Transcript Document
Cumbria Partnership Foundation Trust Russell Norman General Manager Children’s Services Cumbria Partnership NHS Foundation Trust
CPFT – Children’s Services Health Visiting School Nursing Children’s Community Nursing CAMHS Physiotherapy Occupational Therapy Children’s Learning Disability Nurses Audiology Podiatry Community Paediatrics Team 400+(and other services) Cumbria Partnership Foundation Trust
Cumbria Partnership Foundation Trust
Is Child Poverty an Issue ?
•Children from poor families are 5 times more likely to die from unintentional injuries •Children from poor families are 5 times more likely to die as a pedestrian •Children from poor families are 16 times more likely to die in a house fire •Children from poor families are more likely to suffer injuries that require hospital admission and when they are admitted their injuries are likely to be more serious than those experienced by children from affluent families HDA 2005
Cumbria Partnership Foundation Trust
Is Child Poverty an Issue ?
Children from poorer families believe that:
•Health is a matter of luck •Smoking cigarettes is not dangerous
Children from poorer families are more likely to:
•Play truant from school •Leave school at 16 •Not want to be a parent or marry •Have low self esteem •Become pregnant at an early age •Perform poorly in education DWP Research Report 158 2001
How do we measure up?
Cumbria Partnership Foundation Trust ‘ The true measure of a nation children are born ’ – (UNICEF, 2007: 1).
’ s standing is how well it attends to its their health and safety, their material security, their education and socialization, and their sense of being loved, valued, and included in the families and societies into which they
Cumbria Partnership Foundation Trust
Cumbria Partnership Foundation Trust
Partnership Boards and Sub-groups serving Children and Young People in Cumbria
Eden DDG Barrow & S Lakeland Health Builders CCG’s x 6 Services GP x 6 x 6 DDG Allerdale & Copeland CTB Impact & Evaluation Group (CIEG) Governing Body - Virtual Schools Children’s Trust Board Corporate Parenting Panel Children in Care Council
MALAP Care Stream Board Joint Commissioning Board Shadow Health & Wellbeing Board LSCB Board
CLA Health & Wellbeing Group SERG Carlisle & Eden SERG Barrow & S Lakeland SERG Allerdale & Copeland Policies & Procedures Group Years Programme Programme Acute & LTC Programme Vulnerable Child Programme Children’s Workforce Strategy Group Health Safeguarding Network Group LSCB Impact & Evaluation Group Child Death Overview Panel
Resilience?
Cumbria Partnership Foundation Trust Living in poverty is the single most important determinant for children’s outcomes Gap between groups is widening Children in poverty more likely to: Under achieve Get pregnant early Be affected by domestic violence Be involved in alcohol and drug misuse Die younger, suffer health problems Be a cost to society, not just in financial terms
Not intervening early is expensive….
Cumbria Partnership Foundation Trust Child looked after in children’s home – £125,000 per year placement costs Child looked after in secure accommodation – £134,000 per year placement costs Cost Multi-dimensional Treatment Foster Care – £68,000 per year for total package of support Costs increase as children get older Child looked after in foster care – £25,000 per year placement costs Family Intervention Projects – £8-20,000 per family per year Multi-Systemic Therapy – £7-10,000 per year Parenting programme (e.g. Triple P) – £900 1,000 per family Family Nurse Partnerships – £3000 per family a year PEIP – £1,200 3,000 per parent Children’s Centres - around £600 per user Schools £5,400 per pupil Severity of need
Disproportionate costs on services
Cumbria Partnership Foundation Trust Can be as much as
£250,000-330,000 per family per year…… All of these families access universal services… Universal Services 1 Education £580m Child benefits £110m GP/NHS costs £30m £0.7bn universal spend/yr …and specialist services, (often repeatedly for many years) but family breakdown and crises still leads to very poor and costly outcomes Targeted Services 2 Welfare benefits £750m Mental health treatment £20m Parenting support £50m Drug misuse treatment £10m Reactive spend 3 Children going into care, hoax fire calls, nuisance behaviour costs, juvenile criminality costs, truancy costs, alternative education costs, vandalism, evictions due to ASB £0.8bn
targeted spend/yr
46,000 families
£2.5bn reactive spend/yr NOTE: INDICATIVE COSTS ONLY - do not include costs of criminal justice services pending further analysis by MoJ.
Multiple funding and accountability structures make coordinating support for the families with the greatest needs very difficult
Cumbria Partnership Foundation Trust DfE HO MoJ DH CLG DWP LA Police YJB CCG Housing authorities VCS Prisons Young carer support worker Schools Surestart Children’s Centre Intensive family intervention worker/ parenting practitioner YOS worker Police officer Family support workers CAMHS/ Mental Health Worker Drug and alcohol team Housing link worker JCP Employment Personal advisers
Families with Multiple Problems Cumbria Partnership Foundation Trust • • • •
Growing up in a family with significant, social, health, economic and behavioural problems has
lasting and inter-generational impact
on a child’s life chances Around
120,000 families
in England experience multiple social, health and economic problems.
46,000
of those experience ‘problem’ child behaviour Account for a large number of school exclusions, 1 in 5 youth offences, parents 34 times more likely to need drug treatment and 8 times more likely to need alcohol treatment and a third are subject to child protection Contribute to a wide range of social problems
What works?
Cumbria Partnership Foundation Trust
High quality
key workers
worker) working with
low caseloads
(4-6 families per Respectful and persistent
whole family working builds on family strengths
that empowers and Using incentives / rewards / consequences and flexibility to use resources creatively Support
not time-limited
available ‘out of hours’ for support (average 12-18 months) and Effective
multi-agency
working and information sharing Family intervention
costs £14K
1
around £50K
2 per family per year per family per year, making
savings of
Evidence Based Parenting Programmes
1 Steve Parrott and Christine Godfrey, Department of Health Sciences, University of York April 2008 2 calculated using the DfE
Family Savings Calculator
https://registration.livegroup.co.uk/fip/ with data collected from 17 LAs
RSA:
Beyond the Big Society Psychological Foundations of Active Citizenship
Cumbria Partnership Foundation Trust
Jan 2012
“the socialized mind is an adequate order of complexity to meet the demands of a traditionalist world, in which a fairly homogeneous set of definitions of how one should live is constantly promulgated by
the cohesive arrangements, models, and external regulations of
the community or tribe. (However) Modern society is characterized by ever-expanding pluralism, multiplicity, and competition for loyalty to a given way of living. It requires the development of an internal
authority which can “write upon” existing social and psychological productions rather than be “written by” them.
R Kagan 1991
Better health outcomes for children and young people
Cumbria Partnership Foundation Trust
The foundations for virtually every aspect of human development – physical, intellectual, and emotional – are laid in early childhood.
(Marmot)
Better health outcomes for children and young people
1.
Cumbria Partnership Foundation Trust Children, young people and their families will be at the heart of decision making,with the health outcomes that matter most to them taking priority. 2.
3.
4.
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Services, from pregnancy through to adolescence and beyond, will be high quality, evidence based and safe, delivered at the right time, in the right place,by a properly planned, educated and trained workforce.
Good mental and physical health and early interventions, including for children and young people with long term conditions, will be of equal importance to caring for those who become acutely unwell.
Services will be integrated and care will be coordinated around the individual,with an optimal experience of transition to adult services for those young people who require ongoing health and care in adult life.
There will be clear leadership, accountability and assurance and organisations will work in partnership for the benefit of children and young people.
Better health outcomes for children and young people
Cumbria Partnership Foundation Trust
We all have a part to play in promoting the importance of the health of our children and young people. Through our joint commitment and efforts we are determined to:
•
reduce child deaths
through evidence based public health measures and by providing the right care at the right time; •
prevent ill health for children and young people and improve their opportunities for better long-term health
by supporting families to look after their children, when they need it, and helping children and young people and their families to prioritise healthy behaviour; •
improve the mental health of our children and young people
by promoting resilience and mental well being and providing early and effective evidence based treatment for those who need it; •
support and protect the most vulnerable
by focusing on the social determinants of health and providing better support to the groups that have the worst health
outcomes
; •
provide better care for children and young people with long term conditions and disability
and increase life expectancy of those with life limiting conditions.
Better health outcomes for children and young people
Cumbria Partnership Foundation Trust
Because
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the all-cause mortality rate for children aged 0 – 14 years has moved from the average to amongst the worst in Europe
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26% of children’s deaths showed ‘identifiable failure in the child’s direct care’
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more than 8 out of 10 adults who have ever smoked regularly started before 19
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more than 30% of 2 to 15 year olds are overweight or obese
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half of life time mental illness starts by the age of 14
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nearly half of looked after children have a mental health disorder and two thirds have at least one physical health complaint
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about 75% of hospital admissions of children with asthma could have been prevented in primary care
Remember:
Cumbria Partnership Foundation Trust