Giving Our Children the Best Start in Life


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How can we ensure Scotland’s children reach their full potential? What interventions can we reliably deliver across antenatal, maternal, child health and education services so all our children have the best start in life? This session will share evidence, experience from case studies and discuss challenges associated with the implementation of early years interventions.

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Giving Our Children the Best Start in Life

  2. 2. Why? <ul><li>The early years set a large part of the pattern of an individual’s future life </li></ul><ul><li>If we can improve them, we can begin to address inequalities </li></ul><ul><li>Which will also benefit wider society </li></ul><ul><li>Backed up by research from a number of academic fields </li></ul>
  3. 3. Some research evidence <ul><li>Dunedin Study 1972 – longitudinal study on sociological outcomes </li></ul><ul><li>Dr Bruce Perry – neuroscientific evidence on brain development </li></ul><ul><li>EPPE Study – Effective Provision of Pre-school education – educational outcomes </li></ul><ul><li>CMO’s report 2007 – health outcomes </li></ul><ul><li>WAVE trust – tackling violence </li></ul><ul><li>Suzanne Zeedyk, Dundee University – psychological outcomes </li></ul><ul><li>Richard Tremblay (Quebec) – youth justice </li></ul><ul><li>Work Foundation – economics </li></ul><ul><li>Frank Field – child poverty </li></ul><ul><li>Joining the Dots – Report from Professor Susan Deacon </li></ul>
  4. 4. And… <ul><li>Scottish Government economic modelling work published Nov 2010 – investment in early years can yield savings in short medium and long terms. </li></ul><ul><li>Short term – savings of up to £37,400 per child per year </li></ul><ul><li>Medium term – up to £131m across Scotland </li></ul><ul><li>Long term - failure to effectively intervene in early life could result in a nine fold increase in costs to the public purse </li></ul>
  5. 5. Moving from… Education Social Work Health Adult Services
  6. 6. Moving towards
  7. 7. With two important roles <ul><li>Named person </li></ul><ul><li>Lead professional </li></ul><ul><li>Both important to early intervention, that is: </li></ul><ul><li>The life of a child, </li></ul><ul><li>Spectrum of complexity or </li></ul><ul><li>Life of a crisis </li></ul><ul><li>To prevent escalation or deterioration. </li></ul>
  8. 8. Since 2008… <ul><li>Equally Well early years test site </li></ul><ul><li>Playtalkread /Go Play </li></ul><ul><li>NHS Quality Improvement Scotland “A Pathway of Care for Vulnerable Families 0-3” </li></ul><ul><li>Testing of Family Nurse Partnership Programme </li></ul><ul><li>Refreshed Framework for Maternity Care (2011) </li></ul><ul><li>Improving Maternal and Infant Nutrition: a framework for action (2011) </li></ul>
  9. 9. 2011 onwards <ul><li>Continuing and increased commitment to early years </li></ul><ul><li>Change fund </li></ul><ul><li>Continued investment in Early Years Early Action Fund and Playtalkread </li></ul><ul><li>National Parenting Strategy </li></ul><ul><li>Roll out Family Nurse Partnership (FNP) programme across Scotland. </li></ul>
  10. 10. 2011 onwards contd. <ul><li>Early years task force to co-ordinate policy and ensure that early years spending is prioritised by the whole public sector </li></ul><ul><li>Ensuring that every Community Planning Partner in Scotland reflects this agenda in its Single Outcome Agreement. </li></ul><ul><li>New legislation to support early years policy. </li></ul>
  11. 11. PrePare – an integrated approach to working with pregnant women who have problem substance use
  12. 12. <ul><li>Substance misuse during pregnancy is recognised to be associated with increased risks for both mother and baby. </li></ul><ul><li>In April 2006 PrePare was formed to be an integrated multi-disciplinary team designed to offer intensive support to pregnant women with drug/alcohol problems. </li></ul>PrePare
  13. 13. Partnership Working
  14. 14. Referral Criteria <ul><li>Over 16 years of age </li></ul><ul><li>Confirmed pregnancy </li></ul><ul><li>Suspected or known chaotic or illicit drug / alcohol use </li></ul><ul><li>Not engaging with mainstream services </li></ul><ul><li>A history of child protection involvement </li></ul>
  15. 15. Mother and child Intensive Outreach – in the home and in the community midwifery addictions Father and extended family Health visitor Nursery officers
  16. 16. Policies and Guidelines When Working with Families <ul><li>Child Protection Guidelines </li></ul><ul><li>GIRFEC </li></ul><ul><li>Orange Book </li></ul>Regardless the procedure – good communication is paramount
  17. 17. Substance use at point of referral <ul><li>Based on 73 women in 2010 </li></ul><ul><li>Drugs 74% </li></ul><ul><li>Alcohol 3% </li></ul><ul><li>Drugs / alcohol 23% </li></ul>
  18. 18. 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 period
  19. 19. Outcomes 2010 <ul><li>Average age of PrePare client: 27 years </li></ul>
  20. 20. NAS outcomes for babies born 2010 <ul><li>NAS Outcomes for 28 babies; </li></ul><ul><li>Premature birth 8 </li></ul><ul><li>Experiencing NAS symptoms 16 </li></ul><ul><li>In need of treatment for NAS 1 </li></ul><ul><li>Neonatal unit 12 </li></ul>
  21. 21. Why does it work? <ul><li>Team </li></ul><ul><li>Professional skills mix </li></ul><ul><li>Co-located </li></ul><ul><li>Partnership learning </li></ul><ul><li>Shared respect </li></ul><ul><li>Shared goals </li></ul><ul><li>Commitment </li></ul><ul><li>Service Users </li></ul><ul><li>Child centred </li></ul><ul><li>Client centred </li></ul><ul><li>Flexible approach </li></ul><ul><li>‘ One stop shop’ </li></ul><ul><li>Non-judgemental </li></ul><ul><li>Shared goals </li></ul>
  22. 22. Questions <ul><li>What is currently working well where you are in relation to early intervention in the early years ? </li></ul><ul><li>What learning will you take away from today? </li></ul><ul><li>How will you be able to implement it? </li></ul>