These are exciting and challenging times for local children’s services. How can Local Authorities make the most of their new responsibilities for 0-5 public health services? I believe this is a once in a generation opportunity to transform services in the early years, and by doing so transform the life chances of many children and their families.
As a Borough Bolton faces challenges that are familiar to many areas, with one of the steepest internal inequalities in life expectancy. We’ve made positive progress in many outcome areas, but persistent inequalities remain across our communities.
The benefits – and cost benefits - of prevention and the earliest possible intervention are not in doubt, particularly in the first, critical ‘1001 days’. At the heart of achieving this is the 0-5 service transition, but it is local leadership that will turn this into a reality on the ground.
As we take on the responsibility for Health Visiting and Family Nurse Partnership services we’re fortunate to have tangible evidence that new, innovative approaches are possible to transform support to families.
Bolton has been a pioneer of the Greater Manchester Early Years New Delivery Model (EYNDM), enabling us to test out a new service model with the strongest evidence base for improving early years outcomes, across all the prime areas of development: personal, social and emotional development; physical development; communication and language.
Originally driven by the Greater Manchester public service reform programme the EYNDM – focused ultimately on school readiness and long term goals of economic wellbeing – integrates seamlessly with the Healthy Child Programme, led by Health Visitors. Practitioners and parents have welcomed the parent-led approach to assessment, using evidence-based tools, and the renewed focus on attachment and sensitive parenting. Early identification of needs is backed up by a series of pathways offering additional support.
For children and parents we have growing evidence of immediate benefits of the new approach, although the ultimate benefits will be seen life-long, and long into the future.
The model cuts across traditional professional and service boundaries, and is completely focused on each child’s wellbeing, within their family and community. Health Visitors, Family Nurses and their teams are the highly skilled practitioners at the heart of the new approach. Their public health training and clinical skills support a model that aims to meet individual and family needs, at the same time addressing social determinants that undermine life chances.
To truly reduce inequalities 0-5 services need to take this holistic approach – promoting community resilience and parental mental health; access to secure, affordable housing, skills and employment; quality childcare and financial security.
Local Authorities have critical a guardianship role in sustaining these key services, at a time of financial constraint and continuing organisational change. Challenges remain, including the need for wider system re-design to support the new, integrated approaches.
The evidence is growing locally that service transformation really works to better – we need to have the confidence to see the changes through, and harness all the opportunities offered by new freedoms to design a service offer that improves the life chances of all families.
To truly reduce inequalities 0-5 services need to take this holistic approach – promoting community resilience and parental mental health; access to secure, affordable housing, skills and employment; quality childcare and financial security.
Councillor Linda Thomas – Deputy Leader, Bolton Borough Council
