Children and Families
Early Help Commissioning Plan 2012 - 2015
www.milton-keynes.gov.uk
Date issued: October 2011 Review date: October 2012 Prepared by: Val Chambers, Senior Commissioning Manager
Milton Keynes Council: Children and Families Early Help Commissioning Plan 2012-2015 1
Introduction
1.1
This document
1.1.1 This document sets out the commissioning intentions for the provision of early help services for children and families in Milton Keynes. The focus for the Early Help Plan will be community based delivery with the aim of providing a coherent and holistic programme of support encompassing a range of needs and responses. The key principles supporting the development of the commissioning plan are evidenced based delivery and outcomes based commissioning. 2
Background
2.1
Population profile
2.1.1 The number of people living in Milton Keynes is increasing quickly, with the total population having increased by 10.4% from 2002 to 2009. The Office for National Statistics (ONS) mid-year population estimates for 2009 indicate that 236,700 people live in Milton Keynes, of which 62,800 (26.5%) are children and young people aged 0 – 19 years. This increase in population reflects both natural growth and inward migration. There have been consistent increases in the number of births per year (to 3,700 births in 2010) and more children moving into the area than leaving each year. The most striking differences in the child population as compared with 2002 are most notable in the younger age groups - the number of one year olds has increased by 23.7%, and those in the one to four age range have grown by 19.3%. 2.1.2 This young population means that effective services for children and young people are of particular importance in Milton Keynes. 2.2
The challenges
2.2.1 Although the majority of children and young people in Milton Keynes are able to fulfill their potential there are estates in Milton Keynes where deprivation is a significant challenge. This is reflected in the range of difficulties facing children and families in those areas, where the risk of poor outcomes and life chances is significantly worse than for their peers (Milton Keynes Council, Child Poverty Needs Assessment). 2.2.2 The Child Poverty Needs Assessment and other needs analyses have drawn data from a variety of sources and provide information regarding some of the key adverse indicators affecting Milton Keynes families. 2.2.3 The following represent some of the important, commonly agreed indicators affecting families where children are experiencing problems: • • • • • •
Absence from school Exclusion from school Failure to progress satisfactorily in school Teenagers not in education, employment or training Anti-social behaviour Bullying as perpetrator or victim 1
• • • • •
U18 conceptions Contact with the criminal justice system as perpetrator or victim Referrals to Children’s Social Care Obesity Dental caries
2.2.4 The problems cited above affect children and young people at the level of the individual family. Such problems, however, are frequently associated with wider social problems that might affect a whole community or estate and therefore require a more strategic response. These would include • • • • • • • • • •
Lack of community cohesion Poverty - financial and aspirational Adult unemployment Homelessness Frequent housing moves Parental ill health or disability Substance/alcohol misuse Domestic violence Poor parenting Parental involvement with the criminal justice system
2.2.5 This means that an effective Early Help Commissioning Plan must seek to encompass both strategic and operational direction. 3
Evidence of good practice
3.1
What the research tells us
3.1.1 Recent major reviews on child protection (Munro), health inequalities (Marmot), poverty and life chances (Field) have reinforced the case for intervening early to improve the life chances of children. This is reinforced by the Graham Allen led review of early intervention. 3.1.2 The two Allen reports ‘Early Intervention: The next steps’ and ‘Early intervention: smart investment, massive savings’ promote the need for a government led culture change ‘from expensive and largely ineffective late intervention to highly effective and inexpensive early intervention’ to both improve the lives of disadvantaged children and avoid future costs to society . Both reports advocate the use of successful evidence based approaches for working with families, and provide an evaluation of the most effective programmes that can be used to inform local responses to emerging challenges. 3.1.3 The reports referenced above contain summaries and evaluations of some of the early intervention programmes that have achieved success in improving outcomes. In addition the C4EO report “Grasping the Nettle” also contains a considerable body of evaluation helpful to local authorities in developing effective early help services. C4EO have also undertaken further analysis to calculate potential financial benefits accruing from improved social outcomes delivered through early help provision. 3.1.4 It is important to note that some of the most effective programmes have been delivered through early years and school based programmes. Some of the most successful include Early Literacy and Learning Model, Promoting Alternative Thinking Strategies, as well as 2
those that have been used in Milton Keynes such as Family nurse Partnership, Reading Recovery and Families and Schools Together. 3.1.5 The focus for this revised commissioning plan is to complement and support early years and targeted and specialist services and to avoid duplication of funding and effort. Therefore models of delivery will be focused on programmes that can be delivered through community based settings or can be adapted for community delivery such as Functional Family Therapy, Incredible Years and Triple P. 4
Early Help Commissioning Plan
4.1
The Plan Strategic direction
4.1.1 The overall strategic aims for children and young people in Milton Keynes are derived from current understanding of needs and relate to reducing poverty, raising attainment in schools and increasing engagement in work and training for parents as well as young people. The strategic aims will be delivered through integrated and locality based services such as children’s practices, developing relationships with newly re-formed schools and health services, building resilient communities and fully utilising “local experts” 4.1.2 A programme of early help and prevention services will be important for contributing to these strategic aims through tackling barriers to success at the family and community level. The commissioning plan will focus on 5-18 year olds with an emphasis on families with children under ten as evidence suggests this is where early help services can be particularly effective. . Implementing the commissioning plan 4.1.3 The operational impetus is to commission services that are able to step in early, providing services that prevent difficulties escalating to become serious problems. The principal components of the commissioning plan will include: • • • • •
Commissioning early help and prevention services linked to children’s practices Using funding released from contracts ending March 2012 Reducing the number of contracts from eight to no more than three Working smarter with fewer staff to commission and monitor contracts Reducing management overheads and back office functions whilst protecting service delivery.
4.1.4 As contracts come to their natural end, funding will be released to re-invest in different services. These will have new specifications that provide a coherent, family centred approach. This will avoid families and referring professionals having to go from agency to agency to find the “right” service. In addition agencies that have established links with a family can remain involved even where needs may change. This will facilitate a team around the child approach. 4.1.5 The number of contracts be reduced leading to greater efficiency including reduced management costs. This will result in more of the available budget being spent on service delivery. 4.2
Shaping Services 3
4.2.1 The strategic focus for MKC Children and Families Service includes the establishment of children’s practices, bringing together professionals and practitioners delivering early help and targeted services. The new services will work closely to support children’s practices.. 4.2.2 The intention is to commission three service programmes: • • •
Parent training and support programmes Community engagement and support Emotional and psychological well-being
4.2.3 The additional interventions will focus on a range of issues identified by local need such as work readiness, debt management, relationships, effective engagement with schools, health awareness, teenage pregnancy, domestic violence, etc. 4.2.4 Each programme will be co-ordinated and run separately which in each case could be a single organisation or a consortium. In addition to core running costs the responsible agency may hold a small devolved budget to enable them to respond flexibly according to need. 4.4
Outline service specifications Parenting support and intervention
4.4.1 This service will include a range of parenting courses delivered according to established need, in conjunction with children’s practices. The courses on offer will be comprehensive, meeting a range of needs from children five years and above, including teenagers, anger management and managing behaviour and will use established evidence based approaches e.g. Incredible Years as identified through the Allen review of early intervention and the C4EO report “Grasping the Nettle”. Each course will be accompanied, where appropriate, with targeted and short term interventions. 4.4.2 There will be clear pathways established so that routes into and out of programmes are clear, as well as referral on to more targeted or specialist services if positive outcomes are not achieved within timescales or additional difficulties are identified. Community support and engagement 4.4.3 This service will provide a programme of light touch family interventions, using volunteers and peer mentors where possible, trained to manage a range of family difficulties. This service will signpost and encourage engagement with other relevant activities that will be delivered e.g. work skills, money management, coping with domestic violence etc. This service will also use the Community Mobiliser model of engagement through supporting communities to establish and run clubs, services, and projects in their own areas. 4.4.4 Service specifications will be informed by a needs profile and will be structured so that it is clear through the tendering process that flexibility will be required to respond to changing needs.
Emotional and psychological well-being 4
4.4.5 Early help mental health support will be commissioned to work alongside and support the parenting support and community engagement programmes. This will include some relationship counselling for couples with children. In addition practitioners will provide direct interventions and passport those with higher needs to specialist NHS Child and Adolescent Mental Health Services. 4.5
Outcomes based contracting
4.5.1 In his most recent report, Early Intervention: Smart Investment, Massive Savings, Graham Allen advocates serious consideration be given to outcomes based commissioning. By this he means payment by results i.e. payment in return for having met specific measures or outcomes as defined in the service specification. Others use outcome based commissioning to refer to the development of the service specification itself, where the focus is on setting out the aims and outcomes for services as opposed to detailed descriptions of staffing and delivery models. 4.5.2 For the purpose of the Early Help Commissioning Plan an outcomes based approach will form the basis of the development of service specifications. Approaches to payment by results will be explored during the life of the contract ensuring that such payment mechanisms provide an appropriate level of challenge but do not disadvantage or destabilise small, local voluntary agencies. 5.
Implementation The following sets out the timetable for implementing the Early Help Commissioning Plan
Action
Inform partners of plan
Meetings arranged to develop service specifications
Deadline for completion Oct 2011
Nov 2011
Purpose
To ensure all relevant partners are informed of the Early help commissioning intentions. To ensure interested agencies have information to begin to prepare bids. Provide an opportunity for relevant partners to influence service specification. Gather latest evidence on models of best practice.
Develop contract documentation and issue invitations to tender Receive and evaluate tender submissions Award of Tenders
Nov 2011
Jan 2012 Feb 2012
Disseminate knowledge to help agencies form alliances/partnerships/consortia prepare bids. To ensure comprehensive documentation is in place Tenders issued in good time
To ensure sufficient opportunity for tender clarification meetings To allow time for contract mobilisation and service set up
5
References Allen, G., Early Intervention: The Next Steps, 2011 Allen, G., Early Intervention: Smart Investment, Massive Savings, 2011. Field, F., The Foundation Years: preventing poor children becoming poor adults, 2010. Marmot, M., Fair Society, Healthy Lives, 2010. Munro, E., The Munro Review of Child Protection: Final Report A child-centred system, 2011. Milton Keynes Council, Child Poverty Needs Assessment, 2011. C4EO, Grasping the Nettle, 2011. Tickell, C., The Early Years: Foundations for life, health and learning, 2011.
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