cumbria partnership foundation trust russell norman general manager - childrens services cumbria...

Cumbria Partnership Foundation Trust

Russell NormanGeneral Manager - Children’s Services

Cumbria Partnership NHS Foundation Trust

Cumbria Partnership Foundation TrustCPFT – 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 TrustIs Child Poverty an Issue ?

•Children from poor families are 5 times more likely to die from unintentional injuries

HDA 2005

•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

Cumbria Partnership Foundation TrustIs Child Poverty an Issue ?

Children from poorer families believe that:

DWP Research Report 158 2001

•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

Cumbria Partnership Foundation TrustHow do we measure up?

‘The true measure of a nation’s standing is how well it attends to its children – 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 are born’ (UNICEF, 2007: 1).

Cumbria Partnership Foundation TrustPartnership Boards and Sub-groups serving Children and Young People in Cumbria

Children’s Trust

Board LSCB Board

Shadow Health & Wellbeing

Board

Care Stream Board

Joint Commissioning

Board

DDG Carlisle & Eden

DDG Allerdale & Copeland

CTB Impact & Evaluation Group

(CIEG)

DDG Barrow & S Lakeland

Health Builders

Foundation Years Programme

Childhood & Adolescent Programme

Acute & LTC Programme

Vulnerable Child Programme

SERG Allerdale & Copeland

SERG Carlisle & Eden

SERG Barrow & S Lakeland

Children’s Workforce Strategy Group

Policies & Procedures Group

LSCB Impact & Evaluation Group

Child Death Overview Panel

Health Safeguarding Network Group

CCG’s x 6 Named Children’s Services GP x 6 Named Safeguarding GP x 6

MALAP

Governing Body - Virtual Schools

Corporate Parenting Panel

Children in Care Council

CLA Health & Wellbeing Group

Cumbria Partnership Foundation TrustResilience?

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

Cumbria Partnership Foundation TrustNot intervening early is expensive….

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Severity of need

Cost

Family Intervention Projects – £8-20,000 per family per year

Family Nurse Partnerships – £3000 per family a year

Child looked after in children’s home – £125,000 per year placement costs

Child looked after in foster care – £25,000 per year placement costs

Schools - £5,400 per pupil

Children’s Centres - around £600 per user

Costs increase as children get older

Multi-dimensional Treatment Foster Care – £68,000 per year for total package of support

Child looked after in secure accommodation – £134,000 per year placement costs

Parenting programme (e.g. Triple P) – £900-1,000 per family

PEIP – £1,200 - 3,000 per parent

Multi-Systemic Therapy – £7-10,000 per year


Universal Services1

Education - £580m

Child benefits - £110m

GP/NHS costs - £30m

Targeted Services2

Welfare benefits - £750m

Mental health treatment - £20m

Parenting support - £50m

Drug misuse treatment - £10m

£0.7bn universal spend/yr

£0.8bntargeted spend/yrReactive spend3

Children going into care, hoax fire calls, nuisance behaviour costs, juvenile criminality costs, truancy costs, alternative education costs, vandalism, evictions due to ASB

£2.5bn reactive spend/yr

46,000families

All of these families access universal services…

…and specialist services, (often repeatedly for many years)

but family breakdown and crises still leads to very poor and costly outcomes

NOTE: INDICATIVE COSTS ONLY - do not include costs of criminal justice services pending further analysis by MoJ.

Disproportionate costs on services

Can be as much as £250,000-330,000 per family per year……


DfE

Multiple funding and accountability structures make coordinating support for the families with the greatest needs very difficult

Intensive family intervention worker/

parenting practitioner

DH

LA YJB CCGPolice

Surestart Children’s Centre

Schools

Police officer

YOS workerCAMHS/ Mental Health Worker

Drug and

alcohol team

DWP

JCP

Employment Personal advisers

VCS

Young carer support worker

Prisons

Family support workers

CLG

Housingauthorities

Housing link worker

MoJHO

Cumbria Partnership Foundation TrustFamilies with Multiple Problems

• 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?

High quality key workers working with low caseloads (4-6 families per worker)

Respectful and persistent whole family working that empowers and builds on family strengths

Using incentives / rewards / consequences and flexibility to use resources creatively

Support not time-limited for support (average 12-18 months) and available ‘out of hours’

Effective multi-agency working and information sharing Family intervention costs £14K1 per family per year, making savings of

around £50K2 per family per year Evidence Based Parenting Programmes

1Steve Parrott and Christine Godfrey, Department of Health Sciences, University of York April 2008 2calculated using the DfE Family Savings Calculator https://registration.livegroup.co.uk/fip/

with data collected from 17 LAs

yren


“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

RSA: Beyond the Big SocietyPsychological Foundations

of Active Citizenship Jan 2012


Better health outcomesfor children and young people

The foundations for virtually every aspectof human development – physical, intellectual,

and emotional – are laid in early childhood.

(Marmot)



1. 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. 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.

3. 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.

4. 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.

5. There will be clear leadership, accountability and assurance and organisations will work in partnership for the benefit of children and young people.



We all have a part to play in promoting the importance of the health of our childrenand young people. Through our joint commitment and efforts we are determined to:

• reduce child deaths through evidence based public health measures and by providing theright care at the right time;

• prevent ill health for children and young people and improve their opportunities forbetter long-term health by supporting families to look after their children, when they needit, 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 andmental well being and providing early and effective evidence based treatment for thosewho need it;

• support and protect the most vulnerable by focusing on the social determinants of healthand providing better support to the groups that have the worst health outcomes;

• provide better care for children and young people with long term conditions anddisability and increase life expectancy of those with life limiting conditions.



Because• the all-cause mortality rate for children aged 0 – 14 years has moved from the

average to amongst the worst in Europe

• 26% of children’s deaths showed ‘identifiable failure in the child’s direct care’

• more than 8 out of 10 adults who have ever smoked regularly started before 19

• more than 30% of 2 to 15 year olds are overweight or obese

• half of life time mental illness starts by the age of 14

• nearly half of looked after children have a mental health disorder and two thirds have at least one physical health complaint

• about 75% of hospital admissions of children with asthma could have been prevented in primary care


Children’s talent to endure stems from their ignorance of alternatives

May Angelou

We worry about what a child will become tomorrow, yet we forget that he is someone

today.

Stacia Tauscher

Remember:

cumbria partnership foundation trust russell norman general manager - childrens services cumbria...

Documents

year slide

poor families

year child

education slide

year placement costs

poorer families

affluent families

health problems