Allen Early Intervention Review (Part 1)

I recommend that the nation should be made aware of the enormous benefits to individuals, families and society of Early Intervention – a policy approach designed to build the essential social and emotional bedrock in children aged 0–3 and to ensure that children aged 0–18 can become the excellent parents of tomorrow. xviii Early Intervention: The Next Steps

I believe that under the Government’s proposed new arrangements for local health services, a great opportunity exists to localise Early Intervention, and I recommend that one of the reorganisation’s key themes should be a focus on antenatal education/preparation for parenthood, and on social and emotional development for the under-3s. I recommend that: • GP consortia and local authorities should work together to commission evidence-based preventive Early Interventions, especially in pregnancy and the first years of life; • the proposed new local health and well-being boards should, as part of their proposed role in developing and overseeing local health and well-being strategies, create integrated Early Intervention approaches, share best practice and have the freedom to tie into the institutional arrangements for Early Intervention recommended below; and • in establishing the new directors of public health (jointly appointed by the Public Health Service and local authorities), there is strong accountability for improving social and emotional capability as a central aspect of children’s health. Full list of recommendations xix

I recommend that, building on the anticipated cross-government consultation paper for a system of flexible parental leave which enables parents to take more of their entitlement, the Government should form a broad-based cross-party group to explore over the long term what is the appropriate level of maternity and paternity support for all parents and babies in light of international evidence and resources available.

I recommend that the success of Family Nurse Partnership should be taken further, with the aspiration that every vulnerable first-time young mother who meets the criteria and wants to join Family Nurse Partnership should be able to access it, and that discussions should take place with all relevant interests on how to ensure sustained local commissioning, leadership and finance. I anticipate that this would be one of the first programmes to be funded through one of the additional funding mechanisms now under consideration, which will be outlined in my second Report.

I recommend that future expansion of Early Intervention programmes should favour those which combine strong evidence bases with impact on crucial stages in the development of social and emotional bedrock in children, and that the present national network of children’s centres should use such approaches, including evidence- based evaluation systems, to identify and meet the needs of vulnerable children and families. This could include programmes such as Family Nurse Partnership. I support the proposal in the Schools White Paper that the remit of the National College for Leadership of Schools and Children’s Services should be extended to provide training for children’s centre leaders, and recommend that this should include training on social and emotional development and evidence-based Early Intervention approaches.

I recommend that a meeting between the Local Government Association and departmental ministers should be convened to agree solutions to local data-sharing problems.

I recommend that all children should have regular assessment of their development from birth up to and including 5, focusing on social and emotional development, so that they can be put on the path to ‘school readiness’ which many – not least from low-income households – would benefit from. Accountability is confused and divided, policy is incomplete and there is an unnecessary separation between the Healthy Child Programme reviews and the Early Years Foundation Stage assessments. It is timely that several external reviews are taking place. Providing they result in a regular and coherent series of assessments, the Government should act swiftly to ensure that the 0–5s are helped at the earliest and most cost-effective point in their lives to develop the social and emotional bedrock upon which they can thrive.

I recommend that we improve workforce capability of those working with the 0–5s. We should: • increase graduate-led, or even postgraduate, pre-school leadership; • ensure that all early years settings employ someone with Early Years Professional Status (EYPS) on site; and • establish a Workforce Development strategy led by the Departments for Education and Health with input from across government, to ensure that we are developing for the future enough suitably qualified candidates who wish to work with the 0–5s. In the interim, I recommend that all key professionals are made aware of the importance of building on the social and emotional capabilities of babies and children, and of promoting and supporting good parenting, through refocused training initially and then as an integral part of continuing professional development. I would like to see some refocused training and development work starting in 2011/12 with roll-out from 2012/13.

I recommend a new National Parenting Campaign as the Crown Jewel of the Big Society project, pursued with enough passion and vitality to make it irresistible even to the most jaundiced. I recommend the creation of a broad-based alliance of interested groups, charities and foundations to ensure that the public, parents, health professionals and, especially, newly pregnant women are aware of the importance of developing social and emotional capability in the first years of life, and understand the best ways of encouraging xx Early Intervention: The Next Steps good later outcomes for their children. Whitehall departments should participate in this initiative but not control or dominate it. For this reason, I propose that it should be funded and directed from outside central government. In the interim, I recommend that specific recommendations on parenting should be published as a response to the ongoing consultation by the Department of Health on proposals on information for patients, service users, carers and the public.

I recommend that a greater proportion of any new public and private expenditure should be spent on proven Early Intervention policies rather than on unproven ones.

I recommend that a new rigorous methodology for evaluating and assessing Early Intervention programmes should be instituted and developed for the UK, aimed at identifying the best, most effective programmes to help our babies, children and young people.

I recommend that the nation should recognise that influencing social and emotional capability becomes harder and more expensive the later it is attempted, and more likely to fail.

I recommend that the 19 ‘top programmes’ identified in my Report should be supported and expanded to demonstrate our commitment to Early Intervention. However, I also recommend that this list of 19 should not be regarded as exhaustive or complete: all should be reviewed and reassessed by the new Early Intervention Foundation (proposed below) before a ‘living list’ is evolved.

I recommend that a growing number of excellent well-regarded UK programmes should be assisted in joining the list as proven programmes able to help our children the most.

I recommend that Early Intervention should build on the strength of its local base by establishing 15 local Early Intervention Places to spearhead its development. These should be run by local authorities and the voluntary sector, who are already the main initiators and innovators of Early Intervention.

I recommend that, where helpful, the Places could voluntarily link to government departments where Early Intervention agendas overlap: positive preliminary discussions have already taken place with several departments to explore this.

I recommend the establishment of an independent Early Intervention Foundation to support local people, communities and agencies, with initial emphasis on the 15 Early Intervention Places.

I recommend that the Foundation should be led and funded by non-central government sources, including local authorities, ethical and philanthropic trusts, foundations and charities as well as private investors who have already expressed an interest in this. The Government should champion and encourage this concept. Whitehall should neither control nor isolate the Foundation but welcome it and engage with it as a source of complementary activity and advice.

I recommend that the Foundation should be given the following roles: • to lead and motivate the expansion of Early Intervention with initial emphasis on the 15 Early Intervention Places; • to evaluate Early Intervention policies on the basis of a rigorous methodology and a strong evidence base, and encourage others to do the same; • to advise the 15 Places and other local authorities and organisations; and • to develop the capacity to attract private and public investment to Early Intervention.

I recommend the immediate creation of a ‘shadow’ Early Intervention Foundation including those quoted in Annex A to bring these proposals to fruition over the next few months.

I recommend that all political parties should work together on the Early Intervention agenda. Even before the publication of this Report I wrote to all party leaders to ask that they continue to work – together where possible – on Early Intervention policies in the future in a way which builds on the recommendations of this Report. Full list of recommendations xxi

I recommend that the Cabinet Social Justice Committee should resolve the issue of future cross-government co-ordination on Early Intervention policy immediately on presentation of this Report.

I recommend a rebalancing of the current culture of ‘late reaction’ to social problems towards an Early Intervention culture, based on the premise of giving all children the social and emotional bedrock they need to achieve and to pre-empt those problems.

As soon as ministers resolve their approach, I recommend that the commitment across government to Early Intervention should be given the strongest and most active leadership by the Permanent Secretaries Committee, especially on how to join up departmental thinking and delivery on Early Intervention, and in particular how to get buy-in from local authorities.

I recommend that the successful interaction begun by the review with local government should be continued and developed, especially by giving local government a leading role in the Early Intervention Foundation.

I recommend the establishment of a transition team to secure swift implementation of any of the key recommendations accepted by the Cabinet Committee.

A further report on the Financing of Early Intervention is being prepared by my team and I recommend that the Cabinet Social Justice Committee should ensure that the team is properly resourced and staffed to enable the report to be presented before the Parliamentary summer recess.

Within that context, I recommend an essential shift to a primary prevention strategy which offers substantial social and financial benefits.

I recommend proper co-ordination of the machinery of government to put Early Intervention at the heart of departmental strategies, including those seeking to raise educational achievement and employability, improve social mobility, reduce crime, support parents and improve mental and physical health.

Since waiting for problems to take root before reacting costs the taxpayer billions of pounds, I recommend that we should exploit the potential for massive savings in public expenditure through an Early Intervention approach.

I recommend that the United Kingdom should adopt the concept of the foundation years from 0 to 5 (including pregnancy), and give it at least the same status and recognition as primary or secondary stages. Its prime objective should be to produce high levels of ‘school readiness’ for all children regardless of family income. To support this recommendation, it is important that everyone with responsibilities for child development, particularly parents, understands how the 0–18 health and educational cycle is continuous from birth and does not start on entry to primary school. It would therefore be helpful to clarify some of the jargon around school years. I therefore recommend that the Government should number all year groups from birth, not from the start of primary school.

Since a successful Early Intervention approach requires sustainability and a long-term view, I recommend that consideration should be given to creating a lasting, stable settlement between central and local government within a published framework or codification of the local/central relationship. I further recommend that, if developed, this settlement should be agreed by all political parties, and adhered to whichever of them are in power in central or local government.

I recommend that the Department of Health and the Department for Education should work together with other partners and interests to produce within 18 months a seamless Foundation Years Plan from pregnancy to 5 years of age, which should be widely understood and disseminated in order to make the 0–5 foundation years a reality. I recommend that this Plan is endorsed by Parliament.