Partnership commissioning arrangements for children and young people in Hertfordshire

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1 Partnership commissioning arrangements for children and young people in Hertfordshire DRAFT Summary of Commissioning Strategy for D R A F T Early Intervention and Prevention

2 What is a commissioning strategy? We want to ensure we get the best value out of all of our resources. In terms of improving outcomes, make sure they are targeted where they can make the most difference and that we use evidence to make decisions about the types of services and support that are needed for our communities. To do this we need to understand how current services are performing, what impact they are having, and how we may need to do things differently to further improve outcomes for children and young people in Hertfordshire and respond to changing needs. A commissioning strategy sets out how we will do this, what resources are available and who we will be working with. It details what the current outcomes are and what we want to achieve by working in partnership and measuring our performance through the Early Intervention and Prevention Strategic Commissioning Group.. Vision In Hertfordshire, we have strong ambitions for children and young people to succeed. It is essential to give them the best possible start in life and, whenever and wherever they experience problems, be able to provide flexible responses to ensure that support is given and initial problems do not become barriers that prevent children and young people achieving. Our aim is to enable all children and young people in Hertfordshire to aspire to, and achieve their full potential, giving them the foundation for a successful life. The role of health services, children s centres, schools and voluntary sector organisations in delivering and supporting effective early intervention cannot be underestimated from early pregnancy and support for families with young children, throughout childhood and adolescence. The active engagement of all partners in both identifying need at the earliest opportunity and supporting to meet these needs, is vital. Introduction This strategy sets out the shared commissioning objectives of key agencies in Hertfordshire for the children and families in our county. The commissioning strategy provides a framework for identifying children and young peoples needs and gaps in service provision; setting our commissioning intentions and evaluating options for meeting these, including developing the market; identifying the key outcomes we are seeking to achieve; detailing the collective resources available; and setting targets for reducing expenditure. The Thriving Families Programme in Hertfordshire aims to support families who are unable to thrive and achieve their full potential due to the range and complexity of the problems they face. These families will be integral to the outcomes of this strategy. Families who we are aiming to support through this programme will include: Families where the children are not regularly attending school Families who are involved in crime and/or anti social behaviour Families where no member is in paid work Health and Wellbeing Board: Children and Young People Commissioning Group 2

3 Why have a commissioning strategy for Early Intervention and Prevention? Early Intervention and Prevention has been at the heart of the national and local agenda for change for children for many years. Different organisations, which support vulnerable children and their families, are now working together through the Early Intervention and Prevention Strategic Commissioning Group, which forms part of the health and well being board arrangements. A key element of our working together and commissioning services will be to make the best use of existing resources, provide more co-ordinated preventative services, and have clear expectations of how we will work together and a common understanding of what early intervention and prevention means to our different agencies. We know from the work we have done with families that there are many problems that they face that had they been identified and addressed earlier would have prevented them from escalating and becoming far more damaging and complicated. We want to ensure we make the most of our universal services to support families who are most in need and ensure they get the support they need at the earliest possible opportunity. By having a co-ordinated approach to how we commission these services we can make a real difference at a much earlier stage. How have we developed the strategy? Multi-agency workshops were held during the summer of 2011, enabling us to listen to the views of the different partner organisations working with children, young people and their families in Hertfordshire. We listened to children, young people, parents and carers about what makes a difference to them and about services they attend. We also used evidence from needs analysis, for example, evidence about how living in poverty impacts on a child s overall emotional wellbeing and educational attainment. We collated this information, alongside what we know we currently spend on services and support, and identified where by working in partnership, we could make a real difference to the lives of children and young people. We have called these areas our strategic objectives. What are our strategic objectives? For the first year of our commissioning strategy (2012/13) we are proposing five strategic objectives. 1) Reducing child poverty We know children who live in poverty are less likely to achieve at school, are more likely to have health problems, and live in households where there may be other problems such as domestic abuse, parental ill health, and substance misuse. We know that these children have complex lives and are often accessing many different services. According to the Government definition of poverty, approximately 13% of children in Hertfordshire nearly 32,500 children, were considered to be living in relative poverty in Health and Wellbeing Board: Children and Young People Commissioning Group 3

4 Our intention is to develop support for families around the following themes: - Employment and adult skills - Services for children and young people - Financial support - Housing and neighbourhoods 2) Reducing the impact of domestic abuse on children and young people Domestic abuse is a serious issue that can result in poor outcomes for children in all areas of their lives. The annual cost to the county is around 517.5m, with domestic abuse accounting for 20% of all violent crime. It affects approximately 70% of young offenders with involvement in approx. 80% of child protection cases. The commissioning strategy will set out what partner agencies can do to really make a difference to the lives of these children, and ensure that children living within abusive or violent families are helped are helped and protected. This will include how we can work with universal services to help identify when children may be living in households where there is domestic abuse, so that we can intervene as early as possible and help children and their families. 3) Preventing children becoming looked after The aim is to co-ordinate services more effectively with the overall purpose of preventing, where possible, children and young people entering the care system. Using early intervention and preventative services to support children at the earliest possible opportunity through a multi-agency approach. 4) Maintaining a healthy weight Childhood obesity is a serious health problem that can follow people much later into life. It is a causal factor in a number of chronic diseases and conditions including high blood pressure, heart disease and type 2 diabetes. The Hertfordshire Healthy Weight Task and Finish Group has been mandated from the Health and Wellbeing Board to ensure children, young people and their families maintain a healthy weight with the aim of reducing obesity and BMI in children, young people and their families. This will be implemented through increased physical activity programmes in schools, breastfeeding support networks and educating parents around healthy eating within children s centres. Local communities will also be involved to ensure effective partnership working at all levels. A number of projects are running across Stevenage and Watford, developed locally with partners within Stevenage and Watford Borough Council and will be delivered by October The aim is then to then review how the projects and subsequent impact can be made sustainable. 5) Reducing unplanned visits to accident and emergency units The primary care trust spent 3m in 2010/11 on A&E activity for children and young people, where evidence suggests 80% of the activity should have been dealt with Health and Wellbeing Board: Children and Young People Commissioning Group 4

5 by a primary or community care response. Reasons for the use of A&E by families are complex. Initial conversations with GP s, paediatricians and other partners confirm there is potential for improving care pathways and patient and carer experience, and the potential to make significant savings. East & North Herts Hospital trust are keen to work with commissioners and providers to test new ways of delivering care to children young people and their families locally. How will we know we are making a difference? Ensuring that we keep a focus on maintaining and improving outcomes for children and young people at a time of substantial reductions in the public purse is crucial if the improvements made in Hertfordshire in recent years are not to be reversed. That is why our strategy sets out clear indicators for measuring the difference the strategy is having for vulnerable children, young people and their families. All the agencies involved in this strategy will meet on a regular basis to monitor the progress we are making Children and young people and their families are at the centre of service planning and commissioning and all agencies involved in the development of this commissioning strategy are committed to ensuring children s views inform and influence the way in which we commission services. Each agency will have their own plans for engaging with service users, and feedback from partner agencies will inform the commissioning process so that we are continuously improving outcomes for children. Health and Wellbeing Board: Children and Young People Commissioning Group 5

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