Coronavirus (COVID-19): Children and Families Collective Leadership Group minutes - 3 June 2021

Attendees and apologies

Chair: Michael Chalmers

Attendees:

• SOLACE - Grace Vickers (Co-Chair)
• Care Inspectorate - Christopher Lumb
• CELCIS - Claire Burns
• Child Protection Committees Scotland - Alan Small
• Coalition of Care and Support Providers in Scotland (CCPS) - Sheila Gordon 
• COSLA - Eddie Follan
• The Promise - Thomas Carlton, Jackie Brock
• NHS NES - Karen Wilson
• Scottish Ambulance Service - Lisa Jane Naidoo
• Public Health Scotland - Debby Wason
• Scottish Children’s Reporter Administration (SCRA) - Neil Hunter
• Social Work Scotland - Alison Gordon 
• Scottish Social Services Council - Laura Lamb
• Improvement Service - Sarah Gadsden
• Children in Scotland - Amy Woodhouse
• Inspiring Children’s Futures, University of Strathclyde - Jennifer Davidson
• Association of Directors of Education in Scotland (ADES) - Jennifer King
• Children’s Hearings Scotland - Elliot Jackson
• Police Scotland - Sam McCluskey

Scottish Government:  

• Michael Chalmers
• Alison Cumming 
• Iona Colvin 
• Jennifer Hamilton 
• Joanna MacDonald 
• Bill Scott-Watson 
• Lesley Swanson
• Maggie Fallon
• Ruth Christie
• Wendy Mitchell 
• Bryony Revell 
• Phillip Gillespie  
• Carolyn Younie 
• Diana Beveridge 
• Kirsty Campbell, Maternal and Infant Health, Directorate for Children and Families
• Helen Fogarty, Children’s Right’s Unit, Directorate for Children and Families
• David Leng/Suzanne Hutchison, Scottish Attainment Challenge Policy Unit, Learning Directorate  

Secretariat:

• Peter Donachie
• Holly Ferguson
• Sarah Corbett

Items and actions

Welcome and note of last meeting (20 May 2021)

Michael Chalmers welcomed members to the meeting and summarised the latest developments in tackling the pandemic and easing restrictions.  

There were no amendments to the note of the last meeting on 20 May.

Best Start programme remobilisation

Kirstie Campbell gave a presentation on the Best Start Programme and plans for remobilisation. The Five Year Forward Plan for Best Start was published in 2017 and focuses on putting women, babies and families at the centre of maternity and neonatal care to ensure they receive the highest quality of care according to their needs. Best Start is part of a wider policy focus on providing greater assistance for early years development; family support; and reducing inequalities.     

Best Start has to address complex and challenging issues in maternal health including increases in the ages at which women are giving birth and health concerns over obesity; smoking; alcohol; and mental health.   

The original report on Best Start contained 76 recommendations which would create a safe, effective and high quality care. The main elements include:

• person-centred care focused on keeping mothers, babies and families together
• multi-disciplinary team care co-ordinated across services
• continuity of carer
• a new model of neonatal care. This will comprise of 3-5 neonatal ICU immediate model, moving to 3 within 5 years. A national model will be developed for 7-day neonatal community services

Four Early Adopter Boards tested different approaches to develop a range of good practices and a toolkit for other Boards. The programme began implementation in the second half of 2017 for completion and transfer to Boards as business as usual in 2022. The programme was placed on pause due to the pandemic although some Boards have been able to proceed with parts of the programme.

The Programme Board agreed on 14 May to move forward with re-mobilisation in a managed way where boards have the capacity. Many of the recommendations are moving into the delivery phase with support provided for cultural and service change.    

Although the programme was placed on hold during the pandemic, some of the innovations and approaches developed in response to the pandemic will assist the implementation work. These include:

• digital Innovations such as NearMe and Vcreate which helps mothers and families to be closer to babies in neonatal care
• delivering care as close to home as possible through, for example, community hubs and home induction
• greater multi-disciplinary and multi-agency working

Best Start has already promoted greater collaboration between health visitors, social work; mental health and addiction services. However there is scope to develop better links with GIRFEC, UNCRC and the Promise.

Members made the following points in discussion:

• there were queries over what approaches are being taken to reduce the risk of stigma and increase support for women experiencing mental health issues or substance misuse. Kirstie highlighted the role of qualified midwives who have received specialised training and reduced caseloads to enable them to better support women in vulnerable situations. This provided more time, skills and knowledge to provide continuity of care and develop links with other services (e.g. referral pathways to homelessness services). This approach also enhances the public health aspect of the midwife role. An example of this type of work in providing wraparound services and a multi-disciplinary approach is the SNIPS (Special Needs in Pregnancy Service) in Glasgow.  Kirstie also emphasised the importance of strong partnerships across services and with the women involved including clear mechanism to check-in on progress
• engagement and involvement with fathers is crucial. One of the key learning points from the pandemic was that fathers felt “shut out” from neonatal and maternity services

The Group agreed that it would be helpful to receive a further update as work progresses to ensure good links across policy areas and services and achieving shared outcomes.

Additional points from MS Teams chat:

Maternity and Neonatal care an important part of each area's Children's Services Planning partnership and Plan

Should the links to pregnancy planning services be strengthened in the model?  Important for maternal and infant health that pregnancies are planned as far as possible. FNP does great work in terms of "planning gaps" between pregnancies.

Interested in how measuring impact is being approached in terms of any data which demonstrates improved outcomes for mum's and babies and meaningful indicators.

Future Direction of Collective Leadership Group (Paper 29/1)

Workforce Development Sub-Group (Paper 29/2)

Michael Chalmers and Grace Vickers provided their reflections on the Group’s work to date.  Michael noted the value of the Group in bringing different sectors together to develop a consensus and take collective action on policy priorities.  However, the Promise is clear that we need to do better particularly on reducing inequalities.  This made a strong case for continuing the Group.  Grace highlighted the presentations at the Learning Event as impressive examples of the work that has been accomplished.  There is a busy programme of legislative and other changes ahead and important for the Group to continue.  

Discussion on the future direction of Leadership Group will take place over the present meeting and the next meeting on 17 June.  Today’s meeting would focus on the Group’s role in relation to governance, scrutiny and accountability and operational leadership and advice. The meeting on 17 June would concentrate on engagement with children, young people and families; and the wider landscape of national stakeholder groups.

On governance, scrutiny and accountability, Philip Gillespie discussed the proposal for a workforce development sub-group. The sub-group would be co-chaired by Scottish Government and CoSLA and provide strategic oversight on the implementation of the workforce requirements for policies on UNCRC, GIRFEC and The Promise.  

The key objectives will be to:

• promote and support the health and wellbeing of the workforce as they recover from the pandemic
• help the workforce to fully implement the GIRFEC practice model
• ensure effective systems leadership and adequate investment in leadership development
• develop an integrated skills and advanced practice framework
• provide strategic oversight on the prioritisation, development and delivery of a trauma informed training programme for the integrated children and families workforce
• consider the impact of work force supply and demand. Student placement availability being a good example of the work that the sub-group could take forward

Members emphasised the need to learn the lessons from previous initiatives which had experienced significant challenges and barriers. There are difficulties in achieving parity of esteem for the children and families workforce including remuneration and terms and conditions. There is also a limited supply of potential staff who could potentially be more attracted to work in adult social care.      

There are however opportunities to address these challenges. Work is already underway to promote core competencies; provide better training and skills development; and create more flexible pathways for career progression. There is also potential to better share roles and responsibilities across professional groups. This can help to increase recruitment and promote parity of esteem.  

The trauma informed training programme provided in partnership with NHS NES is a good example of new initiatives that will support workforce development. Support for training and development will also be needed in other areas such as Barnahus and Joint Investigative Interviewing. 

It will be also be vital to expand access across the workforce to health and wellbeing support from online to counselling and psychotherapy.

COSLA and SOLACE commented on the support the proposal had received from within their organisations. While there is a need to learn from the past, the pandemic has created a different situation. There is greater momentum for change given the impact of the pandemic on the workforce and the wider developments taking place across the sector. Leadership Group agreed to the proposal to set up the sub-group. Phillip Gillespie offered further discussions with individual members on the issues involved. 

Bill Scott-Watson described the work taking place to strengthen the relationship between Leadership Group and the Children’s Services Planning Strategic Leads Network. In particular, the Strategic Leads Network had reviewed its terms of reference and proposed that the Network escalate issues for resolution or make recommendations to inform decision-making and consideration by the Leadership Group. The Network would also be accountable for responding to requests from the Leadership Group and Ministers in support of action required to improve outcomes for children, young people and their families. Leadership Group accepted this proposal.

Due to lack of time, there was little discussion of Leadership Group’s future role in providing operational leadership and advice. This will be discussed at the next meeting in the context of the wider landscape of national groups. Michael Chalmers noted that the Justice Board developed an overall set of outcomes for its work. Michael invited members to consider how the development of a wellbeing outcomes framework can assist Leadership Group in agreeing a set of outcomes for its own work.

Action:

• members to provide comments to Secretariat on Future Direction of CLG paper to focus on specific issues to discuss on 17 June

Additional Points from MS Teams chat:

Improvement Service is providing a range of support to councils and partners to raise awareness of the benefits of a trauma informed approach across systems, services and workforce and to support them to implement a trauma informed approach. We could connect with the work of the group if it would be helpful. 

SSSC welcomes the opportunity to be part of the workforce sub-group and to support delivery of the priorities. The SSSC has had a number of discussions on how we can support delivery of The Promise through review of regulation and refresh of common core qualifications etc which could be fed into the workplan of the workforce and we support the workforce planning and career flexibility priorities.

Workforce is key but need to be realistic that it’s one aspect of change. We need to be careful that we don’t put the onus on front line staff to make significant improvements without thinking about the other structural barriers that exist.  Also training is essential but not sufficient for change so how are we thinking about the other supports needed ?

Is there a task for this new group to break workforce development down to key priority elements and focus on the most critical and immediate issues at hand post pandemic?

To note NMC regulatory body not devolved, also considerations of Health and Care Staffing Act. 2019.

UNCRC incorporation

Helen Fogarty provided an update on the latest work on UNCRC Incorporation. The Strategic Implementation Board has now been established and will provide oversight across the programme.  A working group has also been set up to develop and test ideas for guidance. A significant amount of work is taking place to ensure that children and young people continue to be involved in the engagement and decision making processes. As part of this, a range of organisations are being invited to be part of a consortium to provide a firm, ongoing channel for this work.   

The Supreme Court case is expected to heard over 28/29 June. Helen emphasised that the referral to the Supreme Court is over a few specific sections of the Bill (sections 6 and 19-21) related to issues on the margins of the devolution settlement. The Bill cannot be presented for Royal Assent until the Supreme Court case is resolved. Although the Bill contains the provision to commence automatically six months after Royal Assent, the power to commence earlier is available and this provides options on how best to proceed as events develop. The majority of work to implement the UNCRC is however continuing as planned.

Members supported a phased approach to producing guidance. An initial set of introductory guidance would help to develop wider understanding of the issues involved and changes required. This should be followed by fuller guidance later.  Helen agreed to consider this approach further and provide a further update to members.

Attainment Challenge: support for wellbeing outcomes

David Leng and Suzanne Hutchison provided a presentation on the Scottish Attainment Challenge and Attainment Scotland Fund. The initiative has the aim of making clear progress in closing the poverty related attainment gap. There are five distinct funding streams. The Scottish Attainment Challenge originally covered seven local authorities: this has now risen to nine local authorities and seventy-three schools. Another of the funding streams – Pupil Equity Funding – provides support to all schools with P1-S3 pupils from low income families and covers over 97% of schools. There is a dedicated funding stream for care experienced children and young people.

Health and wellbeing is included as a specific aspect of the programme and an increasing focus in the plans provided for the Scottish Attainment Challenge. Work is also taking place with families and communities to help children and young people develop their learning skills. However, there is potential to develop these aspects of the initiative further.       

A five year (2016-21) report on the programme has been published. This has been supplemented by an equity audit to better understand the impact of the pandemic on children from disadvantaged backgrounds and areas of focus for accelerating recovery. These and other sources of evidence show that progress has been made in closing the attainment gap although there are some variations across the country. There has been a widespread and systematic focus on improving equity; enhanced teaching and learning and use of data for improvement; and greater joint working.

Read the full report and the equity audit.     

Key areas where improvements can be made include better collaboration with early years and post-school destinations. There are significant opportunities for more effective and holistic partnership working in tackling child poverty. David and Suzanne emphasised that they are keen to develop stronger links with members of Leadership Group to help achieve these objectives.

Members made the following points in discussion:

• it would be useful to frame and promote a rights-based approach more strongly through the programme. Poverty is one of the main structural barriers that prevents children from realising the right to an education
• assumptions about the school-based use of the funding could lead to barriers in supporting wider work in the community with children, young people and families on health and wellbeing and tackling poverty.  Greater joint working through Children's Services Planning Partnerships can help to address this

David and Suzanne offered to hold further discussions with individual members.

Additional points from MS Teams chat:

Will be one of the recommendations of the family support delivery group - look at bigger role of CSPPs as focus and mechanism for attainment funding.

Focus needs to shift to readiness for school and include those who don't attend or are excluded.

AOB and close    

Debby Wason noted under AOB that PHS is hoping to run Round Three of the COVID Early Years Resilience and Impact Survey of parents. This would be a slightly more reflective survey for parents of 2-7s. The core questions from previous surveys will be retained but Debby invited members to suggest additional areas to cover particularly as the survey usually has a good response.    

• members to provide comments to Secretariat