding as a clinical lead for trust wide perinatal and early years services, and as a regional clinical advisor in NHS E on CYP mental health.

Question 1: What progress has been made since the previous Committee’s 2019 First 1000 days of life report in terms of outcomes for children and young people in delivering integrated early years through Family Hubs a) In particular what progress has been made on the calls in the Committee’s 2019 report for a) Proportionate universalism and b) Greater integration and multi-agency working?

The family hubs roll out in Norfolk has been hugely successful, brining NSFT, Norfolk County council and local providers such as action for children together in one place.  This has improved the universal offer for all families and ensured more families are sign-posted through for additional support.  Multi-agency working has been facilitated by our ICB steering group. 

Question 2 : “What should the Government prioritise in upcoming funding allocations for early years services?”

I endorse the recommendations of the parent infant foundation spending review :

• Funding for national rollout of the Family Hubs and Start for Life Programme to all English local authorities, so that every baby can access support.
• Including funding for every local authority area to develop at least one parent-infant team, and provide optimum breastfeeding support
• Investment in the health visiting workforce to address workforce shortages

Funding for parent infant teams is a must.  The needs of younger children are not met by CAMHS services and we are storing up problems for the future by over looking this cohort.  In times of economic uncertainty theses services will only be commissioned if they are mandated. 

Question 4 asks, “What are the key barriers to delivering high-quality early years services, particularly in Family Hubs and through neonatal and paediatric services, and how can they be addressed?”

Its not always clear where parent infant services should be hosted, with some mental health trusts seeing it as ‘not their business’.  Babies do not have a voice, so their needs are often down prioritised in favour of those who present more stress on systems such as adolescents in crisis.   

Question 6: How can the Government most effectively tackle inequalities in access and infant health outcomes for those from underserved groups including those with disabilities, or from ethnic minority or deprived backgrounds?

I think parent infant relationship services and family hubs have been doing this work.  It currently feels under threat in our trust due to the intense focus on productivity and building trust with hard to reach communities is about investing lots of time which does not always look productive on paper.

Parent infant relationship services are being judged against the 4 contacts a day expectation which was developed with adult community mental health services in mind and does not work well with family-based work.  In addition, our service covers the whole of Norfolk so we have to travel to where the vulnerable families are, rather than expecting them to come to us. 

Question 7,  “What could the Government learn from examples of best practice that exist in local authorities, NHS Trusts, or internationally?”

There is some great work happening in the East of England with Together with Baby and the new PAIRS service in Norfolk.  We would be happy to share examples of best practice.