GIVING OUR CHILDREN THE BEST START IN LIFE

Why?

• The early years set a large part of the pattern of an individual’s future life

• If we can improve them, we can begin to address inequalities

• Which will also benefit wider society

• Backed up by research from a number of academic fields

Some research evidenceDunedin Study 1972 – longitudinal study on sociological outcomesDr Bruce Perry – neuroscientific evidence on brain development EPPE Study – Effective Provision of Pre-school education – educational outcomesCMO’s report 2007 – health outcomes WAVE trust – tackling violenceSuzanne Zeedyk, Dundee University – psychological outcomesRichard Tremblay (Quebec) – youth justiceWork Foundation – economicsFrank Field – child povertyJoining the Dots – Report from Professor Susan Deacon

And…

Scottish Government economic modelling work published Nov 2010 – investment in early years can yield savings in short medium and long terms.Short term – savings of up to £37,400 per child per yearMedium term – up to £131m across ScotlandLong term - failure to effectively intervene in early life could result in a nine fold increase in costs to the public purse

Moving from…

Education Social Work Health Adult Services

Moving towards

With two important roles

• Named person• Lead professionalBoth important to early intervention, that is:• The life of a child, • Spectrum of complexity or• Life of a crisisTo prevent escalation or deterioration.

Since 2008…

• Equally Well early years test site • Playtalkread /Go Play• NHS Quality Improvement Scotland “A Pathway of Care

for Vulnerable Families 0-3” • Testing of Family Nurse Partnership Programme• Refreshed Framework for Maternity Care (2011)• Improving Maternal and Infant Nutrition: a framework for

action (2011)

2011 onwards

• Continuing and increased commitment to early years

• Change fund

• Continued investment in Early Years Early Action Fund and Playtalkread

• National Parenting Strategy

• Roll out Family Nurse Partnership (FNP) programme across Scotland.

2011 onwards contd.

• Early years task force to co-ordinate policy and ensure that early years spending is prioritised by the whole public sector

• Ensuring that every Community Planning Partner in Scotland reflects this agenda in its Single Outcome Agreement.

• New legislation to support early years policy.

PrePare – an integrated approach to working with pregnant women who have problem substance use

Substance misuse during pregnancy is Substance misuse during pregnancy is recognised to be associated with increased recognised to be associated with increased risks for both mother and baby. risks for both mother and baby.

In April 2006 PrePare was formed to be an In April 2006 PrePare was formed to be an integrated multi-disciplinary team designed to integrated multi-disciplinary team designed to offer intensive support to pregnant women with offer intensive support to pregnant women with drug/alcohol problems.drug/alcohol problems.

PrePare

Partnership Working

Referral Criteria

1.1. Over 16 years of age Over 16 years of age 2.2. Confirmed pregnancyConfirmed pregnancy3.3. Suspected or known Suspected or known

chaotic or illicit drug / chaotic or illicit drug / alcohol usealcohol use

4.4. Not engaging with Not engaging with mainstream servicesmainstream services

5.5. A history of child A history of child protection involvementprotection involvement

midwifery

addictions

Father and extended familyHealth visitor

Nursery officers

Mother and child

Intensive Outreach – in the home and in the community

Policies and Guidelines When Working with Families

1. Child Protection Guidelines

2. GIRFEC

3. Orange Book

Regardless the procedure – good communication is paramount

Substance use at point of referral

Based on 73 women in 2010

Drugs 74% Alcohol 3% Drugs / alcohol 23%

Change in Substance using behaviour

Changes in substance misusing behaviour in 46 clients working with the addictions nurse within the team during the treatment and support period0

10

20

30

40

50

60

70

80

Heroin Cocaine Alcohol Stable Drug/AlcoholFree

Assessment

Delivery

Discharge

Outcomes 2010

Average age of PrePare client: 27 years

CP Outcomes, at birth (1) and discharge (2)

0

2

4

6

8

10

12

14

16

1 2

with mother

LAAC

birth father

kinship carer

permanent families

NAS outcomes for babies born 2010

NAS Outcomes for 28 babies; Premature birth 8 Experiencing NAS symptoms 16 In need of treatment for NAS 1 Neonatal unit 12

Why does it work?

Team

Professional skills mix Co-located Partnership learning Shared respect Shared goals Commitment

Service Users

Child centred Client centred Flexible approach ‘One stop shop’ Non-judgemental Shared goals

Questions

What is currently working well where you are in relation to early intervention in the early years ?

What learning will you take away from today?

How will you be able to implement it?