Page 363 - Week 02 - Tuesday, 19 February 2019
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A key lesson from Opportunity Nottingham has been the importance of genuinely involving its expert group of beneficiaries in decisions on new services. This was seen as critical to designing a service response that works for those who otherwise do not seek or accept help. It is important to note that, while successful intervention was found to deliver reduced costs in the justice system, in line with a justice reinvestment approach, and in emergency presentations to hospital, it also saw increased demand in rehabilitation and other medical services when clients were able to engage.
In the afternoon of the same day, we visited the city wellbeing hub, one of a number of examples we saw of service collocation facilitating collaboration and referral. A feature of this particular hub was a commitment to seeing everyone who came in as quickly as possible, with all clients seen and assessed by a relevant service on the day. The following day was spent with policy leaders and service providers who are engaged with Nottingham’s commitment to being an early intervention city, a commitment it has had since 2008, and in particular the small steps big changes program.
These meetings were held at one of Nottingham’s eight children’s centres—not dissimilar in concept to our child and family centres—that include multidisciplinary early help teams, public health teams and childcare providers. Early help is part of Nottingham’s family support pathway that is clearly laid out and updated every couple of years. This model of “universal support, early help (universal plus), early help (targeted) and specialist and protection services” is presented as a continuum of support, with the vision that all families get the right help at the right time wherever they are along the spectrum of need.
This approach has seen Nottingham achieve: a significant reduction in the rate of teen pregnancy, from the highest in Europe; an increase in breastfeeding prevalence to above the national average; a reduction in obesity at entry to school and the end of year 6; a reduction in emergency hospital admissions; and a reduction in the number of children in care, reduced costs of care and better outcomes for children and young people who do come into the care system.
A key part of the model is based on a more collaborative approach to procurement or commissioning, clearly identifying outcomes that community partners are working towards, but enabling services to adapt within an existing contract to better meet consumers’ needs. While Nottingham has learned many lessons in its 10-year journey, the executive councillor for children’s services told us that a key lesson is that there are a whole lot of things that evidence tells us will work but actually making them work is about local needs and relationships.
That is exactly what drives small steps big changes, otherwise known as SSBC. SSBC is another big lottery-funded project, through its better start initiative. After two years of engaging with the community, looking in depth at existing services and bringing a range of partners together to bid for funding through a gruelling application process, the program was awarded £45 million over 10 years to deliver parent-led reform to the service system for children and families. To quote SSBC’s website:
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