Decision details

Stewart Horn, Head of Children’s Integrated Commissioning, informed the Board that he worked in an integrated role, representing the Integrated Care Boards, and Kirklees Council’s Children services. He explained that the update would focus on the new integrated governance arrangements for the health and wellbeing of children in Kirklees, called the Starting Well Program.

In summary, the Board was informed that in terms of historical context, there was the Children and Young People's Partnership Plan which ran from 2020 to 2023, and the Health and Wellbeing Board had oversight of that. The priorities in the plan included:

-      To reduce the effects of poverty on children - this has now become a Council wide focus, there is a tackling poverty partnership, there are various cost of living support programmes and poverty awareness when working with families. This ensures the continual monitoring and analysing of the negative effects of poverty on children's experiences and outcomes

-      To support inclusion and better outcomes for LGBT+ young people – this came out loud and clear on many of the children and young people surveys undertaken and as a result of this increase focus, a service has been commissioned to support LGBT plus children and their families as well as the agencies working around them

-      To grow our youth offer, places to go, people to see, things to do – this is now the core work of the youth development programme, and various projects have been delivered including ‘Our Space’ which was regarding capital grants for local voluntary sector providers to improve their facilities, provisions and venues. There is the holiday activity and food program which provides activities for children in school holidays

The integrated approach to governance in Kirklees is known as the ‘Well Programmes,’ and the focus of the programme is to align all of the top tier strategies with the emphasis being the Health and Wellbeing Strategy. This helps the system to work together towards shared outcomes. Under the programme, there is a life course approach, which includes, Starting Well, Living Well and Aging Well.

The idea is that work is undertaken in a collaborative way with providers and Commissioners, giving everybody an equal voice at the table and everyone's view is heard. There is distributed leadership around the system where partners have been given autonomy to deliver in the best way they can, ensuring that the programs are partnership led. It is important that the plans are not seen as  NHS or local authority plan, it is system wide, and it is hoped that partners feel sufficiently engaged.

It was felt important that there was some senior system leadership with the plans, therefore senior leaders from across the partnership lead each of the plans. Tom Brailsford as director of Children's services, has agreed to chair and lead the Starting Well Programme.

The principles worked to when developing the Well Programmes, were developed through some initial workshops, and the outcome from those workshops included the following:

-      Alignment of priorities - to ensure that focus is on collective resource on the same things

-      Prevention and self-management and community empowerment – and an important part of this is VCSE involvement and their sustainability

-      Personalised care - is also a key principle, encouraging people to think beyond the boundaries of their host organisations and that work is undertaken  collaboratively and not in competition. This is not seen as a performance framework but more of a collaboration space and a framework for system support

The Board was informed that the core aim of the Starting Well Programme, is based around one of its aligned shared outcomes, specifically, to ensure that children have the best start in life. In Kirklees, there are a number of markers, which it was an outlier for in terms of stillbirths, infant mortality,  and childhood and maternal obesity. There are inequalities within these outliers, many of which relate to protected characteristics.

In addition to these issues, there are systemic issues that needs to be addressed, for example, families have said that they often have to tell their stories multiple times, and it is recognised that there isn’t always a systematic approach to collecting outcomes from children and families. Where it is collected,  this intelligence appropriately can inform service design and transformation.

One of the primary reasons for the development of Starting Well Board in Kirklees, was that it was recognised that there was a lack of partnership means of oversight for the program in the area. This led to some disjointed priorities and there was a  need to improve systems thinking and leadership and the Starting Well Programme was a means to address that. One of the early models approached with the starting well principles, is the Families Together Programme.

Referring to the presentation, the Board was shown a diagram of the governance arrangements and the workstreams that sit under the Starting Well Programme. The governance arrangements includes the Starting Well Board, Early Years Programme Board, Youth Development Programme Board, Early Support Partnership Steering Committee Group, and Childrens Emotional Health and Wellbeing Partnership.

The Families Together Programme is one of the first examples of the starting well approach. The Board’s attention was drawn to the branding that has been adopted and developed and partners were encouraged to use the branding wherever possible to promote the approach and make everyone aware of families together as a principal. There are a range of slides and headers that people can adopt.

Families together comes from the national Family Hubs program, which is driven by the Department of Health and Social Care and Department for Education. This program was designed to help provide support to parents and carers to enable them to nurture their babies and children, improving healthcare and education outcomes for all, and to contribute to a reduction in health inequalities. It will also help to build the evidence base for what works for future services. This national program did come with some funding opportunities, unfortunately, Kirklees was not successful, howeverit was decided to still work to the principals.

The Board was informed that work is being undertaken to progress that approach in Kirklees, whilst recognising that advances may not progress as quickly as some neighbouring authorities, due to the funding issue. In Kirklees, Families Together has been defined as a place-based integrated early support offer to children, young people and families aged 0-19 or up to 25 where the children have special education needs and disabilities. It is a principle of whole family working and was approved at Cabinet in 2021.

It is split into four geographical areas which have some physical sites however, it is about how organisations in the area are co-ordinated and to help with that,  some Families together area partnerships have been funded and are led by voluntary sector organisations. The four main sites are:

-          Huddersfield (Chestnut Children's Centre)

-          Dewsbury and Mirfield (Dewsbury Moor Children's Centre) 

-          Kirklees Rural (Slaithwaite Town Hall )

-          Batley and Spen (Birstall & Birkenshaw Children's Centre)

It is still very much in its infancy; however, progress is already being seen and it is important that there is this governance process to show accountability for priorities and supportive challenge which will ultimately lead back up to the Health and Wellbeing Board.

In response to the information presented, Board members asked a number of questions and made comments including the following:

-      There has been quite a transformation and change, and it is good to see it actually coming together and the real test is how to move this model going forward.

-      One of the areas mentioned in the presentation was with regard to workforce training, particularly the example given about families having to tell their stories over and over again and it has been like that for a long time. It is important to move away from that,  and workforce training is one way to enable different sectors to understand how each other works and doing things in the same way instead of doing things in their own way. It would be positive to put some effort into that,  and it would include the public sector, the health agencies, VCs and the University all working together, people being trained in the same room

-      Recognising that this is still at an early stage, from the information presented there are some outputs in terms of information being sent out to ensure that people understand about the services. In trying to understand what the outcomes will be, because in some places these are to be determined and other places it will link into strategies, it would be good if there could be clarity on what the expected outcomes will be from these outputs and if possible likely timescales

In closing, the Chair summarised that during the discussion there were a couple of issues to take away. Firstly, how can partners work together to build up training programs with the aim of everyone speaking the same language. Secondly,  work on articulating outcomes including timelines.

RESOLVED:

That:

-          Stewart Horn be thanked for providing an update on Kirklees Health and Care Partnership – Starting Well Programme

-          consideration be given to how partners can work together to build up training programs with the aim of organisations speaking the same language

-          work is undertaken on articulating outcomes including timelines