Health Briefing

Health

Health The Early Years (0-7) / Y blynyddoedd cynnar

Income Poverty

Current Challenges What Can Be Done? Where To Go?

Access to community dental services Better promotion of oral health through com-munity based services and education set-tings. This will be supported by Sustainable nursery and school based tooth brushing programmes are a key priority of WAG’s ‘Designed to smile’ A national oral health improvement programme’ are a key priority. Effective programmes will need to involve health and local authority partnerships and be accepted as an integral part of health promoting activity in nursery and school set-tings.

The national plan, ‘Designed to Smile – A Na-tional Child Oral Health Improvement Pro-gramme’

Benefit Take-up Most disadvantaged families are not taking up their full benefit and tax credit entitle-ments. Only 44% of children in severe pov-erty are in families that report claiming the child tax credit. There is a lack of knowledge among many on low incomes of their entitle-ments to support.

Review the quality/ accessibility of informa-tion and benefits ( particularly in work bene-fits) available via early years settings. Consider undertaking co-ordinated benefit take up work within early years settings.

Citizens Advice Promoting Tax Credits and help towards child-care costs provides a simple, easy to use online toolkit to help your local authority raise aware-ness about help for paying for childcare Sure Start

Health Education and Learning Opportunities / Addysg

Income Poverty


Free school meals administration and take up Efficient, user-friendly free school meal ad-ministration encourages take up.

Establish a course of action that ensures that free school meal and other education related grants administration is accurate, efficient and take up of entitlement is in the top quartile of authorities.

Useful strategies for increasing free school meal takeup Food for life article on free school meal take-up

Sustainable Procurement In 2005 it was estimated that 35% of the £4 billion spent each year by the public sector in Wales was won by indigenous business sup-porting some 70,000 jobs. Every 1% increase to this figure should relate to an increase of some 2,000 jobs.

Develop a common partnership approach to sustainable procurement that ensures oppor-tunities to support the local economy and skills development of young people are se-cured.

Buy Wales http://www.forumforthefuture.org.uk/node/1413 http://www.s-p-i-n.co.uk/toolkit.asp#Socio-Economic

De Stigmatising Payment Methods Some free school meals and other payment methods stigmatise pupils making them more vulnerable to bullying.

Develop sensitive payment methods within school settings

Cashless Catering http://www.familyandparenting.org/item/1202 Denbighshire Cashless Catering

Health Health Freedom from Abuse and Exploitation / Iechyd, a rhyddid rhag cam-drin a

Income Poverty


Engaging socially excluded families in health related community based activities. (Understanding the impacts of poverty on families.)

The WLGA’s Excellence Wales programme is focusing on the theme of ‘Social Inclusion’ for 2008-09 looking at how to mitigate the effects of child poverty and maximise the powers of local government to enhance inclusion. A copy of the four sub themes and the requirements of each is available from www.wlga.gov,uk The Social Care Institute for Excellence have recently published ‘Poverty, Parenting and Social Exclusion’ an e- learning resource to help people working in social care to understand the links between poverty, parenting and social exclusion.

In 2004 the NPHS published Deprivation and Health to highlight the relationship between small area deprivation and health in Wales, using a large number of health indicators. The report shows that, in nearly all instances, people living in the most deprived areas have worse health and health indicators than those in the most affluent areas. The NPHS also published a series of 22 summary reports, one for each LHB, showing how the relationship between health and socio-economic deprivation is likely to be operating at the local level. These can be accessed from: Deprivation and Health: LHB Summary Reports (2006)

Access to community healthcare services

Access to services is wider than the financial ability to pay for services. Using the needs assessment that underpins the HSCWB strategy and CYP plan, community based healthcare services provided by partnerships must be adequately targeted and delivered in areas of highest need to enhance participation, with consideration given to travel links and proximity to universal settings such as schools

Health Poverty Index NSF Standards on access to services

Health Participation and Decision Making / Cymryd rhan yn y broses benderfynu

Income Poverty


Lack of Awareness There is limited awareness of the United Nations Convention on the Rights of the Child.

Raise awareness of children and young people’s right to participate under the United Nations Convention on the Rights of the Child and Welsh Assembly Government policy e.g. Extending Entitlements.

Useful supporting websites on the UNCRC – list some here. Save the Children Wales UNCRC Monitoring Group and Funky Dragon information on website on UNCRC for children and young people. http://www.sccyp.org.uk/participation/resources.php

Being Worse Off Children and young people experiencing poverty should not be worse off as a result of their participation.

Fully review the individual costs of participation and ensure that up front costs are minimised.

Camden documents

Health Income Maximisation / Employment / Heb fod dan anfantais o achos tlodi

Income Poverty


Operating without a bank account can lead to significant costs leading to poor families hav-ing to pay a poverty premium.

Consider developing a multi agency approach (credit unions, voluntary sector, housing, health) to addressing financial inclusion for families and consider innovative approaches using the internet as a means of delivering accessibility to competitive rates/products.

http://www.rightsnet.org.uk/toolkit.shtml http://www.nowletstalkmoney.com/gb/en/default.html http://www.basic-skills.co.uk/ouractivities/financialliteracy/ http://www.pfeg.org/ http://www.learnaboutmoney.org/index.php http://www.moneymadeclear.fsa.gov.uk/

Knowledge of the Carers Pre-mium among front line staff and vulnerable families is limited. Benefits maximisation for families with a disabled/sick person is a key issue as they are at a high risk group.

Consider awareness raising among key staff working with families with a disabled person.

CPAG: Out of Reach: benefits for disabled chil-dren Carer’s UK http://www.carersuk.org/Information


Income Poverty


There is currently no obligation on councils to take responsibility for promoting improved take-up of welfare benefits. Despite this, there is a growing expectation from Central Government that benefit checks and help to claim benefits should be integrated within council key services.

Consider the feasibility of providing holistic benefit checks for vulnerable families within key frontline services in partnership with the voluntary sector and encourage the take up of WTC/CTC and DLA (especially for children) and Attendance Allowance.

The unclaimed millions: dla and cancer patients CPAG: Out of Reach: benefits for disabled children Citizens advice: Tax credit take-up re-source pack


Income Poverty


Research indicates that benefit take-up is an issue within Wales Official figures show 44% of couples with chil-dren are paying out much more than they need to in council tax. HMRC state that in 2005-2006, 60,000 families did not claim their entitlement to Child Tax Credit and Working Tax Credit which amounted to £80m of unclaimed Tax credits. (central estimates)

Consider the feasibility of undertaking in work benefit-take up take up activities with working families on low incomes. Such activity should be multiagency involving experts from the voluntary sector.

http://www.lga.gov.uk/lga/publications/publication-display.do?id=22235 http://www.entitledto.co.uk/default.aspx

The nature and degree of partnership working between Job Centre Plus and the local councils varies across Wales. To date only a small percentage of Council’s have signed up to the Job Centre Plus Local Employment Partnerships initiative (which aims to bring together Government and large employers to help 250,000 disadvantaged people into jobs within three years).

Consider the appropriateness of committing the Council to the Job Centre Plus’s Local Employment Initiative (the following public sector bodies have signed up to this Scheme Somerset County Council, Coventry City Council, Glasgow City Council, Middlesbrough City Council, NHS Wales, North Glamorgan NHS Trust, West Lothian Council, Birmingham City Council). Review HR policies to ensure that recruitment practices are inclusive and do not disadvantage vulnerable groups.

Local Employment Partner-ships


Service Poverty


Positive Behaviour Promoting positive behaviour within early years settings can be particularly challenging in deprived areas.

Utilise the Behaviour 4 Learning website which aims to ensure that teacher educators and trainees are provided with high quality relevant resources that enable trainers and trainees engage with the principles of be-haviour for learning to improve the management of classroom behaviour, enable achievement and foster the emotional wellbeing of learners.

http://www.behaviour4learning.ac.uk/index.aspx?menuId=10126

Parenting 'Positive' parenting styles may help protect children against the risks attached to poverty and deprivation.

Consider approaches to promoting positive parenting and priorities areas of high deprivation and social housing and with vulnerable families.

http://www.incredibleyears.com/ http://www.parenting.org.uk/ http://www.youngfoundation.org.uk/work/local_innovation/consortiums/the_local_wellbeing_project

Breastfeeding Despite considerable efforts to encourage breast feeding in the UK, rates have remained static for the past 20 years with a strong disparity between social classes and ethnic groups

Consider reviewing the level of provision and support available to disadvantaged mothers.

http://www.breastfeeding.nhs.uk/en/docs/FINAL_Breastfeeding_Guide.pdf


Service Poverty


Food Poverty The inequalities in what families eat – de-pending on their socioeconomic group, where they live in Wales, and their ethnic back-ground – have not been recognised.

Think about establishing a group to work through the nutrition and food poverty toolkit.

http://www.heartforum.org.uk/downloads/Nut_TkitAll.pdf

Reaching Out Outreach work remains a particular challenge for early years programmes, specifically with regards to improving services for fathers, the parents of children with disabilities, and for ethnic minorities in areas with smaller minority populations

Consider innovative approaches to outreach for early years provision such as investing in Children’s Information Service Outreach.

Toolkit for Reaching Priority and Excluded Families

Gypsy, Roma and Traveller families Gypsy, Roma and Traveller families are particularly marginalised in terms of early years provision.

Utilise the “working towards inclusive practice” toolkit which has been designed to support training into Gypsy, Roma and Traveller culture. The exercises can be used separately as part of an existing programme or used together as a complete package.

https://www.savethechildren.org.uk/en/docs/earlyyears_traintoolkit.pdf

Health Education and Learning Opportunities / Addysg

Service Poverty


Information advice and Guidance Focus advice and guidance services for those at risk of disengagement.

The effectiveness of the Careers Wales Companies in supporting young people in making a successful transition from education to employment

Working with others Consider bringing in role models to show people from their own background that can be successful.

http://www.infed.org/biblio/role_model_education.htm http://www.teachers.tv/video/244

School Rewards Develop in partnership a flexible pastoral and youth support framework

dfes goodpractice WAG: A whole school approach to behav-iour and attendance

Basic Skills Low levels of basic skills in work hamper the ability of employees to progress and perpetu-ates in work poverty.

Prioritise basic skills within your own organi-sations and encourage all partners to sign up to "Basic skills employer pledge". Complete and implement the action plan.

Basic-skills-Wales: employer_pledge


Service Poverty


Access to community healthcare services

Access to services is wider than the financial ability to pay for services. Using the needs assessment that underpins the HSCWB strategy and CYP plan, community based healthcare services provided by partnerships must be adequately targeted and delivered in areas of highest need to enhance participation, with consideration given to travel links and proximity to universal settings such as schools.

Health Poverty Index NSF Standards on access to services

Access to a safe and healthy environment

It is very often the environment in which a child or young person is living that can have the most impact on their health. Children living in poverty are more likely to be exposed to substandard facilities, such as school toilets or a lack of open access play areas. The public health strategic framework will set out a vision of improved public health and wellbeing for all children and young people by 2020. But for the framework to be successful action at a local level must begin now with reviews of community facilities and a better understanding of the links between wellbeing and poverty.

Public Health Strategic Framework Route to Health Improve-ment (WLGA) Review of school toilets (WAG &WLGA)


Service Poverty


Access to substance misuse services Poverty and neighbourhood deprivation increase children’s vulnerability to illicit drug use and looked-after children have been identified as particularly at risk. Working with the community safety partnership a review of the existing approach to reducing substance misuse and supporting families could ensure better aligned targets and outcomes across the authority as a corporate centre.

Access to community run healthy lifestyle groups

Integration of health promotion and education into core community based universal services, such as Parent & toddler classes/Crèche’s/fitness groups and support groups

London Borough of Islington Instant Crèche Company

Access to a healthy and balanced diet There are a number of mechanisms to promote the benefits of a healthy diet alongside information on how local authorities can support the development of community food co-operatives such as an easy start up guide and access to funding.

Health Challenge Wales Food and Fitness Action Plan: Welsh community food co operatives Food Access Network Newcastle Community Food Initiative Access to affordable food in rural areas- Community interventions Accessing affordable food-Policy link Report


Service Poverty


Access to information and support on key areas of public health such as: Nutrition, Maternal & Neo natal health, Breastfeeding, Immunisation, Sexual Health, Physical Activity, Obesity Understanding the impacts of poverty on families

Ensuring that targeted information is accessible to excluded groups such as families living in poverty is essential. In terms of health related behaviours partnerships and local government services such as environmental health and housing have a key role to play in delivering responsive and use-ful information in a suitable format on sub-jects relevant to public health including nutrition, breastfeeding, immunisations, healthy and hygienic environments etc An evaluation of HSCWB & CYP targets would support a strengthened approach to joined up working targeting limited resources around priority areas determined to have a poverty related impact on health and wellbeing, pooling budgets and resources.

WLGA Nutrition & food poverty toolkit D - developing a local nutrition and food pov-erty strategy Health Challenge Wales have produced a leaflet and poster entitled the small steps to a healthier you Kettering healthy lifestyles info sheet Low Income Diet and Nutrition Survey Western Health Action Zone (Northern Ire-land) supports a diversity of projects under the Family and Poverty theme Food poverty and health toolkit Nutrition and Health toolkit Breastfeeding strategy (Wales) Sports Council for Wales


Service Poverty


Access to family planning services Poverty and deprivation, poor educational achievement and low expectations have all been identified as key factors contributing to high rates of teenage pregnancy Poverty is a key risk factor for teenage pregnancy. Girls whose families are in social class V (unskilled manual) are ten times more likely to become teenage mothers than girls from professional backgrounds. They are also far less likely to have an abortion if they do become pregnant. Providing well targeted family planning and sexual education programmes are essential and linking this provision to the education curricula i.e. via P.S.E. would support the mainstreaming of some family planning and sexual health advice.

Brook information sheet Planned Teenage Pregnancy- JRF per-spectives on teenage pregnancy and com-munity based support mechanisms SCIE research briefing


Service Poverty


Workforce Development There is a perception that there are skills gaps in relation to the delivery of participation activities relating to child poverty.

Training adults in the participation of children and young people living in poverty so that they can support, encourage and facilitate this process.

The Participation Unit has a list of participation trainers from across Wales. The Unit is also piloting a Train the Train-ers in children and young people’s participation which will cascade training across Wales.

Limited local knowledge There is limited research on the local barriers to participation caused by child poverty

Undertake participatory approaches to explore the barriers to participation of hard to reach children and young people / children and young people living in poverty in particular.

Download the good practice guide on ‘Ensuring Inclusion’ from www.participationworkerswales.org.uk Contact organisations with expertise in reaching hard to reach groups e.g. Black Voluntary Sector Network


Service Poverty


Lack of Resources There are limited practical resources for facilitating the participation of vulnerable children and young people with sensitive issues such as child poverty.

Use resources available e.g. Dyamix ‘Spice It Up’ pack for games and activities. Draw on good practice from other areas / organisations

Sign up as a member to the participation e-briefings for the Participation Workers’ Network for Wales and get examples of good practice from across Wales. Download good practice guides on children and young people’s participation from www.participationworkerswales.org.uk. Liaise with local participation workers / youth forum workers who have a remit for the participation of children and young people locally. Liaise with local school councils. Liaise with Funky Dragon, the Children and Young People’s Assembly for Wales, which has a national remit for children and young people’s participation.

Processes Improving the process of children and young people’s participation and the quality of their experience overall remains a key issue for practitioners.

Use the National Children and Young People’s Participation Standards as a guide. There are seven standards: information, it’s your choice, no discrimination, respect, you get something out of it, feedback and improving how we work. Keeping to these Standards will mean upholding what children and young people have identified as the core components of participation.

Download the National Participation Standards document and the Self Assessment Pack from the website www.participationworkerswales.org.uk which shows how to measure and evidence against the Standards to improve good practice.

Health A Safe Home and Community / Cartrefi a chymunedau diogel

Service Poverty


Child Pedestrian Injuries Child Pedestrian Injuries are strongly related to with deprivation.

Explore methods of improving road safety in disadvantaged areas. Via the NSF arrangements within key action 2.38.

department for transport t roadsafety research

Home Safety Accidents within the home are a major health problem throughout Wales and are associated with a range of factors including poor housing conditions and poverty.

Develop robust information provision and projects regarding the prevention of accidents with vulnerable families.

http://www.rospa.com/homesafety/wales/whsc/links.htm


Service Poverty


Fuel Poverty Utilise the Fuel Poverty Toolkit NEA Fuel Poverty Toolkit


Participation Poverty


Children’s Information Services Poor communication with parents about the range of services available limits participation.

Develop a range of materials to support the promotion of early years provision to parents who are at risk of experiencing poverty.

http://www.surestart.gov.uk/_doc/P0002522.pdf

Fathers Fathers’ involvement in the earliest months of a child’s life may be critical to later outcomes.

Utilise the information provided and review practice.

http://www.surestart.gov.uk/_doc/P0002547.pdf

Lone Parents Lone Parents participation Needs of disabled participation, ethnic minority.

Ensure that steps are taken to research the local needs of lone parents and other groups at risk of child poverty.

Day Care Trust




Engaging local people in learning about nutrition

Cymru Cooks Cymru Cooks supports the development of cookery clubs, as an out of school hours learning activity. Clubs can now register on the Cymru Cook website either by downloading an online form or a word document.

Cymru Cook website

Ensuring children and young people are able to participate in health related activities i.e. sport and exercise

Many families are often put off or excluded from extra curricular community activities as a result of the cost. Through maximising community facilities and programmes such as the community focused schools scheme, local provision can be enhanced at little cost. Additionally, working in partnership with local business to provide facilities and activity can reduce cost and en-hance participation, creating local jobs along the way.

National Participation standards and Self Assessment pack Regeneration outcome agreement (Scotland)

Health Play Sport, Leisure and Culture / Chwarae, campau, hamdden a'r pethe



Lack of local capacity A number of councils work in partnership with communities first partnerships, the arts council, sports councils and other voluntary sector providers to bid for funding and enhance local community capacity, specifically in the arts and cultural pursuits. Such collaboration ensures community needs are met whilst increasing facilities, access and engagement. The sports council, working with local authorities, has developed a programme called 5 x 60 aimed at increasing access to physical activity and sports. Sixth formers from across Wales have been trained to deliver support to younger children, enhancing both their skills and values and ensuring increased participation. Local grants are available from the Sports Council for Wales to support small enterprise organisations in their provision of local sporting opportunities. Grants are also available to a wide range of organisations to support the development of capacity.

The role of sport in regenerating communities

Health Play Sport, Leisure and Culture / Chwarae, campau, hamdden a'r pethe



The need for local services to encourage greater participation.

There will be enhanced participation if service provision is worthwhile, fun and gives opportunity to gain new skills or an award (e.g. Millennium volunteers Grant scheme) Development of intergenerational projects enhances skills and provides access to services e.g. cinema night or cultural trips. Some local authority areas have sports’ councils who provide a voice for local clubs. The umbrella body for these is the Welsh Association of Local Sport Councils. The Libraries for Life scheme launched by WAG should encourage greater engagement with and use of local library facilities

Communities First Network- Billy Brown Creative Partnerships Arts Council Wales strategies for promoting participation and funding opportunities. WAG Statement 2005 Welsh Association of Local Sport Councils Libraries for Life

Health A Safe Home and Community / Cartrefi a chymunedau diogel



Play Research over recent years has repeatedly highlighted children’s declining presence in the outdoor world that was traditionally their playground. Possible causes are traffic, fear of crime, negative attitudes to children in public and planning policies that take little account of their needs.

One of the main reasons children give for not playing outdoors more is that they and their parents are afraid for their safety. Fear of strangers, traffic and bullying by other children combine to keep children in their own homes. Good play provision protects children through reducing unacceptable levels of danger, while allowing them the opportunity to challenge themselves and use their initiative

Child's Play: Facilitating play on housing estates Open Space and Children's Play Areas Checklist

Participation and Leisure Consider the creation of a virtual team to work with homeless families in hostel and other settings. The idea of a virtual team is to bring together services such as a link social worker, education welfare, children’s worker and other agencies to co-ordinate their work. Each team member would retain their existing line management and job title but would be given time to contribute.




Lack of appropriate profession debt advice can adversely affect participation and access to services.

Develop a co-ordinated approach that links voluntary sector and statutory provision to deliver streamlined debt advice provision.

Citizens Advice Cymru is the lead Organisation of the Financial Inclusion Fund project, which offers face to face debt advice in Wales

Families and young experiencing poverty often face difficulties accessing financial products and internet deals such as basic bank accounts.

Basic Bank accounts Toolkit E.g. Carmarthen LA and Carmarthen CAB have worked to ensure that Local Housing Allowance claimants have access to bank accounts

Basic Bank Account Toolkit for Housing Benefit claims is designed to guide other Local Authorities through the process of setting up the same kind of service we have with one bank and to address any questions

Health Briefing

Documents

Transcript of Health Briefing