EARLY INTERVENTION FOUNDATION – WRITTEN EVIDENCE (PSR0020)

Children and family services: Lessons from Coronavirus

1. This written evidence is submitted by the Early Intervention Foundation (EIF). EIF is an independent charity and What Works Centre that promotes and supports the use of effective early intervention to improve the lives of children and young people at risk of poor outcomes.

2. Our evidence is focused on the impact of the pandemic on early intervention and early help services: the range of services that support vulnerable children and families below the threshold for statutory local authority intervention, including targeted support provided by universal services.

3. The evidence draws on qualitative research carried out by EIF and Action for Children in April and May 2020, exploring the impact of COVID-19 on early help services, which will be published in June[1]. The research is based on 28 semi-structured qualitative interviews with heads of early help services, lead practitioners, and head teachers. It also draws on our report on the evidence for virtual and digital delivery of interventions for children and families, which we published in May[2] and references other relevant evidence.

General: What have been the main areas of public service success and failure during the Covid-19 outbreak?

4. Our comments focus on the delivery of early intervention. By early intervention we mean the range of non-statutory services that support vulnerable children and families below the threshold for children’s social care intervention. This includes targeted support provided through universal services such as schools, children’s centres and family hubs, early years childcare and education settings, midwifery or health visiting. In summary, we see the main areas of public service success and failure as:
1. School closures, social distancing and the lockdown have seriously affected the ability of services to support children and families at the very time that these families are facing even greater challenges.
2. Local services have responded flexibly and innovatively, moving rapidly to virtual or digital support for children and families, but we currently know very little about the effectiveness of these adapted services. It is vital that the lessons from this period of innovation and rapid adaptation are learnt, and that decisions about longer-term changes to service delivery models are informed by testing and evaluation of the impact of these approaches on the lives of children and families.
3. As lockdown conditions are eased, schools and early years provision reopen and universal services start to operate more normally, we expect the full extent of the impact of the pandemic on the lives of vulnerable children and families to come to light. It is highly likely that this will lead to a rapid increase in referrals to children’s social care and other acute services.
4. It will also mean that many more families will need help to prevent children falling behind in aspects of their development before problems become entrenched and harder to resolve. We expect a significant spike in referrals to early help. Early intervention and early help must be an integral part of the recovery from COVID-19.
5. Local authorities must be funded to a level that enables them to meet their statutory child protection duties but also to run fully functioning early help and wider family support services that can mitigate escalation into statutory services as we enter the recovery phase.

Resource, efficiency and workforce

5. The clearest message from our conversations with professionals is that the biggest challenges are yet to come. This period will have been hugely stressful for many families and the implications for them and for support services could be widespread and long lasting.

6. We and the professionals we spoke to anticipate a significant spike in both early help and social care referrals once lockdown measures have eased, schools and early years provision has reopened, and the full extent of what children have experienced starts to come to light. We do not believe that local authorities will be able to manage this increased demand and ensure that children and families receive effective and appropriate support without a significant uplift in funding.

Technology, data and innovation

7. Early intervention has been delivered virtually or digitally through the lockdown and social distancing measures, but the nature and extent of this virtual support varies considerably. Some services are focusing on regular telephone or videoconferencing check-ins with vulnerable families, offering practical support in response to their immediate needs during the pandemic. Others are adapting the delivery of face-to-face programmes such as group parenting programmes to use videoconferencing. Social media channels or apps are also being used to offer general advice and support to parents of the kind that would have previously been offered through children’s centres or family hubs. Inevitably, there has been limited evaluation to date on the impact of these changes.

8. Programme developers and providers are rapidly mobilising to allow remote delivery of interventions. We surveyed 88 developers and providers of early intervention services – most of whom are working in the UK – and found that the great majority (91%) were continuing to deliver interventions. However over three-quarters of respondents were doing so with major adaptations to standard delivery. Adaptations included moving resources and content online to facilitate remote access, and using phones, messaging services such as Whatsapp, and video conferencing software such as Skype, Zoom, and Microsoft Teams to deliver sessions. Some developers had begun to redesign the content and format of their interventions to make them easier to deliver remotely. Although continuing with services, several providers had paused the delivery of some components of interventions, such as group sessions or certain therapies and activities that have yet to be adapted for remote delivery.[3]

9. The move to virtual and digital support and the decrease in home visits has meant that capacity to deliver early help has increased in some areas. However, whilst the move to virtual provision seems to have increased the accessibility of early help and wider family support services for some, it has almost certainly reduced it for others, including families with very complex needs, families with limited access to the internet or laptops, parents with English as a second language, or those who would usually receive more tailored support including disabled children or those with special educational needs.

Inequalities

10.         The rapid move to a largely digital or virtual offer has led to concern that professionals are less able to identify escalating or changing risk and respond to this. The subtler signs of abuse, neglect or domestic violence for example, are simply much harder to spot without home visits or other face to face contact. Local services have tried to mitigate this risk through, for example, new guidance for staff about the signs that may be spotted through virtual contact and may necessitate escalation to children’s social care.

11.         The dramatic reduction in the contact that universal services have with children and families as also led to concerns that children who become vulnerable during the lockdown or social distancing measures will not be identified and will not receive the support they need.

12.         Compounding this, we know that take up of school places and places in early years settings for vulnerable children has been extremely low. The head teachers and other schools-facing professionals we have spoken to have been extremely concerned about the safety and wellbeing of vulnerable children who have not been in school or early years settings during the period of closure. They have been working hard with social workers to keep in contact with these families to check in with the children and continue to encourage parents to take up of places, but their ability to do anything more has been limited.
13.         Beyond these serious concerns about safety, the closure of schools and early years settings will have a greater impact on disadvantaged groups. Even before the pandemic, disadvantaged children were four and a half months behind their classmates by the time they finished reception, and over 18 months behind by age 16 according to the Education Policy Institute.[4] In recent years the gap had stopped closing and in reception had even widened in the previous year.

14.         We know the importance of education for school age children. In addition, we know that attending early education and care benefits children’s development, particularly if it is high quality; and that it has been shown to have an impact on school readiness, long-term school attainment and lifelong outcomes.[5] Evidence suggests that the benefits are particularly important for children from disadvantaged backgrounds.[6] The home environment, especially the learning environment, is also critical in supporting children’s academic and socio-emotional development.[7]

15.         However, the Sutton Trust, the Institute for Fiscal Studies, Education Endowment Foundation and Ipsos MORI have all recently documented that the pandemic is highly likely to widen the attainment gap significantly as a result of school and early years setting closures, pressures on families and huge variation in the quantity and quality of education children have been receiving at home.[8] These were all major issues highlighted by those we interviewed as part of our research. Interviewees also suggested, as found in recent survey data, that disadvantaged parents are less willing to send their children back to education in the coming months.[9]

16.         There is also likely to be an impact on the early years workforce from a prolonged period of closure, not only on the supply of qualified staff who may leave the sector, but also on longer term professional development, given limited resources for both childcare and education providers and training providers when settings reopen. This may have a knock- on impact on the quality of early years provision. More needs to be done to assess the impact of the pandemic on the early years sector both in terms of the financial stability of settings and the supply of places but also the demand from parents. However, it is key that the decisions do not focus solely on provision as a means of childcare to enable parental employment but also emphasise the importance of early education for a child’s early development and the expertise early years practitioners provide.

17.         Although the attainment gap is where policy attention is focused, schools and early years settings will also need to respond to children’s social and emotional needs. A focus on relationships and emotional wellbeing will be critical to children’s ability to re-engage and learn, and important for their longer-term outcomes, including their mental health.[10]

18.         The lockdown has resulted in many children spending longer than usual at home, away from peers and early years settings which require adherence to social conventions involving prosocial interaction and self-regulation (e.g. sitting still, taking turns, sharing). Children will likely require some time to readjust to the demands of being back in settings, which require impulse control and getting along with others. Teachers  will need to be sensitive to this and also to the additional needs of those children who have  been exposed to high levels of family stress in recent months and will need clear systems for identifying and obtaining additional support for children and families who have having difficulty coping.

Integration of services

19.         Local responses to the challenges of Covid-19 on the delivery of children and family services have been characterised by innovation and rapid adaptation. Some local partnerships, for example, have rapidly moved referral processes and early help assessments entirely online. One area we spoke to had set up an online joint referral system for health visitors and other practitioners to refer into early help. Another had established virtual processes for joint triage between health visitors, children’s centres and early help.

20.         There was a strong sense from the local authority professionals we spoke to as part of our research that partnerships had pulled together in this time of crisis, and that partnership working had improved significantly. For some, the crisis had, at least temporarily, unblocked longstanding issues in relation to data sharing between public health, schools, children’s centres and local authority early help services. There was a desire to retain some of these gains in the longer term, although interviewees acknowledged that they had yet to be evaluated.

21.         A particularly interesting area of greater collaboration and integration was in the use of children’s centres and family hubs. Most areas participating in our research had had to close centres. However, some had kept a small number open and were using them flexibly as hubs for multi-agency support to families. This support included face-to-face support from social workers or family support workers for particularly vulnerable families, along with support for children with special educational needs, or midwifery and health visiting services no longer able to work out of hospitals or health centres. Others had used children’s centres as emergency hubs providing food and other essential supplies to families. The flexible use of community buildings to provide an integrated service offer is an interesting example of strong partnership working and something to capitalise on moving forward.

Conclusion

22.         We want to highlight three issues that government and local authorities will need to consider to ensure the resilience of the sector in the immediate and medium term recovery phase:

1. Resourcing for children’s services that is at a sufficient level to enable meaningful investment in early help and targeted services in addition to statutory social care.
2. Learning the lessons from this period of rapid adaptation in service delivery models through ensuring rigorous monitoring and evaluation of new ways of working, including new integrated services or partnerships as well as virtual and digital delivery of services.
3. Targeting support at a local level for the children who are likely to be particularly vulnerable to a sustained impact from Covid-19 on their cognitive and social and emotional development.

Funding for children’s services

23.         Children and young people’s services have been under significant financial pressure for many years now, at a time when demand for these services has risen. Local authorities have increasingly had to prioritise their statutory child protection services and scale back non-statutory early help. Longstanding sector concerns about resourcing in children’s services pose questions about the capability of local public services to adapt and respond in the medium term to the expected growth in demand, which is likely to significantly amplify the pre-existing challenges.

24.         Without additional investment, local authorities and wider services will struggle to meet the needs of vulnerable children and families.

25.         Ensuring that local authorities are funded at a level that enables them both to meet the anticipated increase in demand for statutory child protection services and early help services will be a critical part of the pandemic recovery phase.

Learning the lessons from this period of rapid adaptation in service delivery models

26.         The local service leaders and professionals we have spoken to have been quick to identify potential gains from this period of rapid innovation and adaptation and keen to retain some of these changes to service delivery models in the longer term. Many professionals are positive about aspects of virtual and digital delivery in particular, and are interested in the extra capacity this may create within services. Some programme developers have expressed an interest in retaining or further incorporating virtual and digital components devised in response to COVID-19 into the standard delivery of their interventions in the future.

27.         We carried out a rapid review of the evidence for virtual and digital interventions to support children and families in April.[11] This highlighted the limitations in the current evidence base and highlighted the challenges and risk associated virtual and digital delivery methods including, for example, high levels of attrition. Our report concluded that it is essential that programme developers, providers and commissioners work collaboratively to design evaluations which will improve the evidence base on effective approaches to virtual and digital delivery of interventions for children and young people beyond the immediate crisis.

Targeting support where it is most needed

28.         The emphasis needs to be on effective targeting of support for children particularly vulnerable to the absence of early education and a supportive home learning environment as a result of the pandemic. In the short term this could include the targeting of children eligible for free school meals who will be transitioning into reception with an intensive evidence-based support programme over the summer and into their reception year. In the medium term it could include supporting local areas to increase the take up of the two-year entitlement for eligible children and supporting settings to target support at three and four-year-olds who are eligible for early years pupil premium funding.

29 June 2020