At the 2 March 2023 meeting it was proposed and agreed that as a result of work undertaken in partnership with the Local Government Association the Committee adopt a hybrid model moving forward.
This would be based on the assumption that meetings will last no more than three hours, with two hours focused on the theme and the remaining time on general matters that need to be reviewed by the Committee as existing ongoing business.
Following consultation with the Director of People, Children and Adults’ Services it was agreed that this meeting would be Public Health Themed with reports covering Start of Life, Infant Feeding and Child Obesity.
Members then raised a number of questions and comments, which included:
· PEER Support – a question was raised on provision of local support for breastfeeding as there were variances across Medway on the level of support in place for drop in sessions, with no lead person or support in some areas. The officer said that there were approximately eight peer supporters in post but there was a need for more. Medway Community Healthcare (MCH) provided support to recruit and train peer supporters through the voluntary sector. They were looking at incentives to increase the number of volunteers.
The Director of Public Health added that it was important to remember that in order to tackle inequality, there was a need to focus on parts of Medway where it was identified a greater need for enhanced support may be required.
It was further commented that it was essential to focus on the 35% of those that had been identified as not breast feeding and to understand the barriers faced. There were some physical barriers that contributed to mothers not breastfeeding, the specialist clinics and universal support from midwives for which demand had increased would assist in supporting some of that cohort of mothers.
· In response to suggestions to explore the possibility of peer supporters being based at ante natal clinics as well as hospitals and looking into a reward scheme to improve recruitment, the officer said that some of the Family Hubs and Start for Life budget was being used to recruit a specialist onsite team which could include a new infant feeding specialist post. This model was currently in place in some hospitals and was being explored to understand how this worked and whether it could be applied in Medway.
· Early Years Funding - it was commented that the funding received from Government was welcomed but it was encouraging that the Council was considering the sustainability of investment looking at embedding peer support and upskilling the workforce and that there was funding in place to appropriately support families as the benefits of early stimulation was key to enhanced childhood experience.
· Start for Life - it was asked to what extent the programme was developed using the framework and how it would be ensured that both parents of a child would be able to easily access support services. It was crucial to ensure that gender bias and inequality was not reinforced. Officers said that the programme was clear that this was about the family around the child and not just mothers. The work and focus groups that took place was clear that the programme was based on the family unit supporting the infant. Information and support were designed to be inclusive of all, including fathers, same sex parents, grandparents and extended families.
· Incentives for Families- in response to questions on what provision was in place to encourage and support families, the officer said there were various programmes such as the cookery campaigns which were running across Medway and would provide a demonstration on healthy food, this was part of the Medway Food Partnership. The Local Authority operated the Household Support Fund for families to apply for on a continual basis based on need. The holiday activity programme ran during the school holidays, with over 5 thousand children having attended in the last year, with free activities provided including access to hot food. There was also access to transport links to the centres where these activities took place for those families that were eligible.
· Data - in response to a question on how data was used to develop the incentives in place, officers said that many of the incentives were data driven. National studies on child obesity showed that a healthy child performed better academically. There was a direct correlation between access to parks and open spaces and usage by families, and the Council had a responsibility to ensure provision of safe open spaces for use across Medway.
· Speech and Language – it was asked what impact the Covid Pandemic had and what was being done to address issues faced by parents in access to support. The officer said that health visitors continued to carry out checks and there had been a small reduction in children hitting some developmental milestones at the 2.5 year check. As a result, there was aspiration to develop an early intervention programme in order to improve the offer for families. The Council has been running a campaign called “Grow Through Play” which provided families with simple fun ideas to promote language rich environments and communication to improve developmental milestones for their children.
· It was further asked what was being done to reconcile the offer in schools against what was being offered through the programme as there was limited provision in schools. There was concern that capacity was being taken away from schools through the family hubs. The officer said that one of the challenges was children not being identified early enough and then starting school which then put pressure on school resources. The funding allowed for the utilisation of the funds for voluntary sector to be trained in order to intervene early with the aim of reducing pressure on more specialist services in the long run.
· Measure of success - in response to a question on how success of the programme was being measured and how to minimise duplication in services, officers said that there were several measures of success including reduction of escalation from early help to social services, increase in breastfeeding rates and ensuring more children were school ready at the time they started reception class. There were a range of measures of outcomes in place, but improvement in these outcomes over the next two years would not necessarily be seen as some of them would be long term trends. Part of the process of measuring outcomes was through data, some of which was already recorded at national level which provided the ability to track trends. It was important to note that Start for Life was a Department for Health and a Department for Education funded programme and the Local Authority had to demonstrate the impact of the funding received, this included capturing the profile of the number of families that accessed services.
Prevention of duplication was key which was why the programme was not developed in isolation. There were stakeholders from a wide range of services including the voluntary sector, mental health, maternity commissioning, midwifery, education and early years, who all understood the offer in place and ensured that there was minimal duplication within their respective services.
· Accountability - in response to a question on who in this multiagency approach, was accountable and responsible for the programmes, officers said that the Local Authority was accountable for delivering the programme. The Director of Place, Children and Adults’ Services was the responsible officer and as a result governance for the programmes was through the Council’s Early Help Board.
· Training in schools - in response to a question on what the training offer was for staff in schools to have one on one conversations with families, officers said that there was free training in place to support people in being better Medway champions, accessible training for staff in schools to enable them to have difficult conversations with parents and talk about weight with confidence. Training on style and subtle use of language to break down barriers. The programme on obesity was a community based approach with all people in position of trust such as faith leaders, encouraged to access the training available.
The Director of Public Health said the emphasis was about looking at a whole system approach and not for schools to be made totally responsible for tackling issues as they were just one element of the partnership in tacking issues of obesity.
· Raising awareness - in response to a question on how to better engage students whom since the covid pandemic may have become more reclusive and reluctant to speak up about their needs, officers said that getting the message across was one of the biggest challenges. There was investment in ensuring that Start for Life was clear about the offer and how to access support. There was currently work being done on exploration of building a single access page that refers families to other services. Schools were being encouraged to utilise their existing streams of access to promote the offer for families and Medway Champions were also being asked to spread the message on what is available.