Sure Start

[Guest guest]

Woody - thank you for the compliment, it is nice to have a compliment now

and again to fend off the brick bats! I was about to take up my Senate pen

anyway this evening to tell everyone about a good effort I have been

involved in with Sue Walters Special Advisor to the Office of the Deputy

Prime Minister The Homelessness Unit.

Sue and I have been working together since last October to highlight a

number of issues that came to my attention through my Sure Start work with

two women that I first met when they were in a homeless hostel, in one of my

Sure Start research sites.

It seemed to me that their experience just didn't fit with what government

policy was saying should be their experience. They were in dire straits with

no-one but Sure Start and Crossroads (respite for carers with children who

have a disability) supporting them. I was appalled at their experience,

asked them to keep a photo-journal (actually I didn't think they would, I

mean you have horrendous problems and some researcher comes round and visits

and says take pictures!!!!) Long story short! Sue visited and said I am

appalled too!

" Two professional heads " thinks - how can we raise these policy issues, good

health visiting how can we impact on policy! With Sue's help and two

completely wonderful photo journals (that women and researcher spent a lot

of time on) we presented to the CPHVA special interest group on homelessness

and health in April this year.

I held my breath through that because it is terrifying for parents to be

placed in the spotlight. The night before -one parent was up all night with

sick child other parent was up all night sick with nerves over what

Houston had gotten her into. Both were wonderful and came out of the

experience 10 feet tall.

" Two professional heads " thinks - what will we do now!

Sue says lets put on a seminar at the Department and ask civil servants and

important folk and use the photo journals to tell the story of how, in

homeless accommodation - families are menaced and live in fear, they dont

have clothes washing facilities, they have a cooker that doesn't work they

have a fridge that doesn't work, they fight with housing to stay in a Sure

Start area because thats their only support mechanism and they would be on a

knife edge without it.

So anyway after six attempts to set this up - civil servants seem to be

busier than the rest of the world or have more pressing concerns - anyway

the big day (to bring the outside in and hear it like it is) was today!!!

The parents were absolutely wonderful the photo journals were passed round

and I prompted the audience into reading out particular pages.

We addressed standards, stress and support and what is it that acts as a

buffer - Sure Start, Crossroads, community networking, social capital all

were touched on and enlarged. But 'stars of stage and screen' were the women

and their journals and their voice.

Afterwords one of the civil servants said to me 'we are very forgiving of

the local authority when they say how hard it is to get things in place and

we fail to realise the impact of that failure on families like the two here

today' Many said to me how powerful it was to see and read the journals and

understand homelessness from their perspective. Some one else said to me it

was 'gobsmacking' I guess if you are an office based worker, in the Office

of the Deputy Prime Minister and never out in the 'field' as it were then it

probably was!

Judging by the erudite questions and the amount of notes taken for things to

be followed up I think we have definately had an impact on those who make

and write the policy!

From little acorns big oaks grow!

Needless to say Sue and I were delighted at the day and its outcomes!

I'll probably go back into my Sure Start cave not to be heard of on Senate

for some time again. I read everything thats posted in my daily digest and I

am always impressed with people's thoughtful comments and useful follow-ups

and kindly support. In Senate we have something worth treasuring and

supporting and I worry when it goes quiet will it fade away! If someone new

joins in a quiet moment will they think 'boring dull boring' I wonder often

how the quiet background people can be encouraged to contribute - I bet they

have innovative diamonds in practice that they are not sharing or thorny

issues that we could all help with. Anyway back to my research and more

power to the elbow of Senate in its third year now - is that right ? Is

it really three years????

I have put this lengthy epistle all in one email and not an attachment so

that the daily digest people dont have to search for the attachment on the

site so please forgive me for that because it is definately attachment

length!

ps another Sure Start article out in August edition of Community

Practitioner for those interested. I am really delighted that Community

Practitioner are forging ahead and have been so supportive of the need to

get the Sure Start info out to practitioners. I was so despondent at seeing

so little published on Sure Start - Helen 2000 What is Sure

Start?was all that came out of an extensive facet analysis literature search

- thank heavens for NESS but few articles yet from their web reports. I set

about trying hard to fill the gap, Woody I am glad you think it is of some

use.

_________________________________________________________________

Stay in touch with absent friends - get MSN Messenger

http://www.msn.co.uk/messenger

[Guest guest]

Good to hear from you after so long ; well done for your 'influence

on policies affecting health'!

Houston wrote:

[Guest guest]

Thanks for highlighting this Woody I am using it to argue for Community

Practitioner Funding for micro-locality initiatives. Ruth

Sure Start

> In case people missed Houston's excellent summary of Sure Start,

> it is in July's Community Practitioner 257-260.

> I for one will be using it with one of our local PCTs now, to

> illustrate some key aspects of Sure Start initiatives.

> Woody.

> P.S. for anyone unfamiliar with these programmes,

> background information is on the website http://www.surestart.gov.uk/

> but a word of caution - many of the documents supposedly available from

> this site are not actually available/downloadable.

>

> ----------------------

> Woody Caan

> a.w.caan@...

>

>

>

>

[Guest guest]

Fantastic work . So very important to allow clients a voice that can be

heard at all levels including the easily-shockable top. Ruth

Sure Start

> Woody - thank you for the compliment, it is nice to have a compliment now

> and again to fend off the brick bats! I was about to take up my Senate pen

> anyway this evening to tell everyone about a good effort I have been

> involved in with Sue Walters Special Advisor to the Office of the Deputy

> Prime Minister The Homelessness Unit.

> Sue and I have been working together since last October to highlight a

> number of issues that came to my attention through my Sure Start work with

> two women that I first met when they were in a homeless hostel, in one of

my

> Sure Start research sites.

> It seemed to me that their experience just didn't fit with what government

> policy was saying should be their experience. They were in dire straits

with

> no-one but Sure Start and Crossroads (respite for carers with children who

> have a disability) supporting them. I was appalled at their experience,

> asked them to keep a photo-journal (actually I didn't think they would, I

> mean you have horrendous problems and some researcher comes round and

visits

> and says take pictures!!!!) Long story short! Sue visited and said I am

> appalled too!

> " Two professional heads " thinks - how can we raise these policy issues,

good

> health visiting how can we impact on policy! With Sue's help and two

> completely wonderful photo journals (that women and researcher spent a lot

> of time on) we presented to the CPHVA special interest group on

homelessness

> and health in April this year.

> I held my breath through that because it is terrifying for parents to be

> placed in the spotlight. The night before -one parent was up all night

with

> sick child other parent was up all night sick with nerves over what

> Houston had gotten her into. Both were wonderful and came out of the

> experience 10 feet tall.

> " Two professional heads " thinks - what will we do now!

> Sue says lets put on a seminar at the Department and ask civil servants

and

> important folk and use the photo journals to tell the story of how, in

> homeless accommodation - families are menaced and live in fear, they dont

> have clothes washing facilities, they have a cooker that doesn't work they

> have a fridge that doesn't work, they fight with housing to stay in a Sure

> Start area because thats their only support mechanism and they would be on

a

> knife edge without it.

> So anyway after six attempts to set this up - civil servants seem to be

> busier than the rest of the world or have more pressing concerns - anyway

> the big day (to bring the outside in and hear it like it is) was today!!!

> The parents were absolutely wonderful the photo journals were passed round

> and I prompted the audience into reading out particular pages.

> We addressed standards, stress and support and what is it that acts as a

> buffer - Sure Start, Crossroads, community networking, social capital all

> were touched on and enlarged. But 'stars of stage and screen' were the

women

> and their journals and their voice.

> Afterwords one of the civil servants said to me 'we are very forgiving of

> the local authority when they say how hard it is to get things in place

and

> we fail to realise the impact of that failure on families like the two

here

> today' Many said to me how powerful it was to see and read the journals

and

> understand homelessness from their perspective. Some one else said to me

it

> was 'gobsmacking' I guess if you are an office based worker, in the Office

> of the Deputy Prime Minister and never out in the 'field' as it were then

it

> probably was!

> Judging by the erudite questions and the amount of notes taken for things

to

> be followed up I think we have definately had an impact on those who make

> and write the policy!

> From little acorns big oaks grow!

> Needless to say Sue and I were delighted at the day and its outcomes!

> I'll probably go back into my Sure Start cave not to be heard of on Senate

> for some time again. I read everything thats posted in my daily digest and

I

> am always impressed with people's thoughtful comments and useful

follow-ups

> and kindly support. In Senate we have something worth treasuring and

> supporting and I worry when it goes quiet will it fade away! If someone

new

> joins in a quiet moment will they think 'boring dull boring' I wonder

often

> how the quiet background people can be encouraged to contribute - I bet

they

> have innovative diamonds in practice that they are not sharing or thorny

> issues that we could all help with. Anyway back to my research and more

> power to the elbow of Senate in its third year now - is that right ?

Is

> it really three years????

> I have put this lengthy epistle all in one email and not an attachment so

> that the daily digest people dont have to search for the attachment on the

> site so please forgive me for that because it is definately attachment

> length!

>

> ps another Sure Start article out in August edition of Community

> Practitioner for those interested. I am really delighted that Community

> Practitioner are forging ahead and have been so supportive of the need to

> get the Sure Start info out to practitioners. I was so despondent at

seeing

> so little published on Sure Start - Helen 2000 What is Sure

> Start?was all that came out of an extensive facet analysis literature

search

> - thank heavens for NESS but few articles yet from their web reports. I

set

> about trying hard to fill the gap, Woody I am glad you think it is of some

> use.

>

> _________________________________________________________________

> Stay in touch with absent friends - get MSN Messenger

> http://www.msn.co.uk/messenger

>

>

>

>

[Guest guest]

Thanks both Gill and for sharing Sure Start experiences. At a conference

yesterday, a member of the audience responded to an expressed concern about

the end of funding for the earliest (trailblazers and Wave 1) Sure Starts,

saying that within the last week, all have received letters stating that

their funding is assured for the next two financial year (ie, 2005-06 and

2006-07); it might even have been longer but I did not write down what was

said. It would be good if anyone has more information about this and can

expand or verify, as it has been a great concern that most PCTs are simply

not in a position (for all sorts of positive and negative reasons) to take

forward the great work set up in these programmes.

The other point, is that the National Evaluation of Sure Start, when it

published its first report, noted that it takes around three years for programmes

to bed down and start to really deliver the services they need; in the earlyyears,

most programmes experience the kinds of difficulties that describes.

best wishes

kazza402k wrote:

Thank You Gill your experience is fascinating, it seems to echo what I hear of many Sure Starts. Our local Sure Start is in wave 6 and only just up and running!! It seems to be bound up in red tape, trying to recruit and ultimatley relying on agency staff, with any referrals not being actioned and very little actual family support work being carried out! I am also mindful of the postcode issue and find the criteria of postcoding a difficult one as I believe needs assessment should be the way of getting services. (I live and Dream!!)

Our PCT on the other hand is very supportive of Public health work and desperate to get away from the medical model of health visiting. We are about to cease child health surveillence in the traditional sense and replace it with group health promrotion sessions. I have to agree with the comment though that it is often health visitors that are resistant to change and we have experienced that within our trust also. Well I better get back to my assignment, posting this was a nice excuse to have a break!! Lifelong learning eh?? love it or loathe it it has to be done!

Rees

Dear

I've been working exclusively for Sure Start for 18 months and can

only say

that I feel very liberated! To be honest it's the first time

since 1985

that I have felt that I'm doing the job I trained to do. What is

it that

makes the difference?

1. money (essential for innovation and community work)

2. a "can-do" approach with lots of support and encouragement - I

have

encountered no obstacles in developing new services, only goodwill

and

support.

3. not having to follow the medical agenda - although in theory

we're all

meant to be working as public health practitioners, in practice

most HVs are

still tied to the medical role.

4. real partnership working (as opposed to intra NHS partnership

working)which I have found incredibly fruitful

How can this be achieved within the PCTs? Not without a great

deal of

change. I recently posted something about the management of HVs

and am

still working hard to keep discussion alive about our PCT moving

HVs into

the public health directorate and out of nursing (YES!!!) Within

the local

PCT I don't feel the directors would necessarily be against this

degree of

change, but there would be huge opposition from other quarters,

not least

some of the HVs. But change is also needed in training and professional development

eg the

annual mandatory training day for HVs in our PCT consists of CPR

refresher,

a fire prevention lecture, sessions on lifting and handling and

infection

control. Nothing on public health, community development or even

child

protection....is it any wonder that HVs practice the way they do?

There's

just no inspiration to go out and do anything different is there?

By

contrast, our local Sure Start offers me regular training eg

domestic

violence, benefits update, child protection, parenting etc etc...

I could go on and on about what I think needs to happen but I'll

stop before

I break into a rant!

[Guest guest]

I wonder if these links would help in that respect .

http://www.ness.bbk.ac.uk/documents/activities/impact/1183.pdfhttp://www.ness.bbk.ac.uk/documents/activities/impact/1184.pdf

Or: Variation in Sure Start Local Programmes Effectiveness: Early PreliminaryFindingshttp://www.surestart.gov.uk/research/evaluations/ness/latestreports/

Best wishes,

Sure Start

This link leads to a Guardian story about the new Sure Start evaluation. It makes depressing reading. I have not yet followed the link through to the NESS or DfES sites. http://education.guardian.co.uk/earlyyears/story/0,,1654720,00.htmlbest wishes--

This email has been verified as Virus free

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[Guest guest]

Hi every one

the sure start evaluation was leaked some months ago and several column

lengths were dedicated to this in the guardian - The editorial & polly

toynbee had some sensible things to say about it !!!

for £20 million or there abouts it actually says very little - I was at a

yorks & humber NESS meeting with programme evaluation officers last week and

they were appalled by the report ifit was intended to be informative im not

sure about what and to whom - !!!

any way what does concern me is the ECM concept of the lead professional &

Key worker there are some national workshops running at very short notice -

from the dicussions in the District I work in there is a great many

differing views on who this should be - I am concerned that there needs to

be some strong accountblity for anyone who is employed to undertake this

role- which means that more of the C & F workforce need to be registered as

practitioners

D

Sure Start

This link leads to a Guardian story about the new Sure Start

evaluation. It makes depressing reading. I have not yet followed the

link through to the NESS or DfES sites.

http://education.guardian.co.uk/earlyyears/story/0,,1654720,00.html

best wishes

[Guest guest]

Sorry forgot to attach

'Early Impacts of SSLPs'

http://www.surestart.gov.uk/publications/index.cfm?document=1503

and

'Variation in SSLPs Effectiveness'

http://www.surestart.gov.uk/publications/index.cfm?document=1505

The main findings of these reports are likely to prove thought-provoking in

themselves but, of particular interest to my role and the future of

monitoring and evaluation in Children's Centres is the Practice Guidance

that the Sure Start Unit has published at the same time

http://www.surestart.gov.uk/publications/?Document=1500. It has clearly

been developed in the light of these findings and contains some direct

messages about monitoring and evaluation, which echo all the things I and

monitoring and evaluation officers around the region have been recognising

for some time now.

Sure Start

This link leads to a Guardian story about the new Sure Start

evaluation. It makes depressing reading. I have not yet followed the

link through to the NESS or DfES sites.

http://education.guardian.co.uk/earlyyears/story/0,,1654720,00.html

best wishes

[Guest guest]

, it is hardly surprising, after such a short period (3 years)

that results are limited in the case of the most entrenched and

difficult problem areas; this is consistent with international findings,

which typically takes take many more years to show anything really

worthwhile. We know, too, from the early implementation results, that it

takes 3 years for the SSLPs toget set up and running: that is not new,

and if only the government would allow things to settle and evelop we

might get some better long term results. I think we should be very

pleased about the good results for those whose difficulties are still

awful, if not absolutely profound. The improvement in things like

parental warmth may sound small, but we know, in the ling term, just how

huge a differene that kind of shift can make in terms of children's

future potential.

I think we all share your concerns, , about inadequately prepared

practitioners, not only where they act as lead professionals. There is a

comment in the new Sure Start Children's Centre 'good practice guidance'

about the importance of supervision from an appropriately skilled and

qualified practitioner. It is available from

http://www.surestart.gov.uk/improvingquality/guidance/practiceguidance/

There is quite a bit of good stuff in there, which might serve as

ammunition where people need to support service development, but some

naivity as well about the level of services in PCTs. The emphasis on

outreach to excluded/vulnerable families is predictable, given the poor

results for this group in Sure Start areas, but I hope it does not lead

to an even fiercer squeeze on universal services.

I was making notes for a workshop, and have pasted below the key points

that I picked out from the document. It gives a clear direction for

future work, I think, and the promised evaluation framework should serve

as a wake-up call for anyone who isn't already maintaining sufficiently

good records to show what they are achieving in their work. Let's hope

the message that children's centres need to involve the health sector in

this is strong enough to convince those PCTs that think they can opt out!

best wishes

Children's Centres Guidance

p 3: Emphasis on reaching the most disadvantaged families and children -

" a greater emphasis on outreach and home visiting as a basis for

enabling greater access to services for families who are unlikely to

visit a centre "

p4: " We expect all Local Authorities working with PCTs through

children’s trust arrangements to develop effective multi-agency

arrangements for children’s centres . . .

We know from UK and international evidence that well qualified and

trained staff make the biggest difference to the effectiveness of

services for both parents and children. "

p7 " We will be developing a performance management framework to ensure

that the good practice in this guidance is implemented. "

p8: " The framework will seek to use indicators for which data is already

collected. Further details

will be given in national guidance to be issued in Spring 2006. "

p.52 " The level of A and E attendance by children under five is likely

to be an indicator in the

new performance management framework. "

p8: " The services that all families should expect to receive,

irrespective of where they live - Local Authority or NHS services should

offer all families with children under 5:

* free early years provision (integrated early education and care) for

12.5 hours a week, 33 weeks a year for 3 and 4 year olds. This free

early years provision will increase to 38 weeks a year from 2006 and to

15 hours a week by 2010;

* information and access to childcare in the local area;

* information on parenting, drop in groups and opportunities to access

parenting support and education;

* antenatal and post-natal services and child health services and

information on health;

* information about employment, education and training; and

* information at points of transition, including information sessions

around the time of the birth of their child (by linking to and building

on existing antenatal and post-natal services) and on entry to primary

school which, as part of the extended schools programme, will be

offering sessions for parents as their child starts school.

There should be additional support available for families that are

experiencing particular challenges that mean that their children may be

at risk of poor outcomes. "

p12: The role of Sure Start Children’s Centres in delivering services to

families

" In the 30% most disadvantaged areas of the country children’s centres

will be providing a full range of integrated services

.. . . . around 35% of children living in poverty are actually outside

the most disadvantaged areas.

In areas where there are few deprived families, limited support needs

and good quality preexisting early years services, children’s centres

should not duplicate existing provision or provide unnecessary levels of

service. Instead, they should offer a more basic service and signpost

parents to existing services in the area. This is likely to be the case

in the 40% least deprived areas. "

Important partnerships

p15: " Primary Care Trusts should see children’s centres as a vehicle for

delivery of health services to young children and their families. In

some cases health centres will be a good location to develop children’s

centres.

It will not be appropriate or possible to locate all children’s centres

on school sites, but all children’s centres need to work effectively

with their neighbouring schools. "

Outreach services and home visiting

p30 " We need to ensure that outreach or home visiting services are

effective in reaching ('excluded' or vulnerable) families. Children’s

centres will need to work effectively with other services, particularly

health services, to obtain information and to support vulnerable

families. Supporting parents is a key part of the day-today business of

midwives and health visitors.

Offering practical advice early can reduce the need for more extensive

interventions. Outreach means taking services nearer to people’s homes:

delivering them in small venues that people already know and find

welcoming has a good record for increasing the use of services. Small

community buildings, like church halls, can often be familiar and

popular with families. Home visiting is an extension of outreach –

taking services into people’s homes. "

p32 " Visiting families at home requires skill and sensitivity on the

part of the home visitor. They are on the parents’ home territory and

must be sensitive to the context in which they are working. They will

need to be able to offer practical help and support, to encourage

parents’ own strengths and abilities and build their confidence, as well

as providing encouragement to parents in how best to support their

children’s learning and development. This should be based on

evidence-based practice. Appropriate training is therefore essential. "

Structured parenting programmes

p4: " We expect the good practice set out in this guidance to lead to a

greater focus on evidence based practice. For example, (we). . . expect

to see all parenting programmes offered by children’s centres using a

structured course with a proven track record in improving parenting

skills and promoting positive parenting. "

p 30: Children’s centres should provide access to structured parenting

programmes for parents of children aged under 5 who need support. "

Promoting public health

p. 49: " recognise(s) that factors such as poverty, social exclusion,

employment, housing, education and the environment have measurable

adverse impact on the health of the population.

Children’s centres should work in partnership with health agencies to

improve physical and mental health outcomes for young children and their

families as well as to reduce health inequalities. In particular they

should work with services which use evidence-based interventions to:

* support parents so that they are confident in helping their children

develop physically and mentally;

* reduce obesity in children by encouraging active play and healthy eating;

* reduce smoking in pregnancy and smoking around young children;

* improve mental health and the well-being of young children; and

* reduce accidents and injuries among young children.

Children’s centres should contribute to the local Child Health Promotion

Programme "

(SureStart) wrote:

>Hi every one

>

>the sure start evaluation was leaked some months ago and several column

>lengths were dedicated to this in the guardian - The editorial & polly

>toynbee had some sensible things to say about it !!!

>for £20 million or there abouts it actually says very little - I was at a

>yorks & humber NESS meeting with programme evaluation officers last week and

>they were appalled by the report ifit was intended to be informative im not

>sure about what and to whom - !!!

>

>any way what does concern me is the ECM concept of the lead professional &

>Key worker there are some national workshops running at very short notice -

>from the dicussions in the District I work in there is a great many

>differing views on who this should be - I am concerned that there needs to

>be some strong accountblity for anyone who is employed to undertake this

>role- which means that more of the C & F workforce need to be registered as

>practitioners

>

>D

>

>

>

>

>

>

>

>

[Guest guest]

Hi Liz

Would just add to 's comments (thanks ), which show how

confusing and difficult it has been, and still is, in many places to

follow the twists and turns of this policy. Part of that confusion lay

in the fact that, at around the time the sixth wave of Sure Starts was

announced (3 years ago?), the Sure Start Unit expanded, absorbing what

had been the 'children's and young person's unit,' and a few other bits

of both DfES and DH: it was around the time that Margaret Hodge was

first appointed Children's Minister and the Children's NSF and all

associated staff moved from DH to DfES. The Sure Start Unit then split

its expanded self into two: one part of which continued to support what

were firmly relabelled 'Local Sure Start Programmes' (LSSPs), which were

the original concept of local projects as described by , although

it was also announced that that would be the last wave. The rest of the

new expanded Sure Start Unit became responsible for all children 0-16

(and to 21 for LAC and those with complex needs) and families, and drove

the 'mainstreaming agenda' very hard, hence 's experience. This

led to the call for the new Children's Centres (called 'Sure Start

Children's Centres' in some of the policy documents) to be set up, so

that all families and children could benefit from the kind of services

developed in the LSSPs. The idea of Children's Trusts followed very

swiftly after, although it took a while for it to be even remotely clear

what was meant by them.

That requirement to collaborate has been written into legislation, the

Children Act 2004, so the mainstreaming of LSSPs has got mixed up with

the whole Every Child Matters/Change for Children agenda. I get the

impression, too, that it was very much Margaret Hodge's 'baby' and that

Beverley , now Children's minister, is not as hugely enthusiastic

about either Sure Start, or health issues, as her predecessor. The lack

of instant cures shown in the evaluation might have something to do with

this. Essentially a great deal of the activity directed at childhood

poverty and health inequalities still comes out under the 'Sure Start'

banner, like the additional maternity payment (not clear of the details

here) available for everyone on benefits, even if not living in a LSSP

area.

If you were confused before Liz, at least now you will understand why

(it's not you, it's all those others!), but I am not sure if our

responses will have clarified anything! Anyone else have additional or

alternative explanations?

MEERABEAU ELIZABETH wrote:

>Dear Colleagues

>

>Please help if you can - what is the current status of Sure Start.

>Is it correct that its remit has widened, and if so, when did that

>happen.

>

>many thanks, Liz Meerabeau

>Professor Liz Meerabeau

>Head of the School of Health and Social Care

>University of Greenwich

>Avery Hill Campus

>Southwood Site

>Avery Hill Road

>London SE9 2UG

>020 8331 9150

>020 8331 8060 (fax)

>E.Meerabeau@...

>

>

>

>

>

[Guest guest]

Thanks and - I knew Senate would be able to help!

(I'm terminally confused, so used to it).

Professor Liz Meerabeau

Head of the School of Health and Social Care

University of Greenwich

Avery Hill Campus

Southwood Site

Avery Hill Road

London SE9 2UG

020 8331 9150

020 8331 8060 (fax)

E.Meerabeau@...