3 Reaching the most disadvantaged
families
17. The children's centre programme will not achieve
its overall aim of providing the best start in life for all children
if it does not take adequate steps to reach the most disadvantaged
families. To date, centres have been poor at reaching out to the
families that require the most help. Only one third of the centres
visited by the National Audit Office had proactively sought out
hard to reach families (Figure 4). There are examples of
good practice, however, including the use of informal activities
to get parents involved in children's centre services.[26]
Figure 4:
Number of centres targeting disadvantaged and hard to reach groups
About one third of children's centres visited were
pro-actively targeting hard to reach groups
| Directly: Centre is pro-active in identifying and targeting disadvantaged groups and has a strategy /action plan in place. Centre develops strong links with existing community groups and health organisations to maximise outreach potential.
| 9 |
| Indirectly: Centre is engaging disadvantaged groups through being located in one of the most deprived areas. However, it is not pro-actively targeting hard to reach groups, may not be providing much outreach beyond the centre site and is not aware of groups who are currently not using the centre.
| 5 |
| Some outreach: Centre has some outreach activities for their services which target disadvantaged groups, but may be limited.
| 9 |
| None: Centre is located in a relatively less deprived area and does not specifically target disadvantaged or hard to reach groups due to lack of either outreach workers or funds.
| 5 |
| TOTAL
| 28 |
Source: Analysis of results of National Audit
Office visits to 30 children's centres. For two centres the National
Audit Office was unable to draw a clear conclusion.
18. So far there has been only mixed success in achieving
against Public Service Agreement targets to which children's centres
contribute. For example, the proportion of young children with
satisfactory speech and language development at two years has
increased, but the target of a 12% reduction in the proportion
of young children living in households where no one is working
has not yet been achieved. The Department recognises that it is
difficult to reach the most disadvantaged families, and some groups
have not been reached.[27]
19. In November 2006 the Department issued good practice
advice that features case examples of successful outreach. Its
performance monitoring guidance stressed the need to measure success
by the level of outreach to disadvantaged families and the outcomes
for children. Centres are being encouraged to develop measures
that are meaningful for them rather than ones that are imposed
without due regard for local condition and needs.[28]
20. It will also be necessary to work more closely
with voluntary groups who are closer to disadvantaged families.
The Committee's report on Working with the Voluntary Sector
found that voluntary groups were especially good at serving
the hard to reach[29].
The earlier Sure Start Local Programmes were run by bodies including
community and parents' groups, and the Department expects close
parental involvement to continue, but that under the new arrangements
centres will focus on activities that have been shown to make
an impact. It is important that as Sure Start Local Programmes
are superseded by children's centres, involvement of voluntary
groups who may have participated in the earlier programme does
not diminish.[30]
21. Children's centres are not able generally to
meet the needs of children with severe physical, sensory or behavioural
disabilities but they can have an important role in directing
them to specialist services. Parents report that centres are inconsistent
in referring such children on to specialist agencies, as staff
awareness of the needs of disabled children is low.[31]
There are some good examples of centres offering respite for parents,
and the Department is working with the national charity Contact
a Family in order to reach out more to disabled children and their
families. However, more needs to be done to meet specific needs
such as speech and language therapy to provide the early intervention
that is critical to child development.[32]
22. Children's centres are most effective when there
is close co-operation between the different agencies offering
services. In particular, evaluation of the Sure Start Local Programmes
suggested that centres managed by the health sector were particularly
effective. The Childcare Act 2006, together with the Children's
Act 2004, places a responsibility on local authorities, Primary
Care Trusts and other partners such as Jobcentre Plus to work
together to provide effective multi-agency services to improve
the well being of under fives. However, there are sharp variations
across England in the degree to which Primary Care Trusts and
local authorities are coordinating their services for young children.
Very few areas have established a joint strategy. The Department
of Health cannot provide precise information on the areas where
Primary Care Trusts are coordinating most effectively, but it
estimates that in 16 children's centres as at November 2005, Primary
Care Trusts were not using the centre either as a main base for
early years' services or for outreach. The restructuring of Primary
Care Trusts from October 2005 offered a good opportunity to improve
joint working with local authorities, as they and Primary Care
Trusts are now more likely to cover the same geographical areas,
with those having the same boundaries increasing from 44 to 70%.[33]
23. Close working with the health sector is especially
important as health visitors are a very important contact with
hard to reach families. In many areas, health visitors visit all
families after the birth of a child, allowing them to assess the
needs of the family and to provide information about the services
on offer. Children's centres report that a shortage of health
visitors and funding pressures at Primary Care Trusts have contributed
to the difficulties in achieving more commitment from the health
sector. The history of partnership working locally has also had
an influence. The shortage of health visitors could become even
more problematic as the number of centres grows to 3,500 by 2010.
The Department of Health reports some success in recruiting more
health visitors; as at March 2006, reported vacancies were at
their lowest point since 1997. Recognising the important role
played by health visitors, the Secretary of State for Health initiated
a review of health visiting which reported in June 2007.[34]
26 C&AG's Report para 3.2, Figure 15; Qq 8, 105 Back
27
C&AG's Report, para 1.16, Figure 7; Qq 6, 18, 30, 60 Back
28
Qq 7, 18, 22, 30-33, 106 Back
29
Committee of Public Accounts, Thirty-second Report of Session
2005-06, Working with the Voluntary Sector, HC 717, 15
February 2006; found that voluntary sector organisations may be
best placed to deliver a service, particularly to people who are
difficult to reach or distrustful of state agencies. Back
30
Q 107 Back
31
C&AG's Report, paras 3.27-3.28 Back
32
Qq 71-73 Back
33
C&AG's Report, paras 3.18-3.20, Figure 19; Qq 21, 27-28, 44-50;
Ev 18 Back
34
C&AG's Report, para 3.21; Qq 44, 47-48, 67-70; Facing the
Future: A review of the role of health visitors, Chair: Rosalynde
Lowe, Queen's Nursing Institute, June 2007 Back
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