Health
Health The Early Years (0-7) / Y blynyddoedd cynnar Income Poverty
Current Challenges
What Can Be Done?
Where To Go?
Access to community dental services
Better promotion of oral health through com- The national plan, ‘Designed to Smile – A Namunity based services and education set- tional Child Oral Health Improvement Protings. This will be supported by Sustainable gramme’ nursery and school based tooth brushing programmes are a key priority of WAG’s ‘Designed to smile’ A national oral health improvement programme’ are a key priority. Effective programmes will need to involve health and local authority partnerships and be accepted as an integral part of health promoting activity in nursery and school settings.
Benefit Take-up Most disadvantaged families are not taking up their full benefit and tax credit entitlements. Only 44% of children in severe poverty are in families that report claiming the child tax credit. There is a lack of knowledge among many on low incomes of their entitlements to support.
Review the quality/ accessibility of informa- Citizens Advice tion and benefits ( particularly in work benefits) available via early years settings. Promoting Tax Credits and help towards childcare costs provides a simple, easy to use online Consider undertaking co-ordinated benefit toolkit to help your local authority raise awaretake up work within early years settings. ness about help for paying for childcare Sure Start
Health Education and Learning Opportunities / Addysg Income Poverty
Current Challenges
What Can Be Done?
Where To Go?
Free school meals administration and take up Efficient, user-friendly free school meal administration encourages take up.
Establish a course of action that ensures that free school meal and other education related grants administration is accurate, efficient and take up of entitlement is in the top quartile of authorities.
Useful strategies for increasing free school meal takeup Food for life article on free school meal takeup
Sustainable Procurement In 2005 it was estimated that 35% of the ÂŁ4 billion spent each year by the public sector in Wales was won by indigenous business supporting some 70,000 jobs. Every 1% increase to this figure should relate to an increase of some 2,000 jobs.
Develop a common partnership approach to sustainable procurement that ensures opportunities to support the local economy and skills development of young people are secured.
Buy Wales
De Stigmatising Payment Methods Develop sensitive payment methods within Some free school meals and other payment school settings methods stigmatise pupils making them more vulnerable to bullying.
http://www.forumforthefuture.org.uk/ node/1413 http://www.s-p-i-n.co.uk/toolkit.asp#SocioEconomic Cashless Catering http://www.familyandparenting.org/ item/1202 Denbighshire Cashless Catering
Health Health Freedom from Abuse and Exploitation / Iechyd, a rhyddid rhag cam-drin a Income Poverty
Current Challenges
What Can Be Done?
Where To Go?
Engaging socially excluded families in health related community based activities. (Understanding the impacts of poverty on families.)
The WLGA’s Excellence Wales programme is focusing on the theme of ‘Social Inclusion’ for 2008-09 looking at how to mitigate the effects of child poverty and maximise the powers of local government to enhance inclusion. A copy of the four sub themes and the requirements of each is available from www.wlga.gov,uk The Social Care Institute for Excellence have recently published ‘Poverty, Parenting and Social Exclusion’ an e- learning resource to help people working in social care to understand the links between poverty, parenting and social exclusion.
In 2004 the NPHS published Deprivation and Health to highlight the relationship between small area deprivation and health in Wales, using a large number of health indicators. The report shows that, in nearly all instances, people living in the most deprived areas have worse health and health indicators than those in the most affluent areas. The NPHS also published a series of 22 summary reports, one for each LHB, showing how the relationship between health and socio-economic deprivation is likely to be operating at the local level. These can be accessed from: Deprivation and Health: LHB Summary Reports (2006)
Access to community healthcare services
Health Poverty Index Access to services is wider than the financial ability to pay for services. Using the needs NSF Standards on access to services assessment that underpins the HSCWB strategy and CYP plan, community based healthcare services provided by partnerships must be adequately targeted and delivered in areas of highest need to enhance participation, with consideration given to travel links and proximity to universal settings such as schools
Health Participation and Decision Making / Cymryd rhan yn y broses benderfynu Income Poverty
Current Challenges
What Can Be Done?
Where To Go?
Lack of Awareness There is limited awareness of the United Nations Convention on the Rights of the Child.
Raise awareness of children and young people’s right to participate under the United Nations Convention on the Rights of the Child and Welsh Assembly Government policy e.g. Extending Entitlements.
Useful supporting websites on the UNCRC – list some here. Save the Children Wales UNCRC Monitoring Group and Funky Dragon information on website on UNCRC for children and young people. http://www.sccyp.org.uk/participation/resources.php
Being Worse Off Children and young people experiencing poverty should not be worse off as a result of their participation.
Fully review the individual costs of participation and ensure that up front costs are minimised.
Camden documents
Health Income Maximisation / Employment / Heb fod dan anfantais o achos tlodi Income Poverty
Current Challenges
What Can Be Done?
Operating without a bank account can lead to significant costs leading to poor families having to pay a poverty premium.
Consider developing a multi agency approach (credit unions, voluntary sector, housing, health) to addressing financial inclusion for families and consider innovative approaches using the internet as a means of delivering accessibility to competitive rates/products.
Knowledge of the Carers PreConsider awareness raising among key staff mium among front line staff and working with families with a disabled person. vulnerable families is limited. Benefits maximisation for families with a disabled/sick person is a key issue as they are at a high risk group.
Where To Go? http://www.rightsnet.org.uk/toolkit.shtml http://www.nowletstalkmoney.com/gb/en/ default.html http://www.basic-skills.co.uk/ouractivities/ financialliteracy/ http://www.pfeg.org/ http://www.learnaboutmoney.org/index.php http://www.moneymadeclear.fsa.gov.uk/ CPAG: Out of Reach: benefits for disabled children Carer’s UK http://www.carersuk.org/Information
Health Income Maximisation / Employment / Heb fod dan anfantais o achos tlodi Income Poverty
Current Challenges There is currently no obligation on councils to take responsibility for promoting improved take-up of welfare benefits. Despite this, there is a growing expectation from Central Government that benefit checks and help to claim benefits should be integrated within council key services.
What Can Be Done? Consider the feasibility of providing holistic benefit checks for vulnerable families within key frontline services in partnership with the voluntary sector and encourage the take up of WTC/CTC and DLA (especially for children) and Attendance Allowance.
Where To Go? The unclaimed millions: dla and cancer patients CPAG: Out of Reach: benefits for disabled children Citizens advice: Tax credit take-up resource pack
Health Income Maximisation / Employment / Heb fod dan anfantais o achos tlodi Income Poverty
Current Challenges
What Can Be Done?
Where To Go?
Research indicates that benefit takeConsider the feasibility of undertaking in work benefit-take up take up is an issue within Wales Official up activities with working families on low incomes. Such activity figures show 44% of couples with chil- should be multiagency involving experts from the voluntary sector. dren are paying out much more than they need to in council tax. HMRC state that in 2005-2006, 60,000 families did not claim their entitlement to Child Tax Credit and Working Tax Credit which amounted to £80m of unclaimed Tax credits. (central estimates)
http://www.lga.gov.uk/lga/ publications/publicationdisplay.do?id=22235 http://www.entitledto.co.uk/ default.aspx
The nature and degree of partnership working between Job Centre Plus and the local councils varies across Wales. To date only a small percentage of Council’s have signed up to the Job Centre Plus Local Employment Partnerships initiative (which aims to bring together Government and large employers to help 250,000 disadvantaged people into jobs within three years).
Local Employment Partnerships
Consider the appropriateness of committing the Council to the Job Centre Plus’s Local Employment Initiative (the following public sector bodies have signed up to this Scheme Somerset County Council, Coventry City Council, Glasgow City Council, Middlesbrough City Council, NHS Wales, North Glamorgan NHS Trust, West Lothian Council, Birmingham City Council). Review HR policies to ensure that recruitment practices are inclusive and do not disadvantage vulnerable groups.
Health The Early Years (0-7) / Y blynyddoedd cynnar Service Poverty
Current Challenges
What Can Be Done?
Where To Go?
Positive Behaviour Promoting positive behaviour within early years settings can be particularly challenging in deprived areas.
http://www.behaviour4learning.ac.uk/ Utilise the Behaviour 4 Learning website which aims to ensure that teacher educators index.aspx?menuId=10126 and trainees are provided with high quality relevant resources that enable trainers and trainees engage with the principles of behaviour for learning to improve the management of classroom behaviour, enable achievement and foster the emotional wellbeing of learners.
Parenting 'Positive' parenting styles may help protect children against the risks attached to poverty and deprivation.
Consider approaches to promoting positive parenting and priorities areas of high deprivation and social housing and with vulnerable families.
http://www.incredibleyears.com/ http://www.parenting.org.uk/ http://www.youngfoundation.org.uk/work/ local_innovation/consortiums/ the_local_wellbeing_project
Breastfeeding
Consider reviewing the level of provision and support available to disadvantaged mothers.
http://www.breastfeeding.nhs.uk/en/docs/ FINAL_Breastfeeding_Guide.pdf
Despite considerable efforts to encourage breast feeding in the UK, rates have remained static for the past 20 years with a strong disparity between social classes and ethnic groups
Health The Early Years (0-7) / Y blynyddoedd cynnar Service Poverty
Current Challenges Food Poverty The inequalities in what families eat – depending on their socioeconomic group, where they live in Wales, and their ethnic background – have not been recognised.
What Can Be Done?
Where To Go?
Think about establishing a group to work through the nutrition and food poverty toolkit.
http://www.heartforum.org.uk/downloads/ Nut_TkitAll.pdf
Reaching Out Consider innovative approaches to outreach Outreach work remains a particular challenge for early years provision such as investing in for early years programmes, specifically with Children’s Information Service Outreach. regards to improving services for fathers, the parents of children with disabilities, and for ethnic minorities in areas with smaller minority populations
Toolkit for Reaching Priority and Excluded Families
Gypsy, Roma and Traveller families Gypsy, Roma and Traveller families are particularly marginalised in terms of early years provision.
https://www.savethechildren.org.uk/en/ docs/earlyyears_traintoolkit.pdf
Utilise the “working towards inclusive practice” toolkit which has been designed to support training into Gypsy, Roma and Traveller culture. The exercises can be used separately as part of an existing programme or used together as a complete package.
Health Education and Learning Opportunities / Addysg Service Poverty
Current Challenges
What Can Be Done?
Where To Go?
Information advice and Guidance
Focus advice and guidance services for those at risk of disengagement.
The effectiveness of the Careers Wales Companies in supporting young people in making a successful transition from education to employment
Working with others
Consider bringing in role models to show people from their own background that can be successful.
http://www.infed.org/biblio/ role_model_education.htm http://www.teachers.tv/video/244
School Rewards
Develop in partnership a flexible pastoral and dfes goodpractice WAG: A whole school approach to behavyouth support framework iour and attendance
Basic Skills Low levels of basic skills in work hamper the ability of employees to progress and perpetuates in work poverty.
Prioritise basic skills within your own organi- Basic-skills-Wales: employer_pledge sations and encourage all partners to sign up to "Basic skills employer pledge". Complete and implement the action plan.
Health Health Freedom from Abuse and Exploitation / Iechyd, a rhyddid rhag cam-drin a Service Poverty
Current Challenges
What Can Be Done?
Where To Go?
Access to community healthcare services
Access to services is wider than the financial ability to pay for services. Using the needs assessment that underpins the HSCWB strategy and CYP plan, community based healthcare services provided by partnerships must be adequately targeted and delivered in areas of highest need to enhance participation, with consideration given to travel links and proximity to universal settings such as schools.
Health Poverty Index NSF Standards on access to services
Access to a safe and healthy environment
It is very often the environment in which a child or young person is living that can have the most impact on their health. Children living in poverty are more likely to be exposed to substandard facilities, such as school toilets or a lack of open access play areas. The public health strategic framework will set out a vision of improved public health and wellbeing for all children and young people by 2020. But for the framework to be successful action at a local level must begin now with reviews of community facilities and a better understanding of the links between wellbeing and poverty.
Public Health Strategic Framework Route to Health Improvement (WLGA) Review of school toilets (WAG &WLGA)
Health Health Freedom from Abuse and Exploitation / Iechyd, a rhyddid rhag cam-drin a Service Poverty
Current Challenges Access to substance misuse services
What Can Be Done?
Where To Go?
Poverty and neighbourhood deprivation increase children’s vulnerability to illicit drug use and looked-after children have been identified as particularly at risk. Working with the community safety partnership a review of the existing approach to reducing substance misuse and supporting families could ensure better aligned targets and outcomes across the authority as a corporate centre.
Access to community run healthy lifestyle Integration of health promotion and education groups into core community based universal services, such as Parent & toddler classes/Crèche’s/ fitness groups and support groups
London Borough of Islington Instant Crèche Company
Access to a healthy and balanced diet
Health Challenge Wales Food and Fitness Action Plan: Welsh community food co operatives Food Access Network Newcastle Community Food Initiative Access to affordable food in rural areasCommunity interventions Accessing affordable food-Policy link Report
There are a number of mechanisms to promote the benefits of a healthy diet alongside information on how local authorities can support the development of community food co-operatives such as an easy start up guide and access to funding.
Health Health Freedom from Abuse and Exploitation / Iechyd, a rhyddid rhag cam-drin a Service Poverty
Current Challenges
What Can Be Done?
Where To Go?
Access to information and support on key areas of public health such as: Nutrition, Maternal & Neo natal health, Breastfeeding, Immunisation, Sexual Health, Physical Activity, Obesity Understanding the impacts of poverty on families
Ensuring that targeted information is accessible to excluded groups such as families living in poverty is essential. In terms of health related behaviours partnerships and local government services such as environmental health and housing have a key role to play in delivering responsive and useful information in a suitable format on subjects relevant to public health including nutrition, breastfeeding, immunisations, healthy and hygienic environments etc An evaluation of HSCWB & CYP targets would support a strengthened approach to joined up working targeting limited resources around priority areas determined to have a poverty related impact on health and wellbeing, pooling budgets and resources.
WLGA Nutrition & food poverty toolkit D developing a local nutrition and food poverty strategy Health Challenge Wales have produced a leaflet and poster entitled the small steps to a healthier you Kettering healthy lifestyles info sheet Low Income Diet and Nutrition Survey Western Health Action Zone (Northern Ireland) supports a diversity of projects under the Family and Poverty theme Food poverty and health toolkit Nutrition and Health toolkit Breastfeeding strategy (Wales) Sports Council for Wales
Health Health Freedom from Abuse and Exploitation / Iechyd, a rhyddid rhag cam-drin a Service Poverty
Current Challenges Access to family planning services
What Can Be Done?
Where To Go?
Poverty and deprivation, poor educational achievement and low expectations have all been identified as key factors contributing to high rates of teenage pregnancy Poverty is a key risk factor for teenage pregnancy. Girls whose families are in social class V (unskilled manual) are ten times more likely to become teenage mothers than girls from professional backgrounds. They are also far less likely to have an abortion if they do become pregnant. Providing well targeted family planning and sexual education programmes are essential and linking this provision to the education curricula i.e. via P.S.E. would support the mainstreaming of some family planning and sexual health advice.
Brook information sheet Planned Teenage Pregnancy- JRF perspectives on teenage pregnancy and community based support mechanisms SCIE research briefing
Health Participation and Decision Making / Cymryd rhan yn y broses benderfynu Service Poverty
Current Challenges
What Can Be Done?
Where To Go?
Workforce Development There is a perception that there are skills gaps in relation to the delivery of participation activities relating to child poverty.
Training adults in the participation of children and young The Participation Unit has a list of people living in poverty so that they can support, participation trainers from across Wales. encourage and facilitate this process. The Unit is also piloting a Train the Trainers in children and young people’s participation which will cascade training across Wales.
Limited local knowledge There is limited research on the local barriers to participation caused by child poverty
Undertake participatory approaches to explore the barriers to participation of hard to reach children and young people / children and young people living in poverty in particular.
Download the good practice guide on ‘Ensuring Inclusion’ from www.participationworkerswales.org.uk Contact organisations with expertise in reaching hard to reach groups e.g. Black Voluntary Sector Network
Health Participation and Decision Making / Cymryd rhan yn y broses benderfynu Service Poverty
Current Challenges
What Can Be Done?
Where To Go?
Lack of Resources There are limited practical resources for facilitating the participation of vulnerable children and young people with sensitive issues such as child poverty.
Use resources available e.g. Dyamix ‘Spice It Up’ pack for games and activities. Draw on good practice from other areas / organisations
Sign up as a member to the participation e-briefings for the Participation Workers’ Network for Wales and get examples of good practice from across Wales. Download good practice guides on children and young people’s participation from www.participationworkerswales.org.uk. Liaise with local participation workers / youth forum workers who have a remit for the participation of children and young people locally. Liaise with local school councils. Liaise with Funky Dragon, the Children and Young People’s Assembly for Wales, which has a national remit for children and young people’s participation.
Processes Improving the process of children and young people’s participation and the quality of their experience overall remains a key issue for practitioners.
Use the National Children and Young People’s Participation Standards as a guide. There are seven standards: information, it’s your choice, no discrimination, respect, you get something out of it, feedback and improving how we work. Keeping to these Standards will mean upholding what children and young people have identified as the core components of participation.
Download the National Participation Standards document and the Self Assessment Pack from the website www.participationworkerswales.org.uk which shows how to measure and evidence against the Standards to improve good practice.
Health A Safe Home and Community / Cartrefi a chymunedau diogel Service Poverty
Current Challenges
What Can Be Done?
Where To Go?
Child Pedestrian Injuries Child Pedestrian Injuries are strongly related to with deprivation.
Explore methods of improving road safety in disadvantaged areas. Via the NSF arrangements within key action 2.38.
department for transport t roadsafety research
Home Safety Accidents within the home are a major health problem throughout Wales and are associated with a range of factors including poor housing conditions and poverty.
http://www.rospa.com/homesafety/wales/whsc/ Develop robust information provision and projects regarding the prevention of links.htm accidents with vulnerable families.
Health Income Maximisation / Employment / Heb fod dan anfantais o achos tlodi Service Poverty
Current Challenges Fuel Poverty
What Can Be Done? Utilise the Fuel Poverty Toolkit
Where To Go? NEA Fuel Poverty Toolkit
Health The Early Years (0-7) / Y blynyddoedd cynnar Participation Poverty
Current Challenges Children’s Information Services Poor communication with parents about the range of services available limits participation.
What Can Be Done? Develop a range of materials to support the promotion of early years provision to parents who are at risk of experiencing poverty.
Fathers Utilise the information provided and review Fathers’ involvement in the earliest months of practice. a child’s life may be critical to later outcomes.
Lone Parents Lone Parents participation Needs of disabled participation, ethnic minority.
Where To Go? http://www.surestart.gov.uk/_doc/ P0002522.pdf
http://www.surestart.gov.uk/_doc/ P0002547.pdf
Ensure that steps are taken to research the local Day Care Trust needs of lone parents and other groups at risk of child poverty.
Health Health Freedom from Abuse and Exploitation / Iechyd, a rhyddid rhag cam-drin a Participation Poverty
Current Challenges
What Can Be Done?
Where To Go?
Engaging local people in learning about nutrition
Cymru Cooks Cymru Cook website Cymru Cooks supports the development of cookery clubs, as an out of school hours learning activity. Clubs can now register on the Cymru Cook website either by downloading an online form or a word document.
Ensuring children and young people are able to participate in health related activities i.e. sport and exercise
National Participation standards and Self Assessment Many families are often put off or pack excluded from extra curricular Regeneration outcome agreement (Scotland) community activities as a result of the cost. Through maximising community facilities and programmes such as the community focused schools scheme, local provision can be enhanced at little cost. Additionally, working in partnership with local business to provide facilities and activity can reduce cost and enhance participation, creating local jobs along the way.
Health Play Sport, Leisure and Culture / Chwarae, campau, hamdden a'r pethe Participation Poverty
Current Challenges Lack of local capacity
What Can Be Done?
Where To Go?
The role of sport in regenerating communities A number of councils work in partnership with communities first partnerships, the arts council, sports councils and other voluntary sector providers to bid for funding and enhance local community capacity, specifically in the arts and cultural pursuits. Such collaboration ensures community needs are met whilst increasing facilities, access and engagement. The sports council, working with local authorities, has developed a programme called 5 x 60 aimed at increasing access to physical activity and sports. Sixth formers from across Wales have been trained to deliver support to younger children, enhancing both their skills and values and ensuring increased participation. Local grants are available from the Sports Council for Wales to support small enterprise organisations in their provision of local sporting opportunities. Grants are also available to a wide range of organisations to support the development of capacity.
Health Play Sport, Leisure and Culture / Chwarae, campau, hamdden a'r pethe Participation Poverty
Current Challenges The need for local services to encourage greater participation.
What Can Be Done?
Where To Go?
There will be enhanced participation if service provision is worthwhile, fun and gives opportunity to gain new skills or an award (e.g. Millennium volunteers Grant scheme) Development of intergenerational projects enhances skills and provides access to services e.g. cinema night or cultural trips.
Communities First Network- Billy Brown Creative Partnerships Arts Council Wales strategies for promoting participation and funding opportunities. WAG Statement 2005 Welsh Association of Local Sport Councils Libraries for Life
Some local authority areas have sports’ councils who provide a voice for local clubs. The umbrella body for these is the Welsh Association of Local Sport Councils. The Libraries for Life scheme launched by WAG should encourage greater engagement with and use of local library facilities
Health A Safe Home and Community / Cartrefi a chymunedau diogel Participation Poverty
Current Challenges
What Can Be Done?
Where To Go?
Play Research over recent years has repeatedly highlighted children’s declining presence in the outdoor world that was traditionally their playground. Possible causes are traffic, fear of crime, negative attitudes to children in public and planning policies that take little account of their needs.
Child's Play: Facilitating play on housing estates One of the main reasons children give for not playing outdoors more is that they and their parents are afraid for their Open Space and Children's Play Areas Checklist safety. Fear of strangers, traffic and bullying by other children combine to keep children in their own homes. Good play provision protects children through reducing unacceptable levels of danger, while allowing them the opportunity to challenge themselves and use their initiative
Participation and Leisure
Consider the creation of a virtual team to work with homeless families in hostel and other settings. The idea of a virtual team is to bring together services such as a link social worker, education welfare, children’s worker and other agencies to co-ordinate their work. Each team member would retain their existing line management and job title but would be given time to contribute.
Health Income Maximisation / Employment / Heb fod dan anfantais o achos tlodi Participation Poverty
Current Challenges
What Can Be Done?
Where To Go?
Lack of appropriate profession debt advice can adversely affect participation and access to services.
Develop a co-ordinated approach that links voluntary sector and statutory provision to deliver streamlined debt advice provision.
Citizens Advice Cymru is the lead Organisation of the Financial Inclusion Fund project, which offers face to face debt advice in Wales
Families and young experiencing poverty often face difficulties accessing financial products and internet deals such as basic bank accounts.
Basic Bank accounts Toolkit E.g. Carmarthen LA and Carmarthen CAB have worked to ensure that Local Housing Allowance claimants have access to bank accounts
Basic Bank Account Toolkit for Housing Benefit claims is designed to guide other Local Authorities through the process of setting up the same kind of service we have with one bank and to address any questions