Using data on children’s well-being to plan and commission services

1. Using data on children’s well-being to plan and commission services John Hill Research and Statistics Manager Children, Young People and Families Directorate Birmingham LA

2. Birmingham Context CONTEXT • 1 million population • 256,000 children & young people • 180,000 school age • 30% BME (50% of children) • 23% Under 16 • 30% lone parent • 30% under 15 – where no adults work • 2,000 plus Children in Care

3. Birmingham’s Brighter Futures Strategy To Improve Outcomes for Children and Young People • Clarity about outcomes • Guided by high quality evidence on children’s well-being (Epidemiology) • Logic model approach (how activities relate to outcomes), Outcomes Activities Investment Outputs • Informed by robust evidence on what works • Rigorous evaluation

4. Epidemiology Purpose: • To find out how well Birmingham children are doing on the ECM outcomes and where we need to focus attention to improve outcomes. • To use the results to plan and prioritise services. • To monitor outcomes over time to see if they are improving as a result of interventions.

5. Methodology • Review of existing data on outcomes from partners. • Questionnaires compiled by Dartington-i covering ECM outcomes - based on KIDSCREEN and Strengths and Difficulties questionnaires. • Three versions: • 0-6 year olds (for parents/carers to complete) • 7-11 year olds (on-line, completed in school) • 12-18 year olds (on-line, completed in school)

6. Questionnaire Sample • 0-6 year olds (representative sample of 500 parent/ carers visited at home ) • Representative sample of c6000 7-18 year olds used in initial analysis. Questionnaire completed by c15,000 per year • Version for children with learning difficulties to be piloted this term. • Annual survey -schools can choose when they administer the questionnaire during the academic year.

7. Children’s Well-Being Survey Example Questions

8. Physical Health (7-18) In general, how would you say your health is? Have you felt fit and well? Have you been physically active (e.g. running, climbing, biking)? Have you been able to run well? Do you eat ‘junk food’ daily (e.g. hamburgers, chips, crisps, fizzy drinks or sweets)?

9. Physical Health (12-18) Do you ever smoke cigarettes/tobacco? How often do you drink alcohol? How often have you used any illegal drugs during the last month?

10. Safety Have you been afraid of other girls and boys? Have other girls and boys made fun of you? Have other girls and boys bullied you? Have you been in an accident in the last 12 months that meant you had to go to Hospital? In the last 12 months, have you been in trouble with the police? I feel safe when I’m at home I feel safe when I’m at school

11. Enjoy and achieve Have you been happy at school? Have you got on well at school? Have you been satisfied with your teachers? Have you been able to pay attention at school? Have you enjoyed going to school? Have you got along well with your teachers?

12. Emotional well-being I worry a lot I am often unhappy, down-hearted or tearful I am easily distracted, I find it difficult to concentrate I take things that are not mine from home, school or elsewhere I am nervous in new situations. I easily lose confidence I am often accused of lying or cheating I am restless, I cannot stay still for long I get very angry and often lose my temper I am usually on my own. I generally play alone or keep to myself

13. Getting on with others Other people my age generally like me I am helpful if someone is hurt, upset or feeling ill I often volunteer to help others (parents, teachers, children) I try to be nice to other people. I care about their feelings

14. Examples of the survey findings • Results are compiled to produce an overall City picture. Comparisons with national averages. Analysis by different groups (e.g.gender, ethnic group, LAC, SEN) • Participating schools receive their own report on their pupils’ well-being that can be used as evidence for the school’s SEF

15. physical health lifestyles 8% of 12-18 year olds smoke cigarettes 10% of 12-18 year olds drink alcohol ‘a few times a week’ (25% for White, 2% Pakistani) 8% of 12-18 year olds have used illegal drugs in the last 12 months 22% of children ‘always’ eat junk food n = 1,477 12-18 yrs Healthy Lifestyles & PLQ

16. behaviour • 26% of children get very angry and often lose their temper • 9% often fight with other children or bully them 325 children are permanently excluded from school each academic year Levels of offending behaviour are falling - the number of first-time offenders is down 3% n = 5,858 all (7-18 yrs) SDQ & Birmingham data

17. 20% 11% significant behavioural difficulties 2.8 0 10 0.7 4.9 2.2 0 10 0.5 3.9 threshold n = 5,858 all (7-18 yrs) Britain (11-15 yrs) behaviour SDQ

18. emotional health anxiety and depression • 17% of children worry a lot • 20%of children are nervous in new situations and easily lose confidence or are unhappy, downhearted or tearful n = 5,858 all (7-18 yrs) SDQ

19. 9% 5% high levels of anxiety or depression 3.2 0 10 5.5 0.8 2.8 0 10 4.9 0.7 threshold n = 5,858 all (7-18 yrs) Britain (11-15 yrs) emotional health anxiety and depression SDQ

20. 12% 5% impairment to mental health 12.3 0 40 6.4 18.2 10.3 0 40 5.1 15.5 threshold n = 5,858 all (7-18 yrs) Britain (11-15 yrs) mental health total difficulties SDQ

21. 8% 2% poor peer relationships 2.5 0 10 0.6 4.4 1.5 0 10 0.1 2.9 threshold n = 5,858 all (7-18 yrs) Britain (11-15 yrs) social literacy peer relations SDQ

22. 10% 2% unkind or uncaring 7.2 10 0 9.3 5.1 8.0 10 0 9.7 6.3 threshold n = 5,858 all (7-18 yrs) Britain (11-15 yrs) social literacy pro-social behaviour SDQ

23. social literacy summary Alongside their poorer emotional and behavioural well-being, the social literacy of children - their ability to get along with and to support each other - is also suffering.

24. ABRIGHTERFUTURE FOR CHILDREN AND YOUNG PEOPLE Example School Physical health

25. ABRIGHTERFUTURE FOR CHILDREN AND YOUNG PEOPLE Example School Mental health

26. ABRIGHTERFUTURE FOR CHILDREN AND YOUNG PEOPLE Example School About school life

27. What outcomes resulted? Behaviour Physical health Literacy numeracy Emotional health Job Skills Social literacy

28. -9 months - 5 6-11 12-18 19-25 Developmental Framework Primary school Secondary school Transition Services Quality pre -school Secondary school Equipped to learn Ready for School Transition Vocational education Health Visitor Connexions Children’s Centre All All GPs Hospitals Leisure Community Health Service Housing Libraries Play space Children in need Children in need CAMHS SEN CAMHS SEN Ready for School Transition Equipped to learn Parenting Programmes Curriculum Programmes Leaving Care - Disability

29. Where are we now? • Preparation for Pilots • Council Pump Priming Funding • Governance Arrangements • Examples • Nurse Family Partnership • Parenting Programmes -Incredible Years,Triple P • SEAL + (PATHS) • LAC • Integrated services for children with disabilities

30. Challenges of Implementation • Selection of Pilots • Fidelity • Stakeholder Engagement • Communications • Workforce – Culture • Evaluation • Service Re-design • Commissioning/Decommissioning