Children's centres: Where next?

It is little wonder that it is hard to define the purpose of children’s centres in anything but several sentences. In many ways they are the repository for all our hopes for children – the institutional expression of our commitment to better childhoods. Whether it is improving children’s language skills, their health and resilience, or shaping children’s emotional development and their appetite for learning, we look to children’s centres to realise our hopes to change the course of children’s development for the better.

Such bold ambitions should not be dismissed simply because they are hard to realise; quite the opposite. Children’s centres have a better chance of transforming children’s lives than any other government programme, because they bring services together under one roof so that parents do not have to navigate the labyrinth of provision for themselves. If children’s centres were abolished tomorrow and we asked, ‘What kind of programme could transform children’s lives?’, we would no doubt reinvent them.

But bold ambitions cannot be achieved in one step and to pretend otherwise is to risk undermining all attempts to meet them. The story of children’s centres so far is one of high and ever expanding expectations only partially met. The search for evidence that children’s centres make an unequivocal difference to the lives of children has had its ups and downs. As explained by Edward Melhuish in his essay, the very first national evaluation of Sure Start Local Programmes (SSLPs) cast doubt on this claim, but as SSLPs evolved into Sure Start Children’s Centres, more promising evidence began to emerge. By 2008, the national evaluation of Sure Start found evidence of the positive impact of children’s centres on children’s social development. The gap in achievements and school readiness of children living in deprived and non-deprived areas began, and has continued, to narrow. More recently, children’s centres have been shown to be effective in influencing parenting style leading to an improved home learning environment and less harsh discipline, but there is little evidence as yet to suggest an impact on children’s cognitive, social and physical development at the age of seven (NESS Research Team 2012). In short, after more than a decade children’s centres have shown considerable promise but the jury is still out on whether they will realise their potential to transform children’s life chances.

In the current economic context, which requires hard spending choices to be made, there is a danger that children’s centres could be written off unless they are able to demonstrate their worth. This requires some honesty about what is and is not working, not least to ensure that the effective practice in centres is not overlooked because less effective practice is limiting what can be achieved.

Where should children’s centres go next?

Children’s centres have evolved over the past decade and continue to do so. Although headlines focus on the number of children’s centres that are closing as a result of public spending cuts, the vast majority have remained open (4Children 2012). Far more common is the pressure on children’s centres to reduce their spending, which is limiting the range and depth of service provision within centres. The ‘hollowing out’ of children’s centres will reduce their ability to transform children’s lives, particularly if they continue to be required to make progress on so many fronts at once. Consolidating services, rather than spreading them so thin that they become ineffective, is therefore a priority.

Consolidation, or ‘targeting’ of services is often assumed to mean restricting provision to the families that need it most (normally assumed to be the poorest families). Yet there is plenty of evidence to show that limiting services to a sub-population is counter-productive. As soon as services are rationed in this way they become stigmatised and ostracised by the very population that they are aimed at. What is more, there is plenty of evidence to suggest that children’s life chances are improved when there is a good social mix, so that parents and children are exposed to the behaviours of those who are thriving rather than only coming into contact with families in similar circumstances to themselves.

A better way to consolidate services in children’s centres would be to ensure that there was a particular focus on providing high quality support during pregnancy and early infancy. The foundations for children’s social, emotional and cognitive development are established during this period. A parent’s capacity to provide a sensitive and nurturing environment for a child is critical during these formative years, and early infant experiences shape brain development, which affects a child’s capacity to cope with life’s challenges. At the same time this is also a period of increased vulnerability for children. Babies are seven times more likely to be killed than older children and they are the subject of more than a third of serious case reviews (NSPCC 2011). The importance of this period in a child’s development is reason enough to focus services on this age group, but it is also key to building relationships with families that endure. Pregnancy is a time when engagement with public services is almost universal and prospective mothers and fathers are particularly receptive to advice and support. Children’s centres have already demonstrated that it is possible to work very effectively with new parents. Fathers are more likely to attend antenatal classes in children’s centres than other services (Maisey and others 2013). Midwife and health visitor drop-in sessions, where provided by children’s centres, are already as popular as stay and play sessions (Maisey and others 2013).

In addition, there are tried and tested programmes that have been shown to make a difference to children’s development. Programmes such as the Incredible Years, Triple P, Strengthening Families, Mellow Parenting, Family Nurse Partnerships and the Oxford Parent Infant Project provide a solid evidence base from which to build. Other programmes, such as Parents Under Pressure and Baby Steps, both being piloted in the UK by NSPCC, offer valuable insights too.

Rather than consolidate children’s centres by restricting services to certain populations or reducing the number of centres, a shift towards a focus on pregnancy and early infancy would be a more effective use of resources. Others too have recognised the value of prioritising this period of development (All Party Parliamentary Group on Sure Start Children’s Centres 2013).

At the same time, children’s centres also need to consolidate provision based on what works. An obvious place to start is to question why 12 per cent of children’s centres in the most disadvantaged areas offer no evidence-based programmes at all (Tanner and others 2012). But a strong focus on what works should not only rely on adopting tried and tested programmes. A prerequisite to localism is that local authorities are held accountable for outcomes. And yet many

children’s centres are failing to assess their impact on children’s development. The use of data is poor. Most children’s centres do not have a comprehensive picture of the level and nature of need in their area. And measurement of impact is patchy: 7 per cent of children’s centres are not using outcome data such as the Early Years Foundation Stage, 14 per cent are not using local authority data and 27 per cent are not using health data (Tanner and others 2012). There is a need for a national outcomes framework, that goes beyond the Early Years Foundation Stage framework, to incorporate a wider range of child and adult outcomes against which all children’s centres could measure progress. The framework developed by University College London’s Institute of Health Equity provides a useful model (UCL Institute of Health Equity 2012). Alongside this, children’s centres would benefit from a single source of advice about the latest evidenced-based programmes, so they do not have to navigate multiple sources. The newly established Early Intervention Foundation could play this role.

Finally, the vision for children’s centres will never be fully realised until there is better integration of resources. The level of public spending on families with children under five remains considerable, even in these cash-strapped times. Rather than providing services additional to those of midwives, health visitors, speech and language therapists, social workers, early education, drug and alcohol services, domestic violence services, mental health provision and others, children’s centres could harness the collective efforts of a vast array of services and pool resources and expertise to transform children’s life chances.

A 10-point plan for children’s centres

Children’s centres should:

1  focus their resources on supporting under twos and their families

2  ensure that all parents make contact with the children’s centres during pregnancy and ?early infancy – e.g. by co-locating midwifery services and ensuring that all births are registered with children’s centres, and allocating one lead professional to remain in regular contact with the family from pregnancy to two years to provide consistency of support

3  offer incentives or impose penalties to ensure that health, early years and social care share data

4  ensure that more adult services are accessible through children’s centres to support parents whose parenting is affected by domestic violence, mental ill health or substance misuse

5  trainstaffinmotivationalinterviewingandpromotionalinterviewingtechniques–usedin FNP and other public health programmes – to improve parenting

6  promote more use of peer-to-peer support that can be an effective way to support behaviour change

7  pool commissioning budgets and increase joint commissioning – the children’s centre should be seen as a hub around which services are coordinated

8  increase ‘user’ commissioning. Put parents in the driving seat when commissioning services from pregnancy onwards by sharing information about which interventions have been found to be most effective and giving parents more of a say over which services are provided

9  establish a national hub for evidence of what works, led by the Early Intervention Foundation.

10  In addition, government should adopt a clear outcomes frame for children’s centres.

• Children’s centres should be at the heart of the local community, providing vital services to support young children and their families. Get involved in the debate on how we define the future purpose of children’s centres by downloading ‘Partnerships for a better start: perspectives on the role of children’s centres’, leaving a comment or completing the survey at: www.ncb.org.uk/childrenscentres

References

4Children (2012) Sure Start Children’s Centres Census 2012: Developments, Trends and Analysis of Sure Start Children’s Centres Over the Last Year and the Implications for the Future. London: 4Children. Available at: http://www.4children.org.uk/Files/5f1952b8-dd74-432f-a1f0- a0920139fe09/Children_Centre_Census_FINAL.pdf (accessed 10 October 2013).

All Party Parliamentary Group on Sure Start Children’s Centres (2013) Best Practice for a Sure Start: The Way Forward for Children’s Centres. Available at: http://www.4children.org.uk/Files/ cffc42fe-49eb-43e2-b330-a1fd00b8077b/Best-Practice-for-a-Sure-Start.pdf (accessed 10 October 2013).

Maisey, R and others (2013) Evaluation of Children’s Centres in England (ECCE) Strand 2: Baseline Survey of Families Using Children’s Centres in the Most Disadvantaged Areas. London: Department for Education. Available at: https://www.gov.uk/government/uploads/system/uploads/ attachment_data/file/191007/DFE-RR260.pdf (accessed 10 October 2013).