Agenda item

A children's representative from Public Health England will be in attendance for this item.

This item was replaced by a presentation from the Early Intervention Foundation (EIF) on Early intervention in the first five years

Cllr Judith Blake CBE (Chair) introduced Dr Kirsten Asmussen, Head of What Works, Child Development, Early Intervention Foundation (EIF).

The speaker had kindly agreed to attend at short notice after the original presenter from Public Health England had to withdraw due to sickness and the Chair acknowledged this. She informed Dr Asmussen of the Board’s support of their work and that members were pleased to have the opportunity to work directly with them.

Dr Asmussen introduced the background to her talk and thanked the Board for the opportunity to participate and present to the Board. Members received the presentation on work currently underway to look at a range of early interventions with an aim to improve outcomes for children and families. The speaker outlined the purpose behind the EIF and the importance of supporting its work with most recent evidence, proven outcomes and the most important domains vital to early development.

The presentation looked at the important period of children’s brain development and in particular school readiness at age 5. This looked at physical readiness, cognition and factual knowledge at that age, communicative ability, management of impulses and social and emotional measurements. Dr Asmussen referred to factors which impact negatively on progress.

Members noted a range of interventions and practices published in a series of reports. The speaker outlined the nature and timing of support recommended and ways in which parents can be provided with targeted help, appropriate to their own requirements and needs. Evidence-based therapies have proven to have a positive impact on some outcomes for the parent. These have also been shown to have long-term benefits.

Dr Asmussen referred to The Healthy Child Programme which is set to make delivery possible of a range of interventions available at the level of need. She acknowledged however that there are certain challenges in identifying the actual needs and discussed processes being used to access data and correct information. Part of this includes the work of the Early Years Transformation Academy which supports five local areas to assess local needs and determine priorities in order to address these, working together with the local authorities.

Members heard about the different kind of issues faced by populations within particular areas and how specific circumstances affect these. Delays in development are evident in certain cases and the speaker discussed how helping local authorities develop an evidence based combined strategy and theory of change would help address future needs.

Dr Asmussen spoke about EIF’s recommendations to Government and local authorities for an active focus on enabling more effective management of these issues.

The Chair thanked the speaker and invited comments from the Board.

Key points from members included;

·       Appreciation of the work done to date on Bright Futures. However, there are concerns about training and responsibility referenced in the background paper for this item – is it the responsibility of the NHS to train health visitors? 

-        The officer responded that Health Education England and the NHS are responsible for training health visitors. Health visitors are still being trained but there are insufficient numbers coming through in addition to poor retention in the current workforce. The LGA have been lobbying for a comprehensive workforce plan for public health and community nurses such as health visitors and school nurses, this remain a priority. 

·       The UK is a leader in this field due to the existence of the Health Child Programme but is it also leading in delivery of outcomes?

-        The speaker said that we do not know the long term outcomes – although the data is available, local areas need to be better at looking at these as a priority.

·       Members referred to ‘at risk’ children and the fact that poverty is not a given. Poverty is something that can be tackled which would change the outcome. How are children affected with special educational needs and disabilities (SEND) and in poverty identified and intervention provided at an early stage?

-        It was agreed that these often overlap but it is very difficult to know this and correctly assess this before the age of four. However, parents of children younger than this should be able to get the support needed as required. The health visiting workforce is vital to this.

·       Members were concerned about early intervention with the parents and the effects on outcomes for their children.

·       Members asked for more details on Shiny Apps and Fingertips (the PHE data tool) and also asked for more information on areas where existing data can be accessed.

-        The speaker suggested that local assessment and measuring systems would provide a
better understanding of population needs if local councils have the resources available.

·       Members asked what the LGA could do more to lobby for the right level of resources so that improving outcomes is achievable and sustainable.

-        The speaker suggested that joined up working and the provision of evidence is vital to approaching government for this.

·       A lot of work being done is not continuing because of parent disengagement and members questioned how this can be managed.

-        The speaker referred to the role of health visitors in ensuring it continues beyond the 1001 first days.

·       Members referred to work around previous attempts in increasing the number of health visitors and difficulties in assessing impact of their involvement. It was felt that time allocations and other pressures affects their ability to provide an effective and supportive service and these also need to be afforded. There were concerns that home-schooled children are also likely to be missed.

-        Dr Asmussen agreed that there are issues around workload and that data should be used as evidence to plan for need in the future. National support is important.

·       Members referred to the work of the EIF Transformation Academy and the speaker suggested that work would continue around particular areas. Vanessa Lucas agreed to circulate a list of the areas involved, to colleagues.

The Chair raised concerns about accessibility or young mothers and also said that fathers should not be forgotten as key influencers who are very significant to early years development. She thanked the speaker for an informative and interesting presentation and agreed that work around children and young people’s health would continue as a joint priority.

Louise Smith, (Senior Advisor, LGA) took the opportunity to remind members of the Cornerstone VR Preview training session available to them following this meeting. Unfortunately some stated that they were unable to attend this time and so it was agreed to notify the Board should another opportunity arise in the future.

Members requested a copy of the presentation be made available to them in advance of circulation of the minutes.
Action: Fatima de Abreu, LGA Member Services

Details of the academies involved were requested and it was agreed that this would also be circulated.
Action: Vanessa Lucas