Early Intervention: Policy and practice developments in England

Helen JonesProfessional Adviser

ACWA ConferenceSydney

What do we mean by ‘early intervention’?

Prevention of any problem ?

Prevention of most serious problems ?

Trying to stop things getting worse ?

Promotion of positive development?

Policy Problems

• Identification of needs at earlier stage is resource intensive and requires additional services to be in place

• Concern about ‘treating the worried well’ or problems which would have been resolved without intervention

• Does early intervention normalise or stigmatise?

And…

• Do we understand enough about effectiveness in early interventions which may require more than soft focus parenting support ?

emotional/social wellbeing inchildhood and adolescence

social wellbeing in the home

emotional/social wellbeingin adulthood

social wellbeing in

communities and workplaceshealthy public policy

health inadulthood

health inchildhood

effective workingpractices

healthyrelationships

educationalachievement

healthy parenting

The Wellbeing Model of Health

healthyschools

Emotional and social well-being in childhood and adolescence

• Importance of a resilience framework

• Importance of an overarching outcomes framework

• Importance of service integration and partnerships

• Importance of links between universal, targeted and specialist interventions

Resilience framework

‘ In a resilience framework, practitioners are encouraged to attend to the developmental task of doing well in life’

Newman 2004

Current policy framework

• Every Child Matters (ECM)

- ECM : Next Steps

- ECM : Change for Children

• National Service Framework for children, Young people and maternity services

Every Child Matters: focus on outcomes

• be healthy• stay safe• enjoy and achieve• make a positive contribution• achieve economic well-being

Key domains of resilience

Every Child Matters Programme

• Principle of progressive universalism delivered through

-Children’s Centres - Extended Schools - Parenting Strategy • Universal services to identify and reach children

and families in need of targeted and specialist support

Aims of Every Child MattersImproving outcomes through:• improvement and integration of universal

services: early years, schools, health service

• early identification and intervention, with more specialised help

• services reconfigured around child and family – multi disciplinary teams, multi-agency working

• listening to children, young people, parents

• to be delivered through 150 local change programmes

Prevention-Promotion Agenda

• Children’s centres to identify and support families and work with other services

• By 2010 all schools will offer access to core of extended services including parenting support

• Integrated Youth Services for 13-19s

Common Assessment Framework (CAF)

The CAF is a standardised approach to conducting an assessment of a child’s additional needs and deciding how those needs should be met. It can be used by practitioners across children’s services in England

Common Assessment

• To help identify children who require additional services

• To support the integration of services• Used by all professionals • To achieve common thresholds of concern • Legislation in Children Act 2004

Harmonised system of assessments

• Common Assessment (assessments undertaken by any professional in making a referral)

• Assessment framework (assessments of need undertaken by social workers)

+• Looking After Children (Undertaken by social workers to

assess outcomes for children and young people in care)

=• Integrated Children’s System

Information Sharing Index

• Operational information-sharing Index by 2008

• Central index with 150 local parts

• To support effective prevention and early intervention

• Index will contain all children in England

The Index in practice

Information Hub / Information Sharing spine

• name, address and date of birth• school or other educational setting• GP• a flag stating whether the child is known to

agencies/contact details• where a child is known to more than one specialist

agency the lead professional who takes overall responsibility for the case

The leaves and stem model of information systems

Health Record Education Record

Social CareRecordie. ICS

Health RecordEducation Record

Social CareRecordie. ICS

Health Record Education Record

Social CareRecordie. ICS

LEAVES

STEM

CHILD 1

CHILD 2

CHILD 3

R1

R2

R3

System Reform

• Respond earlier to need and so doing improve child outcomes

• Redirect resources way from high cost heavy end where there is little evidence of proportional benefit

Promoting Child and family Wellbeing

• 4 key dimensions

- distinguishing promotion, prevention and early intervention

-focusing the intervention

-length and intensity

-values for engaging the community

Interventions Framework

• Universal, targeted and specialist services delivered at levels of

• Child, family, community, society

Prilleltensky et al

2001

Examples

• Child- Portage programmes

• Family- Surestart

• Communities- Portsmouth ‘Safer Communities’

• Societal- Tax credits

Early intervention for foster and adoptive families

• Using evidence-based interventions with foster and adoptive families as part of standard training, not in response to difficulties e,g Webster Stratton

• Healthy Care: to support the provision of a healthy environment for looked after children by training carers in benefits of play and creativity