The role of public services in addressing child vulnerability

Cu ts to early intervention funding since 2010 have led to worse outcomes for vulnerable children in England. They have not produced savings for the taxpayer: spending on costlier later interventions such as support for looked-after children in social care rose during the same period. The effects of this lack of investment have been felt disproportionately in the most deprived areas.

The Government should publish a national strategy on child vulnerability, supported by a multi-year cross-departmental funding allocation for early intervention. The strategy should include a joint outcomes and evaluation framework and be supported by a cross-Government data-sharing agreement. The strategy should set out clear cross-departmental milestones and targets for reducing the number of children aged 0–19 (i) with serious mental ill-health, (ii) who live in families where parental domestic violence, addiction or mental ill-health is present and (iii) who are at risk of becoming, or who are already, involved in serious crime. The Government should allocate sufficient resources to meet these targets.

Spending on early intervention services in the 20% of local authorities in England with the highest levels of child poverty fell by £766 million in real terms between 2010 and 2019. To underpin a strategy on child vulnerability and its ambitions for ‘levelling up’, the Government should restore ringfenced funding for early intervention to its 2010 levels. This money should fund family support programmes such as the Family Nurse Partnership, Incredible Years and Preparing for Life, and prioritise the most deprived local authority areas. As part of this funding package, the Government should place a requirement on local authorities to evaluate local early intervention programmes across multiple service areas such as health, education, justice, social care and employment.

The Government should introduce a statutory duty on local authorities, the NHS and police to collaborate to improve long-term outcomes for children in their areas and to ensure that early help is provided to children living in families with serious parental addiction or domestic violence concerns, parental mental ill-health, those who are at high risk of criminal exploitation and young carers.

The Department of Health and Social Care, the Department for Education and the Home Office should support agencies working with children in underperforming local systems to access advice from external experts on how to improve performance, integrate services, share best practice and learning and reduce school exclusions, absences and the numbers of children becoming NEET.

The Care Quality Commission, HM Inspectorate of Prisons, HM Inspectorate of Constabulary and Fire and Rescue Services and Ofsted should work with the Government to develop a joint framework for holding local agencies to account for how effectively they collaborate to improve long-term outcomes for children. This should include a shared understanding of what characterises best practice in early intervention and collaboration.

The Health and Care Bill should give the Care Quality Commission powers to hold Integrated Care Systems, service providers and local decision-makers accountable for inequalities in children’s health outcomes. The CQC should regulate local-level commissioning decisions and collaboration between service providers in order to identify and meet the needs of vulnerable children.

The Department for Education, the Department of Health and Social Care and NHS England should set out how they will ensure that schools and early years services can access NHS-held data appropriately in order to identify which children are failing their development indicators when starting school.

The Department for Education should work with the Information Commissioner’s Office and the Central Digital and Data Office to revise their child safeguarding guidance. The guidance must place greater emphasis on the need to share data to support safeguarding and early intervention. The organisations should set out how they will ensure that local service leaders and frontline staff receive training on the importance of sharing information proactively to improve outcomes for children and families.

The Cabinet Office should update its guidance for local commissioners to ensure that users’ voices are heard by making co-production with children and parents a requirement for organisations commissioned to deliver children’s and family services.

As part of a national strategy on child vulnerability, the Government should strongly encourage local statutory services to collaborate with the voluntary sector—and small charities in particular—to identify and understand need in their areas, and to co-design and co-deliver the strategy at the local level.

Family Hubs will need a high degree of autonomy to decide how best to use local assets—such as existing children’s centres and local voluntary organisations—and to identify the unique needs of their community. However, in the absence of a clear vision from Government on minimum requirements for Family Hubs, we propose that the following fundamental characteristics should be at the heart of every Hub to ensure that they meet the needs of vulnerable children and families in their area: Intensive early years (0–5) provision for families, with a focus on child health and school readiness; An open-access service, which any family with children aged 0–19 (and young adults with special educational needs and disabilities) can access if they need information, advice or guidance for family, relationship and other parenting issues; A central point for vulnerable families with children aged 0–19 to access or be directed to early intervention support and services. This provision should cover support for young carers, parenting classes (including specialist support for parents with teenagers), parental mental health services, domestic violence and addiction support services, parental relationship support (including post-separation support), children and young people’s mental health services and support for children involved in serious criminal activity; Services offered through the Family Hub should be co-produced with local children and families; NHS services (such as health visiting and maternity support), agencies tackling criminal exploitation (such as police and youth offending teams), local authority services (such as the Supporting Families Programme and children’s social care) and schools—the public service which has the most interaction with children—should be key partners in delivering Family Hub provision. They should have shared targets and integrated budgets; The voluntary sector should support the delivery and co-production of Family Hub services, working with statutory services to agree shared targets; To support early intervention, Family Hubs should create data-sharing agreements with local NHS services, local police, schools, local authorities and local voluntary organisations. While these agreements should be adapted to local needs, the Government should work with Family Hubs to develop a template agreement.

The Government should commit to introducing a digital Red Book for children and young people aged 0–19. This health record should be made available to all statutory agencies and voluntary organisations working with vulnerable children and young people.

The Government should set out how it will implement learning from existing Family Hubs and evaluate similar integrated early intervention models such as Sure Start and Head Start in the US.

The Government should urgently publish a strategy for delivering the national roll-out of its Family Hub programme. In the initial stages of the roll-out it should prioritise the 20% of local authorities in England with the highest levels of child poverty. The strategy should include a long-term funding settlement, which provides the costs of ensuring that every Family Hub employs a full-time senior leader and a team of family coordinators.