Education Committee - Minutes of EvidenceHC 364

Oral Evidence

Taken before the Education Committee

on Wednesday 10 July 2013

Members present:

Mr Graham Stuart (Chair)

Neil Carmichael

Alex Cunningham

Bill Esterson

Pat Glass

Siobhain McDonagh

Ian Mearns

Mr David Ward

________________

Examination of Witnesses

Witnesses: Louise Silverton, Director for Midwifery, Royal College of Midwives, Councillor Richard Roberts, Lead Member for Children’s Services and member of Health and Wellbeing Board, Hertfordshire County Council, Jane Williams, Head of Children, Young People and Family Services, Integrated and Community Care Division, South Warwickshire NHS Foundation Trust, and Carole Bell, Head of Children’s Commissioning, North West London Commissioning Support Unit, gave evidence.

Q545 Chair: Good morning and welcome to this session of the Education Committee, looking at "Foundation Years: Sure Start Children’s Centres". We are delighted that you have been able to come and join us today. We act in a fairly informal manner and tend to use first names. Are you all comfortable with that? That is great.

To start off with, the most recent impact evaluation of Sure Start that was published found no beneficial effects on children’s educational development, social and behavioural outcomes, or health outcomes; so, why would you as health professionals engage with children’s centres? Louise.

Louise Silverton: I did not know you are supposed to bowl a googly first ball, but there we are.

Chair: It was not a friendly one, was it?

Louise Silverton: It makes a lot of sense for midwives to be working with other professionals who are delivering health and support in the early years, and the joinedupness of care when a children’s centre is working well is extremely important. If you look at the whole agenda of troubled families, it helps greatly if you can identify families early and get them care early, because we certainly do know that early access to antenatal care does improve health outcomes. That does allow you to work on some of the public health aspects of care for parents and babies, including things like promoting breastfeeding and maintaining weight during pregnancy. We should be looking at much longer health gains than the report has been looking at, because we are looking at Foundation Years, and foundation, by its very nature, is not short term.

Q546 Chair: You think, basically, that the research to date, albeit disappointing, is simply too short term for us to draw any real conclusions about this.

Louise Silverton: I believe it is.

Q547 Chair: Would you go further and say that, despite those evaluations, you think that engagement by health with children’s centres is absolutely the right thing to do?

Louise Silverton: Yes, I will say that.

Carole Bell: I would also say that children’s centres are quite complex organisational structures, and we have expected individual professionals to go into children’s centres from a different organisational set of aims and objectives and to try to mix and join in with a range of offers and opportunities to be made available to children and families. It has taken us time to mature all the relationships and all the partnerships that we need in order to make that really efficacious. We are on the right road.

Q548 Chair: Are you sufficiently questioning? One thing the evaluation should do is to get you to ask yourselves some pretty fundamental questions, again, about exactly what you are doing, and whether what perhaps common sense or intuition tells you should work is or is not working. It should get you to go back, think it through and make sure that what you are doing is most likely to lead to positive outcomes for the children.

Carole Bell: As the funding gets tighter and tighter, we are doing more of looking at exactly what we are buying. If I can use the example of speech and language therapy, across Westminster, Hammersmith and Fulham, and Kensington and Chelsea, we have speech and language therapists going into children’s centres to provide a range of functions, training of staff, one to one, but with some group work and some regular dropins. They see a huge number of parents who have concerns about their child’s communication developments: thousands over the course of a few years in those three boroughs. Very, very few referrals to speech and language therapy come out of that, so there is a question there: are we doing the right thing by seeing all those parents and giving them a lot of reassurance? Would they have come to the health services anyway, or are they in a sense just checking out what is required? We have been thinking about: do we have the model right; are we investing the right amount of money; are we doing the right things? At the moment, we are saying we think we are, but we need to follow it up, so there is a question mark over all the investments that we are making.

Jane Williams: I would agree with both Louise and Carole. We have been working really closely with children’s centres, certainly in Warwickshire. We have got over 50% of our health visitors based in children’s centres. We know that we are making a difference. We have figures to show that we are making a difference. We have reduced obesity and we have raised the numbers of people that are breastfeeding, so we know that we are narrowing that gap. I do not think that we could work together now-certainly from a health visiting point of view-without the children’s centres. I agree with what you are saying: because we have had to make significant reductions-there are significant reductions in funding-we are having to really examine exactly what we are doing, and we are really focussing on the nought-to-three agenda, so from antenatal to around two and a half or three years.

Q549 Chair: Is that unusual? I think it was Naomi Eisenstadt who said we do a pretty poor job with babies at children’s centres-that babies have been the missing part of the focus.

Jane Williams: Well, I do not think they are. They are certainly not in my part of the world. We as health visitors anyway are encouraging women to go into children’s centres antenatally, working very closely with the midwives. Midwives are doing some of their booking clinics in children’s centres. We are just about to start some pilots with the NSPCC around their Baby Steps programme, which is working antenatally with those women that are really hard to reach. I think, because we work so closely with the children’s centres, that we are managing to get in touch with quite a lot of those women who would not normally go to a children’s centre. That has often been an issue: getting to those women who do not traditionally like going out.

Q550 Chair: How does that work?

Jane Williams: Because we run all of our clinics in children’s centres. We work out of children’s centres all the time.

Q551 Chair: So simply by locating a fundamental health provision within the children’s centre, it helps to bring them in and introduce them to the children’s centre on that basis.

Jane Williams: That is right. We have a partnership agreement with the children’s centres-I think you have had a copy of that-and it sets out quite clearly what the expectation of the children’s centre is and what the expectations of the health visitors are. They attend what we call Family Matters meetings every week to fortnight in the children’s centres, so there is a lot of information sharing.

Chair: Super, thank you very much. Richard?

Councillor Roberts: Your question is, "Has it made any difference?"

Q552 Chair: Well, my question was more that the evaluation suggests that there is no sign that it has, so what are you doing working with them?

Councillor Roberts: I think I ask that question; you would expect me to. Once I was invited here, the first thing I did was stride off round and go and talk to an awful lot of children’s centre managers, and all sorts of other people. I have asked the question, "What difference does it make?" I am told that preparing children for school has made a difference, and we have narrowed the gap between the highest achievers and the least highest achieving-demonstrated through, for example, free school meals-so it is making a difference. I have to agree with colleagues here.

Q553 Chair: How have you evaluated that? Sorry to interrupt.

Councillor Roberts: Through evidence.

Q554 Chair: I appreciate you have not got it immediately to hand, but what evidence? Was it survey evidence of schools? Do primaries do assessment of children on entry, and have they seen a demonstrable closing of the gap between children on free school meals and the rest, or something like that? What exactly does this evidence look like?

Councillor Roberts: It is the evidence that children’s centres have to submit to the DfE as part of their remit.

Carole Bell: There is also the readiness for school assessment, which is an indicator of whether children are ready to start school, having been through the process of being involved in children’s centres. Of course, not all children will have been involved in children’s centres. That is another issue-whether we get the right children into them.

Q555 Chair: The official national evaluation has suggested, disappointingly, that they have not been able to find these benefits, and we are getting-I am not saying it is not evidentially based-fundamentally a more anecdotal statement that it is having these benefits. I do not know whether people involved in things tend to think that they are effective, even if wider evaluations suggest they are not, and it is that tension that I am exploring today.

Councillor Roberts: I will make sure that we get the evidence to you in written form to prove that, because having asked, I do not expect to be told something that is not true. The excitement of the agenda right now is that we have had children’s centres for anything between seven and two years, depending on when they were set up, and phase one through to phase three, but in a sense it is a relatively ad hoc process that we task children’s centres and managers with undertaking. For the first time, because of the involvement of Health and Wellbeing Boards-the opportunity for health and local government to work together-now is the time to evaluate the successes and failures, or the difficulties and the challenges, and to reevaluate that and to come up with a new model for children’s centres or family centres, or whatever they become.

Chair: Thank you very much. We have got a lot to cover in very limited time. Colleagues will whisk us through some of the material, and short answers will be helpful, too.

Q556 Bill Esterson: You have all mentioned the importance of working together and partnerships, and a number of you have touched on the issue of the financial situation. What effect has the financial situation had particularly on local government budgets, particularly in social care? Also, where the health service has been reorganised, has this had a big impact on working together and an effect on children’s centres?

Jane Williams: Certainly, from my point of view in Warwickshire, we do work really closely with our colleagues in the local authority, and appreciate that they have had to make some savings, as have we, but we have also had quite an increase in terms of health visitors. We have had substantially more health visitors. We will be having 42 whole-time equivalents by 2015, and I really see health visiting as providing the early years offer-the early intervention offer-within the universal offer within children’s centres. They will work very closely with those children’s centres and the family support workers in those children’s centres to enable perhaps the children’s centres to focus more on those families that really, really need it. We have been providing that universal element of the Healthy Child Programme, and leading on the Healthy Child Programme within the children’s centres, and then allowing the children’s centres to provide support to the families that really, really need it.

Carole Bell: What we have had to do, both in Hammersmith and Fulham, and in Westminster, is relook at all of our children’s centres, and organise them into a slightly different arrangement, where there is a hub, but then there are spokes-still children’s centres, but not so much funding going into those-with a manager, particularly in the Westminster model, overseeing both the hub and the spokes. There is still that same level of co-ordination, but simply not as much investment right across the board. What we did, though, was carefully select the hubs in the light of where the most deprived communities were, so we have tried to maintain the link between the location of the hubs and the deprived communities. In terms of the relationship with health, I would say in the last year that GPs have been more interested in what we are doing in children’s centres than they have previously. As they have taken on a broader role, they have thought about what is happening in their own surgery and thought about the ways in which they could develop services with the local authority, with others, to try to enhance arrangements and support.

Q557 Bill Esterson: What is the situation for you, Richard?

Councillor Roberts: The budget for children’s centres has not changed over the last four years, so we spent £13.2 million then and we spend it now.

Q558 Bill Esterson: What about the impact of cuts across local government, social care and so on?

Councillor Roberts: We have saved money across children’s services across our county, Hertfordshire, running to £20odd million, but actually much of that has genuinely been efficiency and reorganisation. Although I do not want to reiterate too much the earlier answer, in future for children’s centres, there may be savings by integrating or thinking through a transformation of how they are delivered, but fundamentally it is less about budgets and more about doing the right thing for family centres or children’s centres, however they are.

Q559 Pat Glass: Can I ask something? What percentage of the council’s budget has been lost in cuts? In my local authority it is 40%.

Councillor Roberts: As a percentage, I guess we are looking at somewhere approaching 25%. We have saved about £150 million, or will have, over the four-year period, which ends next year, and that was preplanned before.

Q560 Pat Glass: So we are talking about a very different situation across the country.

Councillor Roberts: You are. Some councils have dealt with the transformation and reduction in budgets.

Q561 Pat Glass: It is really hard to deal with a 40% cut in your budget.

Councillor Roberts: Some authorities have had a harder task than others. We spent 18 months preparing for it before the budgets were announced.

Q562 Bill Esterson: Sorry, Louise, you were going to answer that last question.

Louise Silverton: Midwifery services are not in every children’s centre by any means; however, children’s centres close. We did a survey of our heads of midwifery, and Sheffield was a particular area where they had gone from 37 down to 17 children’s centres. We are also hearing that some of the heads of midwifery are under pressure from the CCGs, in that the GPs now want to get their midwives back into the GPs’ surgeries, which we do not think is the most efficient way of delivering midwifery care in the community. This has been a longrunning sore with the GPs, who have never forgiven us for moving.

Our members also tell us that where the children’s centres are run by third sector organisations, they are under a lot of pressure to put money into the children’s centre for the use of their space. Maternity services do not have any money for the use of space. I reported this three years ago when I was at the predecessor of this Committee, and it seems as though only those organisations or functions that have got money to put in are getting into some of the children’s centres.

Jane Williams: You can get around that. One of the things that we have done is to have a health policy agreed around charging for rooms, so even though we have 50% of our health visitors in children’s centres, we are not paying rent for those rooms. We pay for facility costs; that is all. That is the agreement we made. We do not pay for any use of any rooms, because they see health as being the key to their children’s centre, so it is part of that offer.

Q563 Bill Esterson: Why do you think that is not happening in some parts of the country? The evidence we have had is a very mixed picture.

Jane Williams: I do not know why. It is just something about how we have all worked together for all the years since the children’s centres have been developed.

Q564 Mr Ward: We have really gone on to my question, so shall we just pick this one up then go back? Is it a good idea for all midwifery and health visiting teams not just to work with, but out of, the children’s centres?

Jane Williams: Absolutely.

Mr Ward: Nods all round.

Carole Bell: There is a bit about the balance between what GP practices need and their need to have links with both midwifery and health visiting, and the link to children’s centres. What is disappointing out of that, which we have established-a reasonable balance between GPs and children’s centres in the use of health visitors and midwives-is that a bit of the problem is around things like shared care for GPs. Lots of GPs have given up shared care in maternity because they feel as though they have been quite detached from midwifery, because it appears to be focused in children’s centres rather than in GP practices. There is a tension all the time between where best to place staff, and who thinks they, in a sense, own them.

Jane Williams: We have a named health visitor for every single GP practice, and those named health visitors are responsible for going into that practice and communicating with that practice on a weekly basis, and we do regular audits to make sure that is happening.

Louise Silverton: It is possible to offer and run a mixed model, where you have midwifery clinics, postnatal clinics and dropin breastfeeding support in health centres as well as in children’s centres, and it is the mixed model that seems to be the one that stops women falling through the cracks.

Q565 Mr Ward: It does seem to be a bit of a dog’s dinner, though. I mean, a children’s centre is not just a children’s centre-they are all different. There are bits here and bits there, and some of them are working there and some of them based in there, so in terms of the original question about evaluating these things, have we not got some idea of what the best model should be?

Councillor Roberts: A key date is 2015. We have extended the recommissioning of children’s centres until that date. That will give us the time to evaluate what we should do, particularly with this brand new health and well-being linkage, to pull together the good will of health and local government to make sure that the children’s centres of the future really do serve the communities and the families that they need to. I agree with you; they have been to some extent a little bit driven by the need to put in a certain number for a certain number of children, rather than: "What are the services needed to support families?" They are two different perspectives, and we are moving in the right direction.

Q566 Bill Esterson: A number of you have already mentioned the point that the children’s centres in your areas are being much more targeted in the services they deliver. We have heard evidence that this is in response to the new core purpose. What effect is that going to have on you as partners, given that you provide universal services, or is that just not going to happen in your areas?

Chair: The children’s centres are getting very targeted on the most vulnerable, but you have to provide broad services for everybody. Is there a tension there?

Councillor Roberts: There is a huge tension. There really is a huge tension and, again, this is part of the mix. We have a Thriving Families programme, or a troubled families programme that we have called Thriving Families, and that is one area of targeted work. We have targeted work within youth services. We have not got rid of youth services; youth services is targeted work, and that is ongoing. We have targeted work being run from and with children’s centres, and there are other areas. There is targeted work within the safeguarding elements of children’s services. All these need reevaluating for how you focus that far better in the future.

Again, 2015 is critical. That was the original date when the troubled families programme was to be reevaluated, and it is the time when health visitors transfer from NHS England to public health, which is with local government, and therefore if you start to bring these together, you can start to picture how we can have a better relationship. Just to echo what has been said, this relationship with GPs is critical. As chairman of the shadow Health and Wellbeing Board, we still have to reach out to GPs and their new way of working-a way of working that is utterly new for them in terms of being responsible for their CCG-because, as we found when did a survey earlier this year of children’s services managers, what confidence did the children’s services managers have in terms of their relationship with GPs? It was down at 10%, whereas with health visiting teams it was at 90%. We have got to change that relationship.

Q567 Chair: Louise, in 2015, the health visitors will be in the local authority control and the midwives will still be with the CCG. Are we going to have another breaking apart-departmental silo damage-caused by that?

Louise Silverton: I do not think so. There are examples of where midwives and health visitors work very closely together, and it certainly does help if they see each other on a regular basis, because it does not help if they are both in the health centre, but on totally different days of the week-that is not going to work. We have a major concern about the lack of universality with respect to midwifery services, and we do think there is a value in them being in the children’s centre in areas where there are some vulnerable families, but even in the most affluent areas, there are pockets of vulnerability.

Q568 Chair: I do not understand. Health visitors, when the numbers fell, ceased to be universal. I can see an issue with universality in health visiting and when, eventually-we will touch on that later-the numbers come up again, hopefully it will return, but midwives are not targeted. Midwives are universal, are they not?

Louise Silverton: We are universal.

Q569 Chair: So what is the issue with universality for you?

Louise Silverton: The difficulty with universality is that, by linking it in the antenatal period with the health visitors, it does actually start to support some of these more vulnerable families, and the vulnerabilities are obviously of many sorts: cultural and social vulnerabilities, as well as those related to health and mental health. Our concerns are that if the midwives are not in the children’s centres, and they are caring, essentially, in a silo-either in health centres, GP surgeries or even in the hospitals-they are not being able to give the added value or even to know that there are vulnerable people. I mean, if you are in a children’s centre, someone may go, "I saw soandso’s sister. Is she pregnant?" Now, if you see this woman in the hospital, you may not know who she is. You have no context, so knowing that this is another member of an extended troubled family is actually hugely useful to the midwives in the targeting.

Jane Williams: We are using the word "targeted", but families actually do not like to be thought of as targeted. That is the whole thing: the whole wonderful thing about children’s centres is that it was thought of as a universal service, with people thinking, "It is okay for me to go there, because everybody goes there. My mate goes there."

Q570 Chair: We understand that. Bill’s question, though, was about the fact that there is increasing targeting, with limited resources coupled with a core purpose.

Jane Williams: In terms of what we are saying about being targeted, the health visiting service will be offering that universal offer. There are some families that they would not be able to support, even with an increase in numbers-those families that need a little bit more, so what we are calling "universal plus" and "universal partnership plus". For those families, we would hope to get that little bit extra from a children’s centre, so we work together as a team.

Chair: Thank you. I will have to be brutal. My chairmanship is way off; we are barely a 10th of the way through our questions and we have 25 minutes left.

Q571 Mr Ward: I guess this is on the issue of silos. One way of breaking down the silos is to exchange information, and DfE referred to what it described as "lingering barriers": confidentiality, data protection and so on. Have you come across or experienced problems with the sharing of information, and if so, what has been done to break that down?

Carole Bell: I would say it has got better year on year as people have got used to working in mixed professional environments, and it does take time for people to build up trust about with whom they can share information they feel is quite personal to that family. But the new birth data is shared well, and it works best when the children’s centre is seen as part of a whole system of supporting families, and being clear about identifying families who have got extra needs, and being able to use the children’s centre as one of the forms of support along with early help, early intervention or whatever you call it, and locality teams-Team Around the Family. Those sorts of mechanisms can be as soft as we want to make those families feel welcome, and can be accommodating in how we provide them-going to a person’s house, using outreach workers-enabling people to feel as though they are being welcomed back into a support system.

Q572 Mr Ward: Should we register births in children’s centres so that we can start from somewhere?

Carole Bell: It is quite a good idea.

Louise Silverton: Why not? Yes.

Jane Williams: We are looking at that. We have got a meeting in the next couple of weeks to look at that.

Q573 Mr Ward: Is that a blinding flash of the obvious? Should we just do it?

Jane Williams: It would make a lot of sense to do that, but we also routinely share birth data with children’s centres. Every two weeks, we send them birth data. We are looking all the time at how we are sharing information. We have integrated records pilots, so we have family support workers writing in the same records as health visitors. That is working really well. I mean, there are lots; we also do these Families Matter meetings, where we are talking about families. The message that comes from me, if you like, is that you are part of a children’s centre team.

Q574 Chair: Thank you very much, and Louise and Carole were both nodding in thinking it was a good idea to have birth registry services in children’s centres, or at least worth exploring.

Louise Silverton: Yes.

Chair: That is just for the record. I do not know what you thought, Richard, about that.

Councillor Roberts: It sounds like a great idea, especially if we can save some money, yes.

Q575 Ian Mearns: The Health and Wellbeing Boards and Health Commissioners now are being established around the country, and they are running up against significant challenges in local areas. Do you think that the recent structural changes in health, and changes in responsibilities for commissioning, will be a driver for greater integrated working in the future?

Carole Bell: They can be, if partnerships are built and based on trust and good joint working. Yes, we have re-sorted the cards. We have got to rebuild some of those networks and partnerships, but if we do, we can do it. Partnership is a delicate flower all the time, it seems to me, and you have to make sure that the relationships work so that people can come together and make joint agreements.

Q576 Ian Mearns: I will be controversial in as much as the previous Government were not averse to shuffling the deck themselves, were they? My PCT arrangements were rearranged something like seven or eight times in 13 years. People in the health services must be used to change from that perspective. Louise, you are smiling wryly there.

Louise Silverton: I am smiling about issues of the amount of change. I mean, we were familiar with working with health visitors who were part of the PCTs; we were part of the acute sector. Shortly they are going to be part of public health in local authorities; we are still part of the acute sector. You just have to get used to it, but things did not work before. Even in your own constituency, there was limited presence of midwives in east and central Gateshead, really only doing breastfeeding support, whereas in Blaydon and Winlaton they were fully integrated. It is not as if we are going from something that was really good potentially to something that will not work. This is another opportunity to make it work.

Q577 Ian Mearns: I will stray back into a slightly different area of territory now, if you do not mind. The NSPCC has suggested that universal services such as midwifery and health visiting could be better at picking up and acting on early warning signs with regard to vulnerable families. That is almost selfevident from my perspective, but do you think that is a fair assessment?

Councillor Roberts: Yes.

Jane Williams: That is what we are doing. By having these additional health visitors, that is what we are doing. We are doing antenatal visits now, which is a particular one that has come from the Healthy Child programme, which is around a promotional guide. It is picking up women who are likely to have attachment issues later on and doing work with them antenatally, before they have the baby, and that has been shown to have improved outcomes for children at two, so we are doing that work already.

Q578 Chair: The suggestion was that you can do it better-that you are not doing it as well as you should do. Is that fair?

Councillor Roberts: One of the issues must be that we have got a commissioning framework that is all over the place at the moment. We have different bodies doing commissioning, and-going back to the first part of your question-whether this new world will work depends on whether all the partners and players believe it is sustainable. We have gone to one PCT from eight-from six, my apologies, but a large number-to one; we are now back to two CCGs in Hertfordshire. We all as players have to understand that this is a longer term change, because every time there is a change, we have an 18month delay. If the health players believe it is all going to change again in 18 months, why would you engage, why would you commit resources, why would you pool and why would you integrate? While I am hugely optimistic, and some of the work I see happening is very, very good, there is that danger.

Q579 Ian Mearns: It is a loaded question, but one of the things that helped to drive a change in Gateshead during the time I was there was that there was a bunch of elected members who frankly were never satisfied. You have to be constantly striving for improvement. As good as you can get, you have always got to look for ways of improving things. That has to be borne out; it does not matter which sphere of work you are in, does it?

Louise Silverton: Absolutely, but one of the things that holds the maternity services back-midwifery-in contributing is lack of access to its information systems. Now, we do know we suffer terribly from a lack of joinedup information systems. The children’s services system does not talk to the acute health system, which normally talks to the GPs, and this is a major issue. In the evidence that the East Riding of Yorkshire gave to this Committee, they said they are dealing with eight different hospitals where women in East Riding could be booked to have their babies, and they have had to negotiate access to information individually for each of those. If you are identifying vulnerable families, information-having the information and sharing it appropriately-is absolutely vital.

Jane Williams: That is a major, major problem for us, and I am sure if it is for us, it is the same for others. We have three acute maternity hospitals that we relate to. They do not share the same systems, and it is really complex when you are trying to work in an integrated way. We are going to be going to electronic records down the line, and at the moment I am fighting and saying, "Until other people from outside are able to access those integrated records, we are not going to go on to electronic records in health visiting." I am based in the local authority, but I have to have an NHS computer, and I cannot access the Warwickshire county council intranet. It is crazy.

Q580 Mr Ward: I know you will say this is a rubbish comparison, but, say, Marks and Spencer will be able to tell you in all their shops, every day, what they sold and what lines were most popular-all of that information-and here we are saying that because there are eight hospitals, we will struggle to get some information on a child. It just seems poor.

Councillor Roberts: We are focusing on health, but you could apply the same elsewhere. Wouldn’t it be useful to know who is on benefits in your area? Wouldn’t it be useful to know who is unemployed so that when they come through, actually you can start to target the work? So they might drop in to a children’s centre; the children are going to school, but you find out that mum or dad is unemployed, and you can start to help them. The same goes for mental health services. Having better data sharing, and having information flows into children’s centres and family centres, will ultimately enable better universal and then targeted work to take place.

Q581 Ian Mearns: Just for the record, I do not think David is suggesting children be given a barcode.

Councillor Roberts: Well, they get given a unique number, don’t they?

Chair: David, we have so little time, I am going to have to cut you off and go on with Ian’s question.

Mr Ward: On the identification of children, I think it is in Denmark that they just know about all the children.

Q582 Ian Mearns: One of the things that we have come across is that some staff from children’s centres are saying that they are struggling to connect with families that most need their care and concern. I am convinced that all those families, at some stage, will have been seen by midwifery, maternity services, health visitors or whatever, and yet there is some way in which that information has not been passed on to the children’s centre. Is there some way in which we can do that much more effectively to make sure the children’s centre immediately becomes aware that some other service has had a view of a family that they regard to have problems that need to be addressed?

Jane Williams: It does happen in some areas. It certainly happens in my area.

Carole Bell: It can happen; therefore, it should be able to happen everywhere.

Q583 Pat Glass: On the problem of information sharing, it has been there since the dawn of time. It is a long time since I worked in education, but we had exactly the same issues. Certainly, in my time, health was always seen as the main offender. I found it difficult to get information about children’s services, although I got it, but getting information out of health was sometimes beyond me. Carole and Richard, do you get the information that you need around children whose parents have issues with alcohol or around domestic violence? Do you get the information that you need around these critical areas to be able to commission services properly?

Carole Bell: I would say that one of my previous answers was around having children’s centres as being part of a system. If that system is receiving the new birth data and the health visitor attends the monthly meeting that looks at all the new births and families that there are concerns about-new families and families that are on their way, but are still being visited by the health visitor-we have a good opportunity to look at things like domestic violence and mental health issues, and we have responded with commissioning services for domestic violence, and we have a link into adult mental health. Does it work perfectly in all cases? Probably not, but at least we have developed a system that can enable it to happen, and that is really key to how we drive this forward. The very lowlevel concerns can be supported by children’s centres; the higher level concerns need the introduction of social work, social work assessment and so on, but it can happen, and it does happen locally.

Councillor Roberts: Domestic violence information is shared, and I believe that that does go to children’s centres.

Q584 Pat Glass: In this instance, I am more interested in if you have the information that you need as the chair of the Health and Wellbeing Board in order to commission services. Is it coming through about the amount of domestic violence, illness, mental health issues and all of those kinds of areas?

Councillor Roberts: Can I turn that around ever so slightly, Pat? Yesterday, I was in a development session for Hertfordshire’s Health and Wellbeing Board, and we discussed in detail children’s issues, one of which was mental health, and specifically what resource is going into that early tier 2, for example. We discovered that there was not enough money going into the early prevention; we thought it was less than 1% of a very large mental health budget.

The point is that we were discussing it at the board level, and therefore those key health and local government public health executives, and directors and members, are looking at data and therefore able to start to direct commissioners. I do not think it is for the board itself to do the commissioning, but directing and leading is really key to a lot of this. Leadership from the health bodies back down into their organisations is vital in this area.

Q585 Pat Glass: Right, and therefore, Louise and Jane, are you, within your organisations, passing on that kind of information about families where there is illness, mental health or domestic violence? I worked in an authority in southeast London where in every single case-100% of the cases that I saw-where children were struggling with behaviour in primary, those children had either seen or been subject to domestic violence. It is massive, so is that kind of information being passed on to services-to individuals in schools, but also up through the system-so that the proper services can be commissioned, or are there barriers in your organisations that prevent that information being passed on?

Louise Silverton: Obviously, I speak for the Royal College of Midwives, so we are speaking for our members who are employed as midwives throughout the whole of the country. It is very patchy. There are areas where it works well and where there are good systems. There are other areas where our midwives will say, "Well, I told someone, and then I told someone else," and nothing seems to happen. There needs to be a very clear area about how you pass the information on, because the information systems themselves, as we are saying, cannot do it automatically. Sometimes also midwives feel very wary, because they may not know that there is actually domestic violence. They are beginning to suspect that there is, and at which point do you then decide that you need to tell somebody?

Q586 Pat Glass: Is that not something you have training for?

Louise Silverton: Absolutely.

Q587 Pat Glass: I frequently used to get people say to me, "I have a suspicion about that family," and I would say, "Stop, because when you hand that over, that is your problem handed to me. Do it formally, do it properly, or do not do it at all."

Louise Silverton: And then you go through the processes, and certainly involve the health visitors in the suspicions and seeking to try to get to the bottom of whether there is anything here: things like controlling partners, or concerns there may be drug or alcohol abuse. One of the things that is worrying us, which is not in the remit of this Committee, is the reduction of postnatal visiting, because visiting in the home is absolutely important-to see people in their own environment.

Councillor Roberts: Absolutely.

Louise Silverton: That is the way that you can get the context, and then that does help sometimes to remove suspicions, but you do need a clear process for whom you have to tell and when you tell them.

Q588 Pat Glass: And we still have not got that right.

Louise Silverton: No.

Jane Williams: I would say that certainly with health visiting and the new service offer within health visiting, that element is certainly taken into account, so we do a visit around 28 weeks, which as I have said before is this promotional guide, which will pick up issues around domestic abuse at that point. The health visitors and our school nurses get notified about every single lowlevel domestic abuse incident that has gone into the police. We get e-mailed those all the time, and we have our highlevel, MARAC ones, so they are the more severe; we have a really good process within Warwickshire to identify those. With the promotional guides that we are using antenatally and then postnatally, and with the increase in health visiting numbers, we are going to be able to see many more of these women universally, and identify things like alcohol or issues within relationships.

Q589 Pat Glass: As this Committee is about making recommendations, should we be recommending that the health services should be looking at this and making sure that there are clear lines of reporting that everybody knows about, and that there is proper training, looking at where there is best practice, and sharing it?

Louise Silverton: Yes. We could support that, but you do need to remember what Lord Laming said in his report about appropriate information sharing. It is quite difficult, because there are things that you are told in confidence, and then you say, "I am going to potentially have to share this," but you almost need to protect the woman as well, because she is potentially vulnerable. So it is sharing appropriately, and with whom, and it is maintaining confidentiality when you actually should do that-the needtoknow basis on whom you are sharing with-but those decisions are really quite hard for professionals to make.

Pat Glass: We faced similar issues in teaching many years ago, but we have got over those now. No teacher would ever say, "I potentially have to share this"; they would say, "I have to share this." They know that. We can get the same kinds of clarity if we look at where there is best practice.

Q590 Ian Mearns: Is the Healthy Child programme being delivered as intended in all areas? Are all children aged two to two and a half now having a healthy development review?

Carole Bell: The aim is for all of them to have a review, and they are all invited to a review, and we have done some quite exciting things about doing them in the evening or doing them on a Saturday morning so that fathers can be present, or fathers can bring them along. Actually, at the moment across our three boroughs, we do not get 100% completed, partly because parents do not take up the offer. It takes two to tango.

Q591 Chair: What percentage are you at?

Carole Bell: It is around 80%.

Q592 Chair: So one in five is missing out. Does that coincide with the most vulnerable children?

Carole Bell: It is mixed. People who are already going out to work find it difficult to make time to come, even though we offer Saturday morning opportunities.

Jane Williams: We have about 98% coverage in Warwickshire, and we are part of the integrated review, so we are working really closely with early years settings to work together around that. We are being a pilot for the Department of Health and the Department for Education on that. We use a model, evidence based tool which is called Ages and Stages; we send a questionnaire out to all parents, so it gives them ownership of what it is. It has certainly increased our attendance for those sessions, and we are doing okay. As we have an increase as well in our staff, we will be able to try to make sure that everybody gets it, but certainly we know that we will follow up at home the most vulnerable children. If they have not come in for their check, they will have it at home.

Q593 Ian Mearns: I understand about the aim and the invitation, but on the fact that 20% are not engaging, some of them we might have no real concerns about, but it is the fact that among those will be some really quite vulnerable families and particularly vulnerable children. Is there anything we can do to address that?

Carole Bell: We have done a huge amount over the last couple of years to try to improve the takeup of the check, and we have been doing some work on the integrated check because we can see that families might be interested in a prenursery early education check alongside the health development. So we have tried to do a number of things to ensure that as many people as possible are encouraged to come. I mean, we do repeat invitations where people have not responded. Saturday mornings and joining it up with education-we have tried a number of possibilities.

Q594 Ian Mearns: Dame Clare Tickell suggested that an integrated review for twoyearolds between Health and Education would be a good idea. Do you agree with that?

Carole Bell: I do. Parents will see the sense of it much more than perhaps a separate health review, particularly when they think their child’s health is okay. If they do not have any immediate worries, they are not quite sure why they should have a review or a developmental check. It is a bit about looking forward to their educational possibilities. As a much more onwardlooking, futurelooking opportunity, it is good.

Jane Williams: Going back to the use of a model tool like Ages and Stages, it is going out to parents and putting it on their doorstep. We did an evaluation when we piloted it. We had over 1,000 responses to that evaluation, and the parents like it. They really like having that opportunity to come forward with their own things: they see what their child is doing; they see what their child is not doing. There are lots of ideas within that questionnaire to give those parents ideas about what they can do with their child, but they actually are coming in to meet up with the nursery nurse or the health visitor with a clear understanding about where their child is, and it is not quite as threatening as it used to be. It does not feel like a test anymore, so that model is making a difference for us.

Louise Silverton: We wonder if it is a mistake that local authorities are not commissioning the Healthy Child programme. I mean, you have the responsibilities for early years being with local authorities; you have got the Health and Wellbeing Boards-public health. Is it time that you looked at the whole programme being commissioned that way?

Jane Williams: That is how we are all working together. My view is that we are all working together on the Healthy Child programme. To me, the Healthy Child programme does not feel like a health offer, necessarily. I feel like we are all working together on it.

Q595 Ian Mearns: It might feel like you are all working together on it, Jane, in Warwickshire, but the problem is, from the evidence we have had from so many people sitting in this forum, what we have across the country is a patchwork quilt, frankly, and it is good in some places and not so good in others.

Jane Williams: Part of our national service specification and our key performance indicators is around the twoyear review, so nationally we are being told that we have to perform on that, so we have really strong KPIs. They have not put all this money into health visiting for us to sit there and do nothing. We have got key performance indicators as long as our arm, and the two to two and a halfyear review is one of them. We have got to perform on that and we have to produce 98%, so that is going to be a driver, and it will be a driver to work really closely with our colleagues to think about the whole early years offer.

I believe it is a pathway along an early years offer, and health visiting is part of that. Midwifery is a part of that. We are all part of this one big offer, and it is about how we work together. We know that it improves outcomes for children if they have had that twoyear check. We know that it will make a difference, so to me it is a nobrainer. We have got to do it, and we have got to prove to the Government that the additional funding they have put into heath visiting is going to make a difference.

Q596 Ian Mearns: Just to finish that question off, is there anything additional you can specifically think of that children’s centres could do in relation to the two to two and a halfyear review?

Jane Williams: I suppose, certainly, where we work, they are. We are working really closely together, and there is still work in progress.

Councillor Roberts: To answer the question, if there is duplication, it would be helpful if there was not.

Jane Williams: But I do not think there is.

Councillor Roberts: That is right, and I know you have been working specifically on sorting that out, Jane, but the simple answer is: if there is duplication across health and education in terms of the twoyear check, avoid it and find a single check. It is simply going to save money and just be more efficient.

Q597 Ian Mearns: I could not agree more that where there is duplication, it needs to be avoided, but equally, where you have not got coverage and where 20% of youngsters are being missed, that is a massive cause for concern-probably more than the duplication, from my perspective, but there we go. The latest Department of Health progress report on increasing health visitor numbers suggests that the plan is slightly below its target. What are the implications for children’s centres if the recruitment drive does not get back on track?

Jane Williams: The universal element of what health visitors bring to the children’s centres is going to be a challenge. And it is a challenge, because the way that we need to have health visitors through the nursing profession makes it a long course for people. They have to do three years’ nursing and then they have to do a degree in health visiting, and I think we need to be looking at different people coming into health visiting from other sources, not just from nursing. I know that there are lots of issues around that, and that is part of the problem that we have-there are not enough people out there to be bringing them in.

Carole Bell: The quality of the health visiting trainees is really, really important, and unless we get high-quality trainees, we will not have the health visitors we really need to do this quite complicated set of tasks with children’s centres, GPs and others.

Q598 Chair: Is that a comment on the quality of them at the moment?

Carole Bell: Sorry?

Chair: This drive is going on right now: they have recruited 1,000 more; they have got another 3,000 to go. Are you suggesting that we are not getting the quality of applicants that we want?

Jane Williams: Talking to the local community provider yesterday, of the trainees they got in this year, some are not going to make the grade, so there is an issue about how we make sure we get the best quality. Of course, in this drive to get more health visitors, we have rather drained the pot of people who would, in other circumstances, have been school nurses. We have pushed the ball in one direction instead of perhaps another.

Chair: Richard, did you want to come in there?

Councillor Roberts: I am delighted that we are putting more money into health visitors. That is excellent. In Hertfordshire, for underfives, the population went up by 10,000 children-from 64,000 to 75,000-over a sixyear period, and that number has remained high, so health visitor workloads are very high anyway, before you introduce new ones. Just thinking across the spectrum, this debate has been about different health services, and midwifery has been in there, and the pressure on midwives is increasing. That is one point I picked up. One of the areas you have covered or mentioned is training: I was delighted to visit the children’s centre attached to Hertford Regional College, Turnford, where the lecturers who teach midwifery and health visitor courses make sure that they go through the children’s centre, and therefore inculcate that training into that, so that when health visitors emerge, they are aware of children’s centres and the relationship with them. I found that encouraging.

Chair: Thank you. I apologise for the lack of time, in particular to Siobhain, but we probably have time for just a couple more questions.

Q599 Siobhain McDonagh: What objectives and outcome measures do you share with children’s centres? Are there measures that you use that children’s centres could also be using to demonstrate the impact of their services on improved outcomes for children?

Jane Williams: We do. We are certainly sharing things like immunisation figures and breastfeeding figures. We send out all the breastfeeding figures around each children’s centre cluster area. They have all the figures for that, so they can see that. There are the obesity figures-anything we can we certainly share with them, and I am just about to start doing some work with the children’s centres because their new Ofsted framework is quite different. We need to be demonstrating-the children’s centres need to be demonstrating-the impact they are having in a much firmer way, and we need to be thinking about how we are supporting that. I am going to be working with our children’s centre leaders to try to work out a way we can share our data and our information much more closely with children’s centres.

Carole Bell: If I just turn it on its head, there is an issue about when we do the Joint Strategic Needs Assessment, asking children’s centres what the views of parents are about what the needs are. Parents do not seem to have been mentioned all that much today; they have helped shape and develop local services within children’s centres, and they often have very strong views about what they think the priorities are. It is a bit of a twoway street, and it ought to be.

Q600 Siobhain McDonagh: The NSPCC has recommended that children’s centres should focus more on very young children, aged nought to two, and in particular on their social, emotional and language development. Do you agree?

Carole Bell: Clearly, with the amount of investment we have made in speech and language therapy, it is our understanding that we have to get in early with parents, and help them to understand how to talk and play with their children. I was reading about one project called Cooking with Words, an interesting combination of getting dialogue going between a parent and child when doing something like cooking, so, yes, we have taken that very, very seriously. I would say, though, that after the two to two and a halfyear check, unless children are going to nursery, the next point at which they need statutory services is when they start school, so it is quite a gap. So although I understand the focus on nought to two, there is that three-to-five period when things can go horribly wrong as much as it can in the early years.

Louise Silverton: We think that children’s centres are hugely important as places where mothers can begin to understand the importance of maternal-infant interaction-or parent-infant interaction, because we need to involve fathers in this as well. We are concerned, however, with some of those services that are perceived to be softer. For example, North Southwark has now discontinued baby massage classes. This seems to be a nice, fluffy thing you do, but if you take very young mothers and teach them how to massage their baby, you are encouraging them to talk and sing to their baby while they are doing it. It is all part of the way that the infant brain grows. We know that without that strong bond and the care that you get from your parents, the infant brain will not grow properly, and we then have problems down the line. We think that the continued involvement of midwives in supporting some of these vulnerable families and in keeping breastfeeding going-with the best will in the world, not all health visitors are breastfeeding specialists-is something that should be done, and we support this focus on very young babies.

Councillor Roberts: I would extend it the other way: to minus nine months. I am a councillor; I should not be getting this, should I? However, I genuinely believe that the universal offer here is around preparing families to bring up children. It is about parenting. If we can do that better, that will be a really good measure of success. My Baby’s Brain is something that we have incorporated into our thinking. I believe it has gone into the red books that go to mums of newborns. Having listened to Professor Matt Sanders from PPP and having been involved in Graham Allen’s work around early intervention studies and some of the work that he has been looking at, this focus on the early years is absolutely vital.

This is, however, about families, and the key here is not to be too rigid about what everybody is doing, whose data is acceptable, and the age cut-offs. It is really important that, yes, we do focus on those very early years, especially those young mums and young families. They need support, not just as teenagers, but going up to 19, 20, 21 or 22. Picking up, through the fact that they exist, that there are older children with behavioural problems, those families too can be seen in a revamped model of what a children’s centre might look like. As part of that, defining what success might look like gives us the potential to get it right in future.

Chair: On that note, we come to an end. Thank you so much indeed, and could we switch as quickly as possible to the next panel?

<?oasys [pg6,cwe1] ?>Examination of Witnesses

Witnesses: Neil Couling, Work Services Director, Department for Work and Pensions, Annie Hudson, Chief Executive Designate, The College of Social Work, Tim Sherriff, Head Teacher, Westfield Community School and Children’s Centre, Wigan, and Elizabeth Young, Director, Research Evolution and Policy, Home-Start UK, gave evidence.

Q601 Chair: Good morning. Thank you very much indeed for joining us. I think you got to hear some or all of the previous session, which is always helpful. I always think it is quite a good idea to ask: what did you hear in the previous session that you thought was most interesting or that you most disagreed with? Elizabeth, I will pick on you, as I was drinking with you at Number 10 Downing street last night.

Elizabeth Young: I did pick up on some of the things around data sharing. While, in Home-Start, we recognise there was may have been some issue three or four years ago about sharing individual data with families, now there has been quite a lot of work to make that much more fluid. We are working in a team around the family. We are sometimes the lead professional around that. That area is working quite well across England. What we have picked up on, however, is dataset and aggregate data sharing, which is an important contribution to children’s centre partnership work. We are now seeing that children’s centres are needing to collect monitoring data-both contact data and participation data-and it is really important that we look at how that data goes into children’s centres and what it means. Home-Start is providing quite a lot of contact data for children’s centres, because we are sub-contracted to provide quite a lot of support.

When that monitoring data is then used to inform outcome frameworks, we need to look at attribution and who is part of that provision to get that child outcome. As we heard earlier this morning, children’s centres are quite complex organisations now, so in order to work out an outcome framework and appropriate outcomes, we need to track that monitoring data and see what impact it is having. Along with Anne Longfield at 4Children, who was saying that she thinks that outcomes frameworks are important for children’s centres, we would advocate that as well.

However, it is really important to get the right outcomes. For instance, in Home-Start, we have had quite a lot of evaluation in the past. If you choose an outcome measure such as postnatal depression and you are not aware that only, say, 15% of your families suffer from postnatal depression, you are immediately going to have a complex understanding of what outcome measure you have when you get 85% of your parents without it.

Tim Sherriff: Being a head teacher, we have selective hearing. We hear the word "Ofsted" and we always sit and listen. I heard the comments about the new framework in terms of children’s centres, so that is something that I am particularly concerned about and interested in, and something I would like to talk about.

Neil Couling: Like Elizabeth, it was data sharing, which came up yesterday at the Welfare to Work UK convention. On Monday, a group of my managers were talking about troubled families and the work we are trying to do there. We need to really have a look at this issue of how, if we are serious about cross-agency working, we do data sharing, because it is getting in the way at the moment.

Annie Hudson: It is the perennial issue of children’s centres around "with whom and how do we focus"? That becomes an even more critical question in a resource-hungry context. The other issue that I think relates to the data question, but is broader, is that the quality of partnership working across all agencies makes or breaks the effectiveness of children’s centres.

Q602 Bill Esterson: That brings us nicely on to partnership working. Where partnership is working well, why is it working well? Where it is not working so well, what is the reason for that? Who wants to go first? Annie, do you want start?

Annie Hudson: I am happy to kick off, since I raised it. While data and information protocols and so on are important prerequisites, at the end of the day, if you look at where partnership is working well, it is to do with culture and communication. It is about different professional agencies and groups having a respect and understanding about their differential contribution to children’s and families’ lives.

For example, in Bristol, I am currently working with DCS there. There are some excellent examples where early years leaders and social workers are investing quite a lot of time in understanding each other’s demands and imperatives etc., so that they can have good-quality conversations. "Rich conversations", I think, was the phrase that Clare Tickell used in one of these earlier sessions. It is about not stepping on each other’s toes but being able to respect and see the contribution that other professional groups can have.

Q603 Bill Esterson: What has been the effect of the cuts to social care on those working relationships?

Annie Hudson: I can speak only for Bristol, because that is where I am working at the moment. We have not had any cuts to social care services as such, but clearly the pressure that everybody is under, particularly around some of the early help services, has meant that people have to work harder. In Bristol, and it was referred to elsewhere, we have had a huge rise in the number of small children, so there is the same number of professionals working with a greater number of children. People just have to invest energy and time in making those relationships and thinking creatively about how you broker good-quality partnerships.

For example, in one area of Bristol, although we are now having it right across the city, we have something called an early help social worker, who does not have a case load in the traditional social care sense, but is linked to a certain number of children’s centres and schools. They go in and out of those schools, picking up on some of the soft intelligence about worrying families, and giving advice to head teachers, early years leaders and staff about some of the things that they can do, and then, if necessary, signposting those families to other services, including social care. That has worked tremendously well and has helped to build confident communication and relationships.

Q604 Bill Esterson: Tim, you have the partnership between the school and the children’s centre in one place. What about partnership with other agencies?

Tim Sherriff: I would echo a lot of the things that have already been said in terms of it being the culture. I was thinking, as you were talking, that the culture of partnerships with parents is still critical. We have a lot of hard-to-reach families, so it is about creating that culture within the centre, where parents and families feel welcomed and happy to come in and share things. The culture is really important, as is understanding what each person’s job is.

Q605 Bill Esterson: Elizabeth, to ask you an additional question, how does Home-Start complement the universal and targeted work combination? There are pressures to maintain the universal services that are going on in children’s centres.

Elizabeth Young: We work in several different ways with children’s centres, depending on the particular local mix. We refer into children’s centres; children’s centres refer out to us. We provide volunteers for children’s centres. We train volunteers. The universal offer is really important for Home-Start’s approach and for that of children’s centres. If we are targeting only areas of deprivation-and we have looked at this through some postcode work-families with real vulnerabilities because of things like mental health issues, postnatal depression or domestic abuse can fall in little pockets of postcode lottery that put them out of areas of high deprivation, but they have real needs. We would always be looking for a universal offer, but Professor Marmot talks about proportional universalism, where you target within it. Once you have picked up that family, you are then able to customise the support for them and enable them to access the appropriate services. It is a wraparound to the offer that children’s centres are providing, and it varies, depending on the locality.

Q606 Bill Esterson: We heard earlier about the patchy nature of partnership working across the country. Neil, what is your assessment of why that is the case?

Neil Couling: In one sense, it is almost the desired outcome, in that I am trying to let people decide locally on the appropriate level of engagement for that particular labour market viewed through the lens of Jobcentre Plus. In some locations, we have advisers embedded in Sure Start centres; in others, we have advisers linked to them and willing to go in and do sessions there. In other locations, we do not have much contact at all. I would like to think that was down to people making explicit choices about how best to deliver labour market services in those localities. That will be the case in a lot of those examples, but there will also be other cases where we are just not working well with people yet.

Q607 Bill Esterson: Elizabeth, what do you think are the reasons for it? Do you agree with Neil or are there other factors?

Elizabeth Young: I do think that having what someone called a patchwork quilt is going to make it very difficult to have a universal evaluation of the offer. From Home-Start’s point of view, picking up on what Neil was saying, if there is a Jobcentre Plus based in a children’s centre, you do need to have some kind of outreach to enable families to engage with that-not just at the appointment, but being prepared to go to the appointment, having the appropriate paperwork, following up with letters, and all the kinds of things that go with engaging with a specialist service. You need to have that kind of wraparound offer to enable families not only to engage, but to follow through on what it means.

It has to be meeting local needs, as well as in tendering to specify what those services look like. In some cases, it will be that there is a voluntary organisation embedded in the community, but the tender specification is very specific around particular requirements such as age. We can see some tenders going out for nought to 19 now, which means that there is going to be lots of sub-contracting under the first tender engagement. In terms of what you see as a tender partnership arrangement, underlying that there is often quite a lot of sub-contracting going on to be able to fulfil that tender.

Q608 Bill Esterson: Is collocation necessary or is it sufficient for successful partnership working? Tim, you start, as somebody with very obvious experience of that.

Tim Sherriff: From our experience, having a children’s centre on the school site has been very beneficial. Clearly, in terms of transition, we are able to work with families from birth. The vast majority of those pupils do enter into the school so, in terms of transition, it has been very helpful. One of the issues originally was about where the children’s centre is. It is not some magical place: we have a few rooms, and the school loans out halls and various things. We just work together in an integrated way.

I do think our philosophy of a one-stop shop is good. We did have a nurse on site for a period of time, and that worked beautifully well. Families would come in and they might be bringing their child back to school from the dentist or they might be coming in to see the nurse, and it worked beautifully well. Again, the philosophy is about making access to services easier for parents. In our particular circumstance, then, collocation has worked.

Q609 Bill Esterson: Annie, do you think that collocation is enough or is it just the starting point?

Annie Hudson: I have endless discussions about collocation, because you cannot collocate everybody; otherwise, you have an enormous castle in the sky. It can be beneficial but the critical things for me are about accessibility for children and families, and about visibility. There are going to be some professional groups-and social work is probably one of those-that can be, but do not necessarily need to be, collocated, yet need to be accessible to families using children’s centres. For me, then, that is about having visibility and presence, rather than being collocated, if you get the distinction.

Elizabeth Young: Some of you visited Pen Green with Margy, and you have seen that Home-Start Corby is collocated. That is one model, and that works really well. Picking up on what Annie was saying, however, it is an awful lot about signposting and enabling people to use the services. It is not where the professionals or services are based, but where the families need to go. It is always about turning it round: not hard-to-reach families, but hard-to-reach services. Services need to change in order to enable families to use them and to be family-welcoming and engaging. You can make it work without collocation, but there are obvious benefits that I am sure you saw when you visited Pen Green.

Q610 Bill Esterson: Presumably, Neil, from your earlier answer, it depends on the local situation.

Neil Couling: Our experience with collocation is that, because the policy framework around us has changed, it is more effective to get people into Jobcentres. What has happened over the last five years is that successive Governments have increased the work-search responsibilities, particularly for lone parents. That is very hard to do from a children’s centre, so we have found that we have better outcomes by pulling people into Jobcentres for the ongoing activity, but some of the initial contact works very well in the centres, so that is what we are doing. We are moving away from collocation as an organisation, and that is the direction we will travel in.

Q611 Neil Carmichael: Good morning. This Committee explored governance quite thoroughly in its recent inquiry and report, which has already provoked an interesting debate. Last week, in connection to Sure Start, two things emerged: one was the difference between a governing body and an advisory board; the other was the question of accountability and involvement. I would just like to probe those issues, albeit briefly, because I know we are short of time. My first question is: what sort of involvement do you all have in what we will call, for the sake of argument, the governance of Sure Start organisations? What is your involvement and how does it work? Annie, would you like to start?

Annie Hudson: From a local authority perspective, we are effectively commissioners of children’s centres, so it will vary, depending on who is running the children’s centre. There is a range of models in Bristol, where I am working at the moment. I know that many children’s centres’ advisory boards look to have the range of professional and community organisations that reflect the stakeholders. If you get that kind of diversity in your advisory board, that is really going to help drive good, positive partnership working, as we were talking about before. The governing body will vary, because some of our children’s centres are also nursery schools, so they will have more of a traditional education governing body; others are run by voluntary organisations and will have a slightly different organisation, so it is a mixed approach, I guess. The important thing is about having the range of stakeholders represented to help shape the work of a centre.

Neil Couling: Where we are invited to join advisory boards, Jobcentre Plus will join them or attend to give briefings and so forth. That tends to be the level of our engagement in the governance of this as a separate organisation.

Elizabeth Young: Across England, where we have about 250 Home-Starts, 57% sit on management committees of children’s centres. A local Home-Start is an independent charity and so is completely rehearsed in the governance of having a trustee board. Those skills, which are quality assured, will go into it with the person sitting on the management committee, so they will be very attuned to the responsibilities of sitting on a management committee and, we think, key partnership work.

Q612 Neil Carmichael: Tim is wondering why I have missed him, but I have a specific question for you, because I have noticed that you have a governing body for your school, but you are also involved in an advisory board, so I thought it would be helpful if you could describe the difference between those two structures.

Tim Sherriff: We have what is called a collaborative leadership committee, which comprises the head teacher and a governor from each of the five schools that we support as a children’s centre. In addition, there are parent representatives. There has been an offer, for the last six years, for representatives from health and the police. While they recognised a willingness to try to attend, it just has not worked. For various reasons and pressures, they have not been around the table. It is a group: the head teacher and a governor from each of the schools, and parent representatives. That has directed the work of the children’s centre. Within each individual school’s governing body meetings, there is a standard agenda item whereby the work of that committee is fed back. It is that group that leads the children’s centre.

Q613 Neil Carmichael: We heard last week that, in terms of Sure Start children’s centres, the governance structure really lacked teeth-that was the phrase we heard. Is that something that any of you would concur with?

Tim Sherriff: I would say that, within Wigan, CLCs have had mixed success. Ours has worked particularly well. Without referring to Ofsted too many times this morning, the fact that you have to be inspected gives you the teeth to get things done, so I have not come across that.

Q614 Neil Carmichael: If you look at Ofsted’s website, or even read any Ofsted reports of recent times, clearly there is an emphasis on leadership and structure, and it would want to see some form of structure that they could easily identify and measure. Do you think the existing structures are going to enable Ofsted to get a proper handle on how things are governed in Sure Starts?

Tim Sherriff: Things have improved. For us, the biggest challenge during our inspection was around data, which you have heard about today. It was particularly around health data. The overall experience of the inspection, which was very challenging-and probably more challenging than a school inspection, because we were reliant on so many other people coming to the table during that week-does provide the teeth that you were talking about.

Q615 Neil Carmichael: I just want to finish up with a question about advisory boards, because that is what I was principally talking about. Do you think they are sufficiently robust to hold management in check in terms of accountability?

Chair: Or should we be recommending in our report that they should be beefed up and made more like governing bodies, perhaps, and given a stronger role in determining the running of the institution? Any thoughts on that? Annie, you clearly do not want to answer-you are smiling, leaning back and avoiding my eye.

Annie Hudson: It was more that I am not sure I can give a very authoritative answer. What I was thinking, as I was smiling then, was that, in a sense, it is about looking at the outcomes. Governance is clearly important, as is being clear about accountabilities. Local authorities are becoming clearer now about their roles as commissioners of children’s centres. That is one of the things that has come out of more pressure on resources. Yes, it could do, but I am not sure that it is the most critical lever for delivering the best outcomes, if I am honest.

Q616 Chair: Anyone else? Neil, any thoughts?

Neil Couling: I really do not know enough about governance to comment.

Tim Sherriff: One of the challenges in terms of leadership and governance is to make it everybody’s business. Because I am a children’s centre lead, it is naturally my business, but I work with four other head teachers who do see a point to what we are doing, but it is about trying to engage them in the process, because it can be, "Well, it is the children’s centre manager’s area." The success of a children’s centre is not down to me or my team; it is down to everybody’s involvement. That overarching view that a governing body or committee has is critical. During the inspection, the inspectors were asking, "Where and who are these people who manage it?" We then arranged a conversation with those people, and it was important that they knew about the work of the children’s centre, not just me and my staff.

Elizabeth Young: From our experience, quality assurance and governance is directly related to leadership. We have heard that leadership is absolutely paramount in the successful delivery of child outcomes. While it seems two or three down the causal link or food chain, I would say that governance and leadership are directly related to the outcomes you will achieve for children.

Q617 Neil Carmichael: Could I just ask one more question? That is a very important point. We have been discussing the variance in performance of <?oasys [pc10p0] ?>children’s centres, so you would say that governance is one of the key instruments to keep them on the straight and narrow and doing as well as they possibly can.

Elizabeth Young: Yes, because it is directly related to the characteristics of leadership that are shown in the children’s centre. I think it has been universally agreed in this Committee, over the months, that leadership is the magic ingredient to make partnerships work for us and for the families and children.

Chair: That is going to have to be it.

Neil Carmichael: Thanks very much.

Q618 Alex Cunningham: I have much more on information sharing now, if you do not mind. The joint Department for Education-Department of Health report, Information Sharing in the Foundation Years, is due soon. What would be your hopes from that particular report in terms of recommendations? Not a lot.

Chair: They are not really health specialists. It is not really their area.

Alex Cunningham: Fair enough. Maybe I should just ask something more specific.

Annie Hudson: To make it straightforward and simple. Quite often, what happens is that people-sometimes individuals and sometimes organisations-tie themselves up in knots around information sharing. Sometimes there is a perception that you cannot share information. Particularly at the social work end of things, where we are more likely to be involved in working with children’s centres, it is the most vulnerable families where information sharing is absolutely of the essence and is often critical for a child’s safety and well-being. I would hope that it will make it more straightforward and simpler for people to understand what their roles and responsibilities are.

Q619 Alex Cunningham: That probably just recognises that the DfE has said that there are these "lingering barriers" regarding information sharing. In your experience, what are these lingering barriers and how can they be overcome?

Elizabeth Young: In our experience, three or four years ago, perhaps because we had, in all our training in the past, focused so strongly on confidentiality and the need to know, we almost had to re-engage with that concept and say, "Within a context, what does that mean?" The way that we would do it is with case studies and hypothetical situations, so that people can practise what it means in a safe training environment and then feel confident to go to Team Around the Child or a safeguarding or child protection meeting. From our perspective, that has moved quite a lot, but what I was saying earlier is that we then have aggregate data that is going to be so key for outcome frameworks, but what we do not have quite sorted yet is the attribution associated with that. A different set of information sharing might be a new challenge.

Q620 Alex Cunningham: Are people still worried about sharing information? I know that there are some perceived professional barriers; for example, school nurses think that they have to protect confidentiality because of their registration. Are these real barriers or are they just a perception?

Neil Couling: Can I answer? The loss of the child benefit data in 2008 is still working its way through the systems and attitudes within Government, because there was, understandably, a very risk-averse kind of response to that-a battening down of the hatches. Public servants, individually, know that some very serious consequences could fall upon them personally if they get some of this wrong, and rightly so, in terms of the protection of people’s data. There needs to be a mature debate about this and about how we take forward the responsibility to protect people’s data and the growing need to work together. The one thing that austerity is forcing public organisations to do is to work more effectively together, and one of the impediments to that is data sharing.

It came up on Monday and Tuesday, and now it has come up on Wednesday, and there are still two days of the week to go. This nettle does need to be grasped, but it is not the sort of thing that a recommendation from a Select Committee is going to solve magically. This is right across the public sector, and we need a serious response to the responsibility to protect people’s information and we need to be sharing information to work effectively together.

Q621 Alex Cunningham: We will do our best to keep Thursday and Friday going as well. Tim, have you succeeded in overcoming some of the barriers that you have experienced to accessing information from health partners, such as live birth data?

Tim Sherriff: Yes, that has definitely improved since the time of our inspection. We now get the pink slip six weeks after the birth, so that has definitely improved. One of the areas we have less access is represented by my colleague here on the right, in terms of worklessness. That is one of the challenges that we have to provide evidence for, and information around that is quite difficult to obtain. The two-year-old assessment has been a critical step forward. The live birth data was critical. From a school and an authority’s perspective, some consistency would be good.

Without sounding Ofsted-obsessed, because the criteria are there across all schools and children’s centres, you are tarred with that same brush if your locality does things in a different way. We found ourselves, during inspection, in deep conversations around health data. We were asked for breastfeeding data that we did not have access to; we were asked for smoking cessation information that we did not have access to. It was not our fault, but we just did not have access to it. Those things have, however, improved.

Q622 Alex Cunningham: From your experience of what you have achieved in improvement and what you would like, what recommendations should we be making to the Government for policy?

Tim Sherriff: The key one would be around worklessness.

Alex Cunningham: A very specific thing for that sharing of data.

Tim Sherriff: Yes.

Q623 Alex Cunningham: The NSPCC has argued that local data on major risk factors such as domestic violence, drugs misuse and mental health should be collated and shared with children’s centres. Do you agree with that as well?

Tim Sherriff: Yes, and we do not get that either. We find out by circumstance if there is a history of domestic violence or drug and alcohol abuse.

Annie Hudson: It is about how and when you share information that is really important. With domestic violence, clearly it is very important, if there are referrals about domestic violence and about a family that is involved in a children’s centre, that that children’s centre knows that. Often, with these very vulnerable families, it is about putting lots of bits of information together to form an assessment about the kind of risk and vulnerability. There are different ways of sharing that information, and that is where we come back to the effectiveness of partnership working, trust, respect for one another, and having continuous conversations. This means that people will feel more comfortable sharing information like that, which is going to be difficult and sensitive, and you need to be always thinking about who needs this information.

I do not think those principles go out of the window. In my experience, in some organisations and agencies, and particularly those that focus on working with adults, there have been issues in adult mental health services and their ability-and reluctance, sometimes-to share information about adults, and their vulnerability around mental health and drugs misuse and so on, with children’s services, including children’s centres. For me, that would be more of the priority from where I sit in the social care context.

Q624 Alex Cunningham: It is interesting that you should say that, because the next question was about how professionals can balance the well-being and safeguarding of a child with the need to protect the vulnerable adult when sharing information. Do you have a view, Elizabeth?

Elizabeth Young: We have recently seen an increase in our referrals from agencies explicitly mentioning domestic abuse-up to 13% of families referred to Home-Start. That is interesting because we had always thought that Home-Start picked up on domestic abuse as that trusting relationship had developed with the volunteer, and it was like a staged disclosure once they felt safe enough to disclose. Now, we are seeing very clear referrals from agencies explicitly mentioning domestic abuse, and I completely endorse what Annie was saying about it being local respect and trust by professionals that would have that communication, and that is why we are seeing that increased referral.

Q625 Alex Cunningham: Going back to the recommendation thing, both the Chair and I are probably quite infatuated with the idea of getting people to make recommendations. Are central Government guidelines on information sharing clear enough? Would further guidance help? Is it about how the information should be shared?

Annie Hudson: Sometimes information protocols do tie themselves up in knots, so front-line practitioners, for want of a better word, are not necessarily going to know or be able to recite perfectly what the local information protocols say. What they need to have are some very clear guidelines about the core principles, so the more that central Government can do to make those core principles very transparent and very unambiguous, the better.

Q626 Alex Cunningham: What does that protocol look like?

Annie Hudson: From a children’s perspective, being child-focused and always prioritising children’s needs is a paramount principle. Going back to the reference to some of the adult mental health services-I am not saying that it is always like this-they sometimes lose the child in their work with individuals. We know, from serious case reviews, that a slightly myopic perspective on a family’s situation does not help the children. Something that puts that as an absolutely paramount principle would be really helpful.

Q627 Bill Esterson: Do you have a way of making that happen? There is a question for me about who decides what putting the child first is. Sometimes, there is more than one way of looking at it, including whether, by looking after the adult, that looks after the child in the long term. Is there a way of stating that in a recommendation?

Annie Hudson: Getting back to "every situation is different", which is a bit of a truism, that is where it gets back to people working with families and being clear and honest about what the perceptions of issues and concerns are. You can then make the best judgments. I do not think that there are any cardinal rules, but that, for me, has to be a paramount principle when you are talking about how and when you share information.

Q628 Chair: Neil, there is Tim, not only running a school but running a children’s centre, and he has his core purpose in front of him, set by Government, as to what he is trying to do with the children’s centre, and you will not let him see who is workless. How the heck is he supposed to fulfil his core purpose if he cannot get the most basic information out of anyone?

Neil Couling: That is a bit outside where I sit. I was going to answer Mr Cunningham’s question. What would help with Tim’s problem was if we could make a national agreement on data sharing with children’s centres. We do not have one at the moment. Picking up on Annie’s point, that would then allow my advisers to know what is and is not safe to disclose.

Q629 Chair: Is that a specific bilateral agreement?

Neil Couling: Yes. At the moment, all we can share is what has the consent of the individual concerned. If they provide written consent, we can tell Tim what the worklessness status of that family unit is, but we do not have a national agreement in place. If you are in the market for recommendations, that is one that you could lay on us-to work through the various processes to put it in place. That would help. I said in <?oasys [pc10p0] ?>one of my earlier answers that I would quite like some local flexibility, because all the local labour markets are different. On something like data sharing, however, my experience is that you need a common core of what you can and cannot do. On the back of that, they prompt a dialogue around whether, if there is more that Tim needs, that could be provided.

Q630 Pat Glass: Neil, you said earlier that austerity is forcing agencies to work together better. What does a Jobcentre offer look like in a children’s centre? How many are there and where are they?

Neil Couling: We currently have relationships with about 471 centres, and we have 123 advisers either collocated there-although, as I said, we tend to be pulling out of collocation at the moment-or visiting and providing help there. I can probably save your time by not reading out the pages of stuff that we have on the things that we do; I can send you a note on that. In essence, what we tend to do now is to do some of the initial engagement in the centres and then pull people into Jobcentres for ongoing activity, in the way that policy is leading us now. There are some good reasons for that, such as the fact that, often, people have language barriers and we can provide translation services in the Jobcentres much more easily than providing them in the Sure Start centres. We are, then, doing quite a lot. I will let the Committee have a note on that, if you would like, just in terms of what the offer is.

Q631 Pat Glass: Given the Chancellor’s announcement last week or the week before about lone parents of children aged three and four being required to look for work, are you stepping that up in children’s centres?

Neil Couling: The Sure Start centres are, again, a good place to do that initial engagement and warn people that this is coming. We are implementing this from January 2014, so you will see, as the autumn gets going, that we will be in centres explaining what is happening and what the expectation of individuals will be. It will not be the only way we contact those claimants, but it will be a good way of doing that.

Q632 Pat Glass: We have heard this morning about the possibility of registering births at children’s centres, Jobcentre Plus offers and adult learning, but these are children’s centres, and we have heard previously that very few now offer child care. Tim, are we losing the focus of all of this?

Tim Sherriff: With adult learning, you might be. That might be a step too far. I appreciate it is critical, but it is not the No. 1 priority of the majority of the families that we are working with. Their No. 1 priority is trying to do the best for their child. A lot of our families are vulnerable and have lots of perhaps more pressing priorities than adult learning. That is a big challenge, and I do not know if that is achievable, given everything else that we have to deal with. I read that it has an increased emphasis in the new framework. I did not mention the word "Ofsted"-now I have done.

Chair: It is like a nervous twitch.

Tim Sherriff: It is, but it is a concern. Its priority has been that the bar has been raised in terms of adult learning, so that is something that I am concerned about.

Pat Glass: So in children’s centres, we are losing the focus on children.

Q633 Mr Ward: Tim, do you have a named social worker attached to your centre?

Tim Sherriff: We do not, but we think it would be a really good idea.

Q634 Mr Ward: The statutory guidance sets an expectation that there should be a named one. Is that something you all think is good?

Tim Sherriff: It would be a good idea, definitely.

Q635 Mr Ward: Is it feasible to have a placed social worker within the centres?

Annie Hudson: In Bristol, we have an early help social worker, who, as I said earlier, does not have a case load and is attached to children’s centres and schools in a particular locality, and so can develop those inter-professional relationships and offer information, advice and guidance. The feedback about that from children’s centres and schools has been extraordinarily positive in terms of the quality of the work that everybody can do with the most vulnerable families. It is a two-way street: it enables the children’s centres to have access to people who are experts in safeguarding, and they can chew over concerns rather than making a referral. We are reflecting on that. They can sometimes do very short, one-off pieces of work with a family who are perhaps anxious about something and help them signpost. The children’s centres’ feedback about that role has been that it really does add an enormous amount of value. From the social care and social work side of things, it means that they have really good relationships with the centres, which are working in an everyday way with very vulnerable families, including those where there are child protection plans, as well as with vulnerable families in general. It has worked really well.

Regarding the concept of the named social worker, there are probably different models and, over time-and this may be something that the College of Social Work will be interested in-it may be worth looking at what models add the most value. You could just have a named social worker and it is just somebody in a duty team who does not have a particular relationship with a children’s centre. As I said, it is about the quality of the relationships that really gives added capacity to the work of children’s centres.

Q636 Mr Ward: There are 3,000 across the country, so presumably it would be within the social work profession, and there would be the development of social workers with those special skills.

Annie Hudson: That is right. What you are potentially going to see is people who develop particularly some of the skills of working with very young families or with children from a very early age, and who have some of the skills of working not only in child development but with other professionals who are similarly focused and specialist in those areas.

Q637 Mr Ward: Tim, have you come across families who are formally within the troubled families programme?

Tim Sherriff: Yes. One of the big challenges for the staff at the centre is knowing when to let go. We have a limited number of staff and they often get involved with families. They move through the thresholds or may be at level 3, and it is knowing when to let go and to pass on. To have a social worker there who you could refer to would be very helpful. Occasionally, staff have become involved in things that maybe they should not have done, but they have been very attached to those particular families and children. We have had to say, "Your job stops there and that needs to move on," so having somebody like that would be very helpful.

Q638 Alex Cunningham: What objectives and outcome measures do you share with children’s centres? Would you welcome a national outcomes framework for children’s centres? Should we go local? Should it be locally determined or should there be a national framework?

Elizabeth Young: We would value a national framework, as long as the outcome measure was appropriate to this very mixed offer. I was saying that we would welcome an outcomes framework, but because we have heard what a mixed bag a children’s centre is now, we have to be really clear about what the main outcome measure should be for the children. That is particularly complicated when you have lots of different specialists going in.

Q639 Alex Cunningham: Should there be some sort of minimum standards or outcomes?

Elizabeth Young: We should be working towards that, definitely. From Home-Start’s point of view, we have been looking at a more generic outcome measure, which is around resilience and coping. If you have families coming in with all kinds of different needs, at different stages, and if the children’s centres are going to expand offers and age range too, you have to look at what is common to all the families that you are supporting if you want a generic outcomes framework. From our point of view, we would always be looking to put the families in a better position to be more resilient to whatever is coming along, because they will all have very different needs. We would welcome that approach.

Annie Hudson: They should be carefully constructed. We have had lots of performance indicators in local authorities and schools etc., many of which are process indicators and measures. They tell you only a very partial bit of the story. It is a very difficult area, because what you are trying to measure here is the long-term impact and value added of children’s centres’ intervention, but I do think we probably need some sort of national framework, because it will make us better able to evaluate and look at what the good practice and less good practice is across the country.

Q640 Alex Cunningham: Tim, when I have talked to secondary head teachers in recent years, they have told me that the child coming in to a secondary school is better equipped than ever they were before, but I just wonder whether, as a primary head teacher, you are seeing children arriving at your school better prepared when there are children’s centres and nursery education for three and four-year-olds. What is your experience of what else happens around the world that you move in?

Tim Sherriff: I would say children are more prepared. As a very simple example, we had an open evening for pre-school parents. This was a meeting for parents, and the idea was for them not to bring children. However, at this particular meeting, there was a parent with a child, and the child just ran amok. She could not keep still the whole time. One of my children’s centre staff said, "Do not worry. We know all about this family." They did, and that girl is now fully integrated. Had we not known about this child in advance of her coming to pre-school, the outcome would have been different. It is about transition, and knowing about the family and the children before they arrive at pre-school has to be a good thing.

Q641 Alex Cunningham: Across the piece, in your experience within your local authority area or even wider than that, are the children coming in better equipped?

Tim Sherriff: Within Wigan, we have an early years outcomes framework, which has been very helpful. One of the key things that the children’s centre has done is that we work with five primary schools around reception and when we do projects from the children’s centre, and it all strengthens our knowledge of pupils and what their particular needs are. More information, to us, has to be a good thing. It is about smooth transition from one phase to the other. Hopefully, they are seeing the benefits of that at high schools as they move from us across into secondary. More information has to be a good thing.

Q642 Alex Cunningham: Let us turn that on its head and ask how children’s centres contribute to school readiness and how they should demonstrate that, especially those centres that do not provide onsite early education and child care. If they do not have education, are the children school-ready?

Elizabeth Young: We have just embarked on a Department for Education grant to look at school readiness. From Home-Start’s point of view, this work will involve partnership work with children’s centres. It will be very much engaged, but not so much on numeracy and literacy, although we think that they are very important. It will be very much around being in a position for the family to engage with an educational institution: morning routines, bedtime routines, reading routines, finances for all the additional costs of going to school, and having the confidence to engage with an educational organisation, whether nursery or primary school. It is that kind of package that we will be working on with children’s centres in nine areas, and we think that it is a really practical approach, as well as encouraging play in order to have home learning.

That would follow through to the child care offer that is happening, going down to two-year-olds. Some of the feedback from our network is that, because that is focused on the 40% of deprived families, you need the wraparound as well. You need to do that work with the parents, too, and a strong message came back from our network about that offer. We would like to see more complementary work to reinforce the home learning environment; otherwise, it could be just a place for the child.

Q643 Alex Cunningham: That moves on, very nicely, to my final question about accountability. The NSPCC has suggested that children’s centres should be held accountable for outcomes other than school readiness. I just wondered what other outcomes should be used to measure the impact of centres’ work.

Annie Hudson: There is something about the contribution of children’s centres around children’s emotional resilience. All the evidence we have about brain development and emotional and social development is that those early years are so critical not only for education, but in terms of developing emotional resilience. Particularly for children from very vulnerable families and communities, that is so important, as is the really wonderful work that children’s centres do around engaging parents. You were referring to secondary schools. I often think that secondary schools, for example, could learn a lot from what children’s centres do in terms of how you engage parents. The engagement of parents in their children’s development, including their learning and education, and emotional resilience, are two really important contributors to children’s lives that children’s centres make when they work really well.

Q644 Alex Cunningham: Just as an aside, do you think secondary schools should be involved in the children’s centres?

Annie Hudson: Yes.

Q645 Alex Cunningham: They could bring value but also gain value.

Annie Hudson: They also have to be realistic. Some secondary schools, and schools working in a particular community or neighbourhood, will work together. That does happen, and it happens particularly, probably, in more deprived communities. I suppose it was just a comment that parents often find it quite difficult to feel engaged with secondary schools-and particularly those parents who have had a negative experience of education. One of the things that children’s centres, when they work well, have done brilliantly and really imaginatively is really to engage people who find learning and education very difficult, and they bring them in.

Alex Cunningham: We can leave it there, I think. We have to move on.

Chair: Can I thank you all very much indeed for giving evidence to us this morning? Please write to us with any thoughts and reflections following today and maybe, Neil-you may just knock it off 10 minutes <?oasys [pc10p0] ?>later on this afternoon-a protocol for the DWP. With your deep understanding, you will be able to write down a quick paragraph on something that bypasses all the problems, reassures all the elements and gets the information that Tim needs to support workless households.

Anyway, thank you very much. Please do write to us and bear in mind that we make recommendations to the Government. If you have any things that you think we should have in our report, please let us know. Thank you very much.