Cumbria Partnership Foundation Trust Russell Norman General Manager - Childrens Services Cumbria Partnership NHS Foundation Trust

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<ul><li>Slide 1</li></ul> <p>Cumbria Partnership Foundation Trust Russell Norman General Manager - Childrens Services Cumbria Partnership NHS Foundation Trust Slide 2 Cumbria Partnership Foundation Trust CPFT Childrens Services Health Visiting School Nursing Childrens Community Nursing CAMHS Physiotherapy Occupational Therapy Childrens Learning Disability Nurses Audiology Podiatry Community Paediatrics Team 400+(and other services) Slide 3 Cumbria Partnership Foundation Trust Is 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 Slide 4 Cumbria Partnership Foundation Trust Is 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 Slide 5 Cumbria Partnership Foundation Trust How do we measure up? The true measure of a nations 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). Slide 6 Cumbria Partnership Foundation Trust Slide 7 Slide 8 Resilience? Living in poverty is the single most important determinant for childrens 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 Slide 9 Cumbria Partnership Foundation Trust Not intervening early is expensive. Cost per child /family 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 childrens home 125,000 per year placement costs Child looked after in foster care 25,000 per year placement costs Schools - 5,400 per pupil Childrens 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 Slide 10 Cumbria Partnership Foundation Trust Universal Services 1 Education - 580m Child benefits - 110m GP/NHS costs - 30m Targeted Services 2 Welfare benefits - 750m Mental health treatment - 20m Parenting support - 50m Drug misuse treatment - 10m 0.7bn universal spend/yr 0.8bn targeted spend/yr 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 2.5bn reactive spend/yr 46,000 families 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 Slide 11 Cumbria Partnership Foundation Trust 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 CCG Police Surestart Childrens Centre Schools Police officer YOS worker CAMHS/ Mental Health Worker Drug and alcohol team DWP JCP Employment Personal advisers VCS Young carer support worker Prisons Family support workers CLG Housing authorities Housing link worker MoJHO Slide 12 Cumbria Partnership Foundation Trust Families with Multiple Problems Growing up in a family with significant, social, health, economic and behavioural problems has lasting and inter-generational impact on a childs 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 Slide 13 Cumbria Partnership Foundation Trust 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 14K 1 per family per year, making savings of around 50K 2 per family per year 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 with data collected from 17 LAs Slide 14 Cumbria Partnership Foundation Trust 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 Society Psychological Foundations of Active Citizenship Jan 2012 Slide 15 Cumbria Partnership Foundation Trust Better health outcomes for children and young people The foundations for virtually every aspect of human development physical, intellectual, and emotional are laid in early childhood. (Marmot) Slide 16 Cumbria Partnership Foundation Trust Better health outcomes for children and young people 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. Slide 17 Cumbria Partnership Foundation Trust Better health outcomes for children and young people 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. Slide 18 Cumbria Partnership Foundation Trust Better health outcomes for children and young people 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 childrens deaths showed identifiable failure in the childs 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 Slide 19 Cumbria Partnership Foundation Trust Childrens 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: </p>