Greenwich Council

Agenda item.

In Depth Scrutiny - Scrutiny of Children's Health Services provided by Commissioned Providers

To consider and comment on the formal and informal evidence received by the Project Team on children’s health services provided by commissioned providers within Royal Borough of Greenwich Children’s Centres.


The Chair introduced the report and confirmed it would be considered jointly with members of the Healthier Communities and Adult Social Care Scrutiny Panel. She added that the in depth review of the Children’s Centres was agreed as a result of discussions between the co-chairs of both panels on perinatal services and the performance data received.


The Chair stated that the types of methodology used during the review included desk top evaluations based on previous reports and national best practice, interviews with health professional members and children service teams and site visits which provided the opportunity to talk to service users.

She added that the children centres provided a valued set of services and the feedback was positive.


The Chair requested the joint panels discuss the recommendations in the iterim report with the Children’s Centres staff and health professionals and use the evidence to finalise the report for late autumn.

 Action: SCDO


The Panel was addressed by Children Centre staff who stated that they provide both universal services and targeted services for under 5’s and their families. They added that they deliver a wide range of services including 1-1 support in speech and language, parenting support with a focus on employment and training, child care and early education and health services. They confirmed there was increased accessibility to the service and that there was a closer working relationship with partners across the borough.


In response to questions from the Panel on the development of a new model into the support of high risk families taking into the account the Councils financial pressures the Children’s Centre staff stated that there were no discussions of a new model at present as the universal services they provide was helping in identifying and targeting children’s needs that had not been recognised previously.


The Director of Children’s Services added that there was a risk of increased responsibility going to children’s centres however the case accountability of care is the responsibility of Children’s Social Care and the Early Help Service who are in the process of developing a more intensive offer that will work in collaboration with the children’s centres. She added that consultation had been going on going for the last year on the levels of need and the importance of universal provision.  She also confirmed that the new model is a reorganisation of local authority services and that consultation will be concluded in the autumn.


Members requested the Director of Children’s Services provide a report on the new model of work after the re-organisation of work is completed.

Action: DCS


In response to questions from the Panel on the relationship between Children’s Centres and the schools during handover periods the staff stated that most centres were located within the schools and that this allowed for a smooth transition especially around safeguarding. They also added that centres not located at schools work closely with parents and Head Teachers to ensure a smooth transition takes place especially for vulnerable families.


With regards to the introduction of 30 hours’ free childcare for 3 & 4 year olds for working families the Children’s Centre staff stated that the information online was comprehensive and the scheme was being promoted at the centres. They shared their concerns about the number of parents taking up the new offer especially in the Woolwich Area. The Director of Children’s services added the scheme was new and data will be looked at in detail.


 In response to question from the Panel on the financial pressures faced by the centres and the renewal of the contract in 2 years the Children Centre staff explained that the Redbridge model would be difficult to follow as their centres are still in house. They also mentioned that the majority of the 10% cut in the budget will come from the reduction in admin costs and should not impact the services dramatically however staff are to be trained on some of the services that they currently buy in. They added that they are limiting the number of free crèche places and introducing strict attendance rules.


With regards to the suitability of the buildings the Children’s Centre staff stated that most of the spaces are sufficient however some are not as the nature of the buildings are being adapted to accommodate the centres. They added that they are using the spaces creatively and commented that they would like to use the Eltham North virtual centre more frequently.


The Chair thanked the Children’s Centre Staff.


Panel Members were addressed by health professionals working in the Children Centres. In response to questions from Members regarding speech and language training at the Children’s Centres the health professionals commented that there are more group therapy sessions and a reduction in the number of lengthy 1-1 training. They added that the training was tailored toward the needs of the families and start with parent only workshop followed by a course of therapy which include sessions with the children. They also commented that the commissioning arrangements has led to a reduction in the waiting times for parents to see therapists leading to positive outcomes.


The health professionals informed the panel of the new model being introduced in September that will mean families will have Integrated assessments at the Children’s Centres allowing parents to see their occupation therapist, physical therapist, speech and language therapist and dietician at the same time. They added that there had been comprehensive training provided to children’s centre staff in recognising children’s communication difficulties to support parents in accepting the difficulties they face and support families to go and see the specialised service.


With regards to the number of children actively accessing treatment in the pre-school years the health professionals confirmed they are currently working with an estimate of 500 children compared to a caseload of 5000 children 7 years ago. This is a result of the introduction of the Universal targeted specialist services. They also commented on the impact of the budget cuts leading to new ways of working and the advantages of using more technology.


In response to Panel Member questions on the role of Children Centres in delivering the public health outcomes the health professionals confirmed that many of the services they deliver are aligned with the centres and support the same children in the same areas. They also added the centres are the preferred place to offer their service and they work closely with children centre staff and provide joint training packages.


Officers added that the children centres play a fundamental part in supporting the public health outcomes. They stated that the centres work through the healthy early year’s framework which provides a structured overview of issues such as obesity and diet and is an important part of the public health infrastructure. They also added that there is a need for other services to collectively assist the Children’s centres in the huge amount of work they do.


 With regards to funding officers identified the deliberate policy taken locally to protect the services provided by the children centres and highlighted the number of children centres retained compared to other parts of the country. They also commented on the positive feedback received after the UNICEF visit.


In response to questions from the Panel on the collaboration with midwifery services the health professionals confirmed they are continually working with midwives at different levels of the service and attend multi-agency training. They stated that for vulnerable families they work closely with best beginning midwives and that the provision of anti-natal groups is offered in collaboration.


The Chair thanked the Health Professionals.


At the conclusion of the item Members of the Healthier Communities and Social Care Scrutiny Panel left the meeting.


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