Croydon’s blueprint to make children’s preventive services pay

Can early years interventions succeed without draining resources? Croydon Council believes they can. Judy Cooper reports

The quest to save preventive services from the effect of budget cuts is consuming most children’s services directors right now.

At Croydon Council in south London, the plan is to ensure services will be self-sufficient within three years and in profit within five.

It is a big change from the mindset that has dominated children’s services in recent years.

“We’ve had a lot of money coming into the system but people have used it to set up pet projects with no thought about sustainability,” says children’s services director Dave Hill. “When the money came to an end so did the project. For every project we pump-prime we have to ensure it becomes self-funding within the term of a parliament.”

Hill is putting the money where his mouth is. In March, as part of its Total Place pilot proposals, Croydon launched a £2.3m investment over the next two years in eight projects in four of the borough’s most “difficult” wards. The expectation is that they will make £8.3m savings by 2013-14 and more than £62m by the time the four-year-olds they are serving now turn 18.

The Child:Family:Place programme is targeting services for under-threes, where the biggest gaps lie.

“We realised we’re very poor at that age group,” Hill says. “Parents get a couple of visits from health visitors but, unless there’s something glaring, that’s it until the children start school.

“Families told us that there were lots of signs they were in trouble early on but they found it difficult to get help. We then get these children on social care referrals when they are between seven and 10.”

He says councils that put their faith in the common assessment framework (CAF) may be disappointed: “Although we’ve pushed the CAF hard we’re finding it is not early enough. The professionals filling in a CAF are doing it when these children are already significantly down the line with concerns. What we’re working on is a pre-CAF form that we can fill in with parents but is much less bureaucratic and more family friendly.”

The mapping of the Total Place pilot also found that, although parents had a lot of contact with the system before and just after a baby was born, most of it focused on specific health activities such as scans, tests and child health checks.

Hill says: “We asked health visitors about their role and they said they do a lot of weighing and measuring of babies. Even when they see things they might be worried about they don’t have the brief or the time to deal with it. It’s a huge amount of work to be bringing together a wide range of people to help these families.”

The solution is an early years service that will open up the health visiting profession to take on more of a family support role too. “We want to expand and add to the things health visitors do, thinking about that role in a different way,” Hill says.

The programme will create virtual “family partnership teams”, including health, family and social care practitioners. All the settings involved, including GP surgeries and children’s centres, will have more training to identify early signs of problems.

This will be followed up by family advocates, who will plan the family’s support care and follow it through. Interventions will include more parenting programmes and peer-to-peer support groups.

Peer support will include “virtual grandparents” and social networks for those at-risk groups such as those recently arrived in the borough, those who do not speak English and young parents.

“It’s striking the capacity of peer-to-peer support with professional facilitation that we are just not tapping at the moment,” Hill says. “We used to have it in communities but we’ve lost it in urban areas and there are many parents feeling isolated.”

Croydon is pushing ahead with the scheme despite the massive funding cuts expected across local government. Hill admits: “There’s going to be a huge diminution of resources. We’re all looking at the figures and we’re all scared.

“But we know we have to do this, otherwise you end up just spending more money on children in care and on child protection plans. You need to have the wherewithal to stand back and say that, if we don’t do this, life will be so much harder.”

Croydon has also set aside £40,000 to fund a three-year research project on the interventions to contribute to the meagre body of evidence on cost-effective preventive interventions. “There is a lack of compelling evidence so it means that in some respects we’re having to make a leap of faith,” Hill says.

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This article is published in the 15 July 2010 edition of Community Care under the headline “Self-sufficient in three years, profitable in five”