Agenda item

Report of the Director of Children's Prevention, Family Help and Safeguarding and Director of Health and Wellbeing.

The report provides updates to the Children, Schools and Families Committee on four interconnected programmes of work under the aegis of the recently-formed Children and Learning Directorate: Family Hubs, Family Help, Start Well, and the cross-cutting Child Health Equity programme.  Each section provides background/ context to the work including information on our population’s needs and governance arrangements; key updates from the last 12 months; challenges; and next steps for the coming year.

Consideration was given to the report of the Director of Children's Prevention, Family Help and Safeguarding and Director of Health and Wellbeing.

The Chair informed the Committee that another Family Hubs paper would report to Committee in the next municipal year because there was national reform and developments in this area. The Chair invited views from Members on any changes to areas the report covers or how information was presented they would like to be incorporated into the next paper.

Manuj Sharma (Public Health Consultant), Debbie Adams (Head of Early Years and Family Hubs) and Kirsten Watters (Director of Health and Wellbeing) summarised the report. The report provided updates on four interconnected programmes of work under the oversight of the recently formed Children and Learning Directorate: Family Hubs, Family Help, Start Well, and the cross-cutting Child Health Equity programme.  The report provided background and context to the work, including information on Camden’s population’s needs and governance arrangements. The report also provided key updates from the last 12 months, challenges, and next steps for the coming year.  

The Chair thanked officers for the report and invited questions and comments from the Committee. The following was discussed:

·       A Member raised concerns about low vaccination rates in Camden, attributing the cause of the issue partly to misinformation spread via social media and other sources. They emphasised the critical role of schools in addressing myths about vaccines, particularly in parent governor meetings, and stressed the importance of clear communication about the serious risks of not vaccinating. The Member expressed particular concern about vaccination uptake in Somali and Bangladeshi communities. Officers reported that Camden had made sustained progress in increasing immunisation rates since 2022, including an improvement in uptake of the Measles, Mumps, and Rubella (MMR) vaccine. While the increases were modest, they were significant, given the difficulty in reaching certain groups. Officers highlighted an upward trend, with the second dose of the vaccine (MMR2) reaching 65%. They attributed this progress to cross-partnership work involving Family Hubs, the Integrated Care Board (ICB), and community participation, noting that Camden was bucking regional and national trends and making measurable progress despite external challenges.

·       A Member highlighted that mental health disorders in Camden were 33% higher than the national average, with social housing and poverty cited as contributing factors. They shared concerns from their ward surgery, noting that some residents would value access to social housing. The Member also expressed particular concern at the high rates of self-harm among 17 to 24 year olds. Reflecting on a 2016-17 scrutiny panel report on mental health in secondary schools, the Member noted the worsening trends, particularly regarding self-harm, which had not been a significant focus in previous years. They also acknowledged positive feedback from interviews with providers and asked why the situation had deteriorated. Officers explained that the increase in mental health challenges reflected broader national trends, driven by factors such as the cost-of-living crisis, the pandemic, and the impact of the digital age, including social media. Although Camden's self-harm rates were better than the London average, officers emphasised ongoing monitoring and efforts to maintain young people in the ‘wellbeing space.’ They outlined a multi-faceted approach, including maximising mental health and wellbeing offers in schools and communities to prevent escalation to self-harm. Officers noted that services remained responsive, addressing issues within the community. Mental health support teams were enabling young people to access services, and a co-produced campaign with young people had focused on raising awareness of available mental health services.

·       A Member asked for more information on the Raise Equity initiative. Officers explained that the initiative focused on addressing inequalities in child health, recognising that socioeconomic factors impacted every health condition. They noted that inequalities and disproportionality in children’s health had been increasing across all age groups. The approach involved collaborating with health services and wider partners to close these gaps and ensure services were reaching children most in need. The initiative included several programme elements, and officers offered to report back to the Committee with further details upon request. Officers highlighted that work had already begun, including audits to assess service accessibility and the prevalence of health issues. They examined paediatric care and the reasons some parents used emergency health department rather than other more suitable secondary care services, with a focus on families who felt isolated or unaware of community resources. The initiative also aimed to address inequalities caused by poverty, including through maternity grants and other supportive measures, with a planned launch in the new year.

·       A Member raised concerns about the growing number of families who were homeless or living in temporary accommodation, highlighting the impact of such instability on health. They asked whether there was any specific work being done to support these families. Officers explained that the health visiting service had a specific focus on homeless families and those in temporary accommodation, with links to family support workers. They noted that the broader support model included universal offers for all families, additional help for those with greater needs, and targeted family support. This model was intended to address rising social and health issues and assist families in securing permanent accommodation. Officers also highlighted the Family Hub, which was open on weekends as part of the warm spaces programme. This initiative offered a place for families to go for support and activities. The service was continuing to develop, with a focus on ensuring that vulnerable families received ongoing assistance. In response to questions about families in hotels and those living out of borough, officers confirmed that support was being tracked, and health visiting services would continue to follow families even if they moved out of borough. However, when families settled in another borough, support would be transferred to the host borough to ensure continuity.

·       In response to Members asking if professionals across different services were contributing to the work, officers stated that there had been significant effort across the system to address mental health and wellbeing, with several forums in place where they met with health partners to adapt, innovate, and explore new approaches. They highlighted the collective goodwill to make meaningful change, emphasising the importance of collaboration despite the pressures that existed. Officers noted that maintaining strong partnerships and momentum was crucial to ensuring the best outcomes for residents.

·       A Member requested more information on how the role of Family Hubs could be maximised. Officers explained that family hubs had evolved from children's centres, which were well-known to families with young children. The current challenge was increasing the visibility of family hubs to families with older children. They were working on various strategies, such as engaging workers speaking directly with families and spreading the word about available services through word of mouth. They were also looking to move additional health services into the hubs, making them more accessible without requiring a referral, and replicating the successes seen in Early Years services. Officers also explained the rationale behind the child health equity work, which aimed to understand who was accessing services in proportion to their needs. They planned to conduct audits alongside qualitative work, with a focus on identifying barriers families might face in accessing services. Despite having ample data, the goal was to implement an equity approach that not only met needs but also reduced inequalities. The officers stressed that having good services alone was not sufficient to address these issues.

·       A Member stated that it appeared funding for the family hubs programme would end after three years and they would like to see quantitative data to demonstrate the programme's success. Officers confirmed that they had secured funding for an additional year and were hopeful for continued funding after the spending review, although the long-term position was still uncertain. The Member also inquired about the engagement of parents of older children, noting that this aspect seemed missing from the report. Officers acknowledged that more work was needed and they explained that engagement with families wasn't just about attending physical Hubs, but also about accessing services across the borough. While Family Hubs mainly served pre-school children, outreach services were available to older children too. Officers highlighted that they were working on tracking engagement and defining the Family Hub offer more clearly. Officers emphasised the importance of a one-stop-shop approach for addressing both emotional and physical health issues, noting that they had conducted extensive engagement with communities that had historically been underserved. They also mentioned Camden's Champions Programme, which involved invested parents who could provide valuable insights into the challenges they faced, as well as their experiences with services. These parents had been asked to share their vision for Family Hubs, contributing to a broader understanding of how they could support families in Camden—not just as physical spaces but as integral parts of the borough's health equity strategy.

·       A Member raised concerns about the lack of coverage on inclusivity, particularly regarding children and parents with disabilities, different types of SEND, and varying access needs. They requested that more information on the actions being taken to enhance inclusivity, especially for individuals with SEND, be provided in a future report.

RESOLVED –

THAT the Committee note the report.