Integrated Children’s Services in a Megalopolis
Professor David Hawker
College of Teachers, UK
Moscow, June 2011
My background
• Head of national school testing, England, 1993-9
• Local Director of Education/children’s services, 19992008
• Director General for Education, Wales, 2008-2010
• Director General, Arms Length Bodies Reform, DfE,
2010-2011
• Advisory work in Russia (World Bank and British
Council), 1998-2007
• Member of General Education Sub-Board, Open
Society Foundations, 2007-2011
The Basic Question:
What is our city’s attitude to its
children, its young people and
its families?
What problems are we trying to address?
• Gap in opportunity and expectations between
children from different social groups
• Stresses on parents, children and family life
• Children’s safety and wellbeing
• Lack of coherence between services – not
seeing children and young people in the round
• Lack of ‘voice’ for children and young people
Relative cognitive shifts, 22m to 10y
100
High Q at 22m
90
Average position in distribution
80
70
60
50
40
30
20
Low Q at 22m
10
0
22
26
30
34
38
42
46
50
54
58
62
66
70
74
78
82
86
90
94
98
102 106 110 114 118
months
Source: Feinstein, L. (2003) ‘Inequality in the Early Cognitive Development of British Children in the 1970 Cohort’, Economica (70) 277, 73-97
The link between academic performance and
socioeconomic background in England
Relationship between free school meals (FSM) and
achieving 5 or more GCSEs at A*-C
%
Not eligible for FSM
57
Relationship between students achieving 5A*-Cs at GCSE
and parental background
%
Higher professional
78
Lower professional
All children
52
Intermediate
Lower supervisory
Eligible for FSM
62
50
32
25
Routine
30
Other
30
Schools are less “effective” (pupils make less progress) in deprived
neighbourhoods serving high proportions of FSM pupils…
% of FSM and non-FSM pupils whose average KS2 prior attainment was level 4
failing to achieve expected level at KS3
Below expected KS3 level
40%
Low FSM school (<5%)
30%
24%
High FSM school (>35%)
26%
25%
21%
20%
17%
16%
10%
0%
English
FSM
English
Non-FSM
Maths
FSM
Maths
Non-FSM
Source: DfES Pupil Level Annual Schools Census linked to attainment data, England
Science
FSM
Science
Non-FSM
You Gov Poll, April 2004
In order to get your child into the school of your
choice, would you…………….
YES
Move house
50%
Fake a separation
10%
Give a false address
15%
Exaggerate religious adherence
20%
Are Extended Schools the Answer?
“Extended Schools can create the relationships and confidence to put the time,
resources and enthusiasm of disadvantaged communities to work for them”.
From “Schools Out”, Demos, September 2004, page 30
“The best extended schools do not simply deliver broader services, they help
to build communities capable of providing them for themselves”.
ibid, page 34
Key societal changes over the past 20-30 years
Changes to the
economy
• Increased inequality and already low social mobility affecting children
• More highly skilled economy. Greater focus on social and emotional
skills. Increased competition for low skilled jobs.
Changes to families
•Greater diversity of family living arrangements.
•Relationships are more likely to break up.
•More female participation in the labour market
•Parenting skills now a bigger focus
Changes to
children’s education
•More children attending early learning and childcare
•Introduction of national curriculum, and more focus on standards,
attainment and assessment
•Fewer failing schools, more children go to university.
Changes to the
public realm and
peers
•Children have lower independent spatial mobility
•Changing attitudes to children in the public realm
•Peer relationships remain important to children, and new
understanding of their sometimes negative effects
Changes to media
and society
•Children have dramatically higher access to all types of media
•Children increasingly targeted by advertising and marketing
What is a ‘good childhood’?
Personal fulfilment
as an adult
These
dimensions are
mutually
supportive
A happy, safe and
healthy childhood
…as an individual
Being a valued and
supported member
of the community
with opportunities
to participate
…as a member of
society
Positive
Contributing to their
maximum potential
as a citizen, with
good parenting skills
Free from
harm
…in childhood
…in preparation for
adulthood
A ‘Good Childhood’ means a child who is experiencing or on the path to:
Safe, with basic
needs met
…as an individual
Positive
Economic
fulfilment
as an adult
Well behaved
children who do
not cause trouble
…as a member of
society
Free from
harm
…in childhood
…in preparation for
adulthood
But, in terms of policy priorities, governments
often have a narrower focus
The importance of different factors depends largely on
age, with family and peers the critical influence
Family vs
Peers
Peers
INFANCY:
Parents by far
the greatest
influence but
consciousness of
peers starts as
early as 6
months
EARLY YEARS: Parents remain
the greatest influence but at
2-5 children start to seek out
& identity with peers,
forming more complex
relationships & shifting from
solitary to parallel play.
Peers
MIDDLE CHILDHOOD: Children beginning
to compete with and desire assimilation
Parents
with peers from 6.
Family
The balance between peer and parent
influences tips some time from 7 -16
Importance of community interactions increases as
children get older and are allowed to spend more leisure
time outside the home or organised institutions
Community
Society (via
Unsupervised
access to media
rises sharply at 1012
Even young children have early awareness of brands and
importance of media influences rises as children get older
media)
Community and society are important
influences but impact is strongly
mediated by the effect of peers and
parents
0
Years
E. ADOLESCENCE: Young
people start to spend more
time with peers than parents.
Parents remain a constant &
important influence.
1
2
3
4
5
6
7
8
9
10
11
12
High access to
media and
disposable income
increases
importance of
advertising
13
14
The relative importance of drivers at different ages has
changed over the past 20-30 years
Family vs
Peers
Peers
Peers
Parents
Where parental relationships
have become less stable,
peers may become more
important at an earlier age
Family
Children are being
allowed out
unsupervised at later
ages…
Community
Society (via
But getting
unsupervised access
to media younger…
media)
0
Years
1
2
3
4
5
6
7
8
9
10
11
12
13
14
An outcomes model for constructing
integrated children’s services
Being Healthy
Enjoying
and
Achieving
Staying Safe
Making a
Positive
Contribution
Economic Wellbeing
What are the main influences on children’s experiences
and outcomes?
Media & consumerism in society
Outcomes
Interactions
School &
Interactions in
in the
the community
children’s
services
Be Healthy
community
Stay safe
Characteristics
Enjoy &
achieve
•Social
& Emotional
•Cognitive
•Physiological
Parents
Peers
Make a
positive
contribution
Economic
Economic
Wellwellbeing
being
A new way of thinking about services
Systemic change to
Create opportunity and build
services around the child, young
person & family
Support parents & carers
Promote prevention & early
intervention
Integration of
Universal & targeted
services
Services across the age
range 0-19
17
• Better outcomes for all
children and young
people
• Choice and confidence
for parents
• Achievement and
opportunity for children
• Narrowing gaps
Why transform the wider system?
• Children don’t come in a vacuum – their families and their
local communities are significant in their development
• Historically, different services have worked in isolation from
one another – this is both inefficient and ineffective in dealing
with complex needs
• Historically, services have looked at fragments of children’s
lives, not their whole experience of growing up
• Schools (and other organisations) benefit from working with
other local agencies
• Children and young people need a more effective voice in
society
A locally based whole system approach
Education
Youth
Government
Social
Care
Communities
Childcare
Healthcare
A service model for different levels of need
What does this service model mean in concrete terms?
Tier 1
Tier 3
Children’s
Centres
Mental health
School
attendance
Extended
Schools
Integrated
Youth
Service
Locality Teams
Family
support
Intensive multi-disciplinary casework
Complex needs
VOICE OF THE CHILD
& YOUNG PERSON
Parents
Tier 2
Workforce Reform
VOICE OF THE CHILD
& YOUNG PERSON
Brighton & Hove – one city’s
journey to integrated services
1999
2002
2006
Education
Social Care
Health
Children, Families and Schools
Health
Children & Young People’s Trust
Brighton & Hove service structure 2007
City wide services
West area
Central area
East area
Commissioning of
support services
Early years services
(0-7)
Early years services
(0-7)
Early years services
(0-7)
Specialist services:
School age services
(8-13)
School age services
(8-13)
School age services
(8-13)
School
improvement
services
Youth services
(14-19)
Youth services
(14-19)
Youth services
(14-19)
Policy advocacy for
children and young
people
Safeguarding and
child protection
Safeguarding and
child protection
Safeguarding and
child protection
-
disability
adoption/fostering
paediatrics
youth justice
The integrated area teams
Early Years (0-7)
School Age (8-13)
Young people (14-19)
Led by family community
nurses
Led by educational
psychologists
Led by professional youth
workers
Services based in Children’s
Centres:
- ante-natal support
- community midwives
- parenting support
- advice on baby care
- early assessment of
needs
- early education
- access to specialist
services
- informal social support
Services based in
‘extended’ schools:
- support for school
attendance
- behaviour support
- family support
- community mental
health
- out of school activities
- support for teachers
- home-school liaison
- access to specialist
services
Services based in youth
centres:
- health advice
- relationships advice
- careers advice
- social activities
- learning support
- community activities
- youth councils
- access to specialist
services
Three key indicators
• Number of children taken into public care
• Number of children out of school
• Number of young people not in education,
training or employment
Each indicator improved by 10% in the 18
months after the new organisational structure
was introduced
An example of effective integrated
services – Intensive family support
Intensive Family Support - Who is involved?
Unemployment
service
Welfare &
Benefits
Children’s
Services
Youth
Services
Housing
Domestic
Violence
Police,
Criminal
Justice,
Probation
Substance
misuse
services
Schools
Mental
Health
Services
Voluntary
Sector
Services and
Community
Groups
Adult
Social
services
Community
Protection
Intensive Family Support Programmes
– value for money benefits
% of families who reached the planned exit stage
70%
60%
Reduction in Risk Factors
(non-educational)
50%
40%
30%
20%
10%
0%
Poor
Inappropriate Family Debt Marriage
parenting peer group
relationship
or f amily
breakdow n
Start of intervention
Domestic
Violence
Child
Protection
Issues
End of intervention
Teenage
Pregancy
…which is consistent with wider US evidence that early
family interventions can provide high returns…
Program
Description
Ben/Cost
Ratio
Nurse Family
Partnership
Targeted at low income families, intensive
visits to mother prior and after birth
$3.02
Parents as
Teachers
Home visiting program with aim of enabling
children to read before they start school
$1.39
Intensive Family Short-term home-based crisis intervention to
Preservation
avoid child being taken into care
Service
$2.54
Parent-child
Interaction
Therapy
$5.93
Intervention with parents and children to
improve attachment, includes coaching and
lifeskills
Source: Washington State Institute for Public Policy
32
Seven challenges in managing change
• Getting consensus on a new service design across all
agencies and levels of management
• Shifting the bureaucracy
• Overcoming a protectionist approach from some
professional groups and some organisations (including
schools, doctors, social workers)
• Managing ongoing services through the change process
• Getting the service model into the right ‘shape’
• Keeping focussed on the children and young people
• Realising the savings and improving the services at the
same time