Healthy City Workshop: Event Report and Feedback
Swansea Early Years Strategy:
‘Giving Every Child the Best Start in Life’
Index
Background/ Rationale Page 3
Planning Page 4
The Event Page 6
Feedback from Table Sessions Page 7
The Way Forward Page 14
Appendix 1: Event Programme Page 16
Healthy City Workshop
Giving Every Child the Best Start in Life: Narrowing the Gap
Swansea Early Years Strategy
‘Disadvantage starts before birth and accumulates throughout life. Action to reduce health inequalities must start before birth and be followed throughout the life of the child. Only then can the close links between early disadvantage and poor outcomes throughout life be broken...For this reason, giving every child the best start in life is our highest priority recommendation’(Fair Society, Healthy Lives’ -Marmot Review 2010 Page 20).
Background/Rationale
One of the main priorities for the Healthy City Board is to give every child the best start in life. Health and educational attainment are both strongly linked to deprivation and the impact of deprivation can be seen across the social gradient in Swansea.
The peak time for early years brain development is between 0 and 3 years old. Data has been collected that indicates that 75% of children have not achieved the expected developmental milestone for their age at 3 years. The majority of these children were not accessing ‘Flying Start‘. (out of the 883 children not reaching the expected milestone 453 of them were not living in a ‘Flying Start’ area). The information collected shows that there is an average development gap of 10 months between children of a similar age depending on where they live.
The negative impact of deprivation starts at a very young age and builds throughout the life course. Action proportional to need to support families and children during the early years can help to mitigate this effect, helping them to break these links.
The concept of ‘readiness for school’ is strongly supported by the Welsh Government, Swansea’s Healthy City Board and the Swansea Local Service Board. It aims to ensure that all children start school from the same vantage point and encompasses a variety of different elements, including physical, mental and emotional development and communications and social skills and is a general indicator for how well a child will be able to cope with starting nursery or school.
The Marmot Review states that ‘giving every child the best start in life is crucial to reducing health inequalities across the life course. The foundations for virtually every aspect of human development physical, intellectual and emotional are laid in early childhood. What happens during these early years (starting in the womb) has lifelong effects on many aspects of health and wellbeing from obesity, heart disease and mental health to educational achievement and economic status’ (Fair Society Healthy Lives. 2010 Page 22).
Planning
The Readiness for School Strategy Group met in July 2014. The project lead determined by the Healthy City Board was the Early Intervention Manager.
The group was jointly chaired by Nina Williams and Sarah Crawley. Actions were agreed with 2 work streams one to lead workshop preparation and the second for strategy development. Readiness for School Strategy group members were consulted and contributed to the strategy. Progress was fed back into the Healthy City Board and the draft strategy was approved at the Board meeting held in September 2014.
The healthy city workshop to share the strategy and the Swansea Statement with partners was arranged for November 2014.
The draft statement was discussed in four focus groups of parents in Swansea Flying Start areas prior to the workshop in September 2014. They were consulted on the practicality in terms of their own life and community experience of parenting, purposefulness, and user friendliness of the statements. The focus groups were chosen to reflect the demographics of the parents the Prevention and Early Intervention Team work with on a weekly basis.They were chosen at random, but also they fitted in to the consultants time scale.
These were:
Teenstart Clase (TC) 6 parents mixed gender
Townhill Make and Mend (TMM) 8 parents female
Dad’s Community Group Mayhill (DCM) 10 parents male
Dad’s Community Group Blaenymaes (DCB) 10 parents male
Responses to the statements
- Looking after yourself, keeping safe and socialising with other parents and children can help keep you both fit and happy.
(TC) Agreed that looking after yourself was important.
(TMM) “Keeping Safe” to them was a judgement, as if someone from authority felt they were unable to keep themselves safe. “It’s like Social Services language!”
Many parents in the group felt this was not wording that should be used but couldn’t come up with a better way of saying it. “Does it need to be in there at all?” “We are all adults!”
Words such as “happy” “socialising” and “fit” meant different things to the group. A question of “what does socialising have to do with keeping fit?”
(TCB) The vast majority of parents stated that they don’t just socialise with other parents, and sometimes find that too difficult. They find their socialising too competitive and emotional when with other parents. They find it easier to relax and have time when they talk to their friends other than parents.
(TCM) Were happy with the statement
- Regularly talking, daily reading, playing and singing with your child, baby, or even your bump, can help their development and strengthen your bond.
(TC) “This makes me feel bad because I can’t read. It’s put me off now.”
“This sounds like the law!”
“Daily Reading isn’t always possible. When people put things like this it makes you feel like a failure. They are unrealistic expectations.
Communicating or Interacting would be a better way of saying it.”
(TMM) Grammar. Paragraph is too long. The group helped come up with:
“Reading, talking, playing or singing every day (with your child, baby or bump) helps strengthen the bond between you and helps them develop well”
(TCB) Happy with the statement
(TCM) Happy with the statement
- Eating together at meal times, having regular bed times, and being consistent with your routines and boundaries, can help get your child ready for nursery and make things a little easier for you.
(TCM) “Great in practice, but in reality, trying to eat together with three children under five is a nightmare! The theory makes sense but reality is very different, and can be very stressful.” The group looked at wording it differently:
“Aim to eat together”, “sit as a family together”
(TCB) “It sounds 50/50 authoritarian” Eating together is impossible in reality. Can’t have a blanket statement for everyone to do the same. Something like “try and eat together” would help.
(TMM) Grammar – take out the “and” in “being consistent with your routines…”
(TC) “Routine is important but it’s like you’re telling me what to do”
There were many who agreed with some of the statements, but the wording in general could be more “user friendly”
Many of the groups’ response to the statements showed that there was an undercurrent of them feeling that the statements were authoritarian rather than helpful and in some cases even made them feel inadequate. This is important for professionals as the language of engagement is important for change. One of the parents stated that this was a small sample, and of course other people in other areas may find it totally acceptable to read to their children, but they possibly would anyway. One member of a group instantly felt on edge as they couldn’t read.
The Event
The Marmot Event was held at theCanolfan Gorseinion Centre on November 17th 2014.
Over 90 delegates attended from the voluntary and statutory sectors including education, health and social services.
The workshop objective was ‘to present the draft Swansea Statement and Early Years Strategy and to gain partners commitment to its dissemination, implementation and delivery’. (Event Programme: See Appendix 1)
The workshop advisers were Professor Peter Goldblatt and Dr Angela Donkin, Deputy Directors of the University College London Institute of Health Equity.
The event was facilitated by Dr Mike Catling, Principal Public Health Practitioner, ABMU Public Health Team.
Other speakers included Mike Jones, Information Officer City and County of Swansea, Dr Nina Williams, Chris Sivers, Director of People City and County of Swansea and presentations from Primary Head Teachers Alison Williams, Craigfelin Primary and Amanda Taylor, Trallwn Primary.
Feedback from ‘Table Sessions’
The feedback from the group exercise that took place at the Healthy City Workshop is outlined below:
Tables were asked to consider
- The Statement
- The Early Years Strategy-recommendations
The following questions were posed:
- Would the Statement make a difference and what else would you need to make it real?
- How would you and your organisation contribute to the 4 main recommendations in the strategy?
- What is the one thing you could concentrate on that would make a difference?
Question 1
Would the statement make a difference and what else would you need to make it real?
The statement was felt to be aspirational and a positive way forward and would make a difference. Actions resulting from the statement were felt to be the critical issue.
The Statement works for all across Swansea however approaches may be very different.It was felt to be helpful from a Communities First point of view as it was useful to see how the service fits into the strategy and can contribute. Practitioners working with family groups stated that it was easy to see how sessions could be run to address each area.
It is important however to get the message out and the use of words in the statement was felt to be important. Most groups flagged the fact that simplicity and ‘bite sized’ chunks was the way forward with regard to the statement. Incentives and simplicity were felt to be key to parental involvement, with short sharp words being used.
One group focussed on the ‘bite sized’ element suggesting that a shorter statement emphasising ‘on going parental involvement’ was important. It was pointed out that parents may not think the statement applies to them as they already feel that they are doing a ‘good enough job’. The responsibility might be viewed by parents as resting not with themselves but with others. The group also raised the point that ‘eating together at mealtimes’ might not be the most appropriate wording. Alternative suggestions were proposed: ‘making time together/enjoying time together’.
To get the message out simplicity was felt to be key. The use of pictures/ animation showing families and children involved in activitieswas felt to be a positive way forward. Another suggestion was involving parents and children to design their own ’Swansea Statement’. One group also mentioned the need to have this in leaflet format
The possibility of using a logo that parents/children would recognise as linked to the Swansea Statement was also noted.
The importance of pooling budgets was flagged.Another essential success factor was felt to be ‘sincere political buy in and commitment from the top’
To keep the statement and strategy ‘live’ it was felt that developing specific roles within the community would be a positive way forward.
The common sense approach to parenting was felt to be positive. The peri natal stage was felt to be important and emphasis needs to be placed on ‘pre birth’. It was felt to be important to focus on how we engage Dads in being ‘hands on’ fathers and being creative in how we engage Dads in the ante natal stage. The need to upskill parents to understand the benefits of being aware of the basics needed for the child was felt to be important. Staff need to understand and translate the advice constantly supporting parents to understand the messages. There is a need to have the right ‘champions’ to support the statement and the message.
One group felt that removing the exclamation mark from the statement strap line would be necessary. A suggestion was also put forward that changing ‘sleep’ to ‘rest’ might be more suitable. One group suggested that changing the wording to ready ourselves and our children might be a more positive statement.
The ‘Teenstart’ programme was mentioned.It was felt that linking with secondary schools to promote the strategy was important for teenagers. The lack of a structured curriculum for Personal and Social Education in schools was mentioned. It was deemed important to upskill the Youth Service to deliver the statement and strategy in schools as part of the PSE curriculum.
The importance of all agencies including schools being made aware of the statement was noted. It was felt that local area co ordination was important. Some gaps were identified (groups not represented at the training event) IE: GP’s, Nurse practitioners, Contraception Services, Youth Service .
Parental mental health was raised as a concern as waiting for mental health services and support was deemed a barrier to being a ‘good enough’ parent. It was felt to be important for teams to be explicit in what the statement meant and operate a brokerage service and not a signposting’ referring out service to enable better support for parents.
Key Words:
Simplicity
Bite sized chunks
Parental responsibility
Commitment and buy in from the top
Peri Natal Stage
Upskilling
Schools: PSE Curriculum
Parental Mental Health
Question 2
How would you and your organisation contribute to the 4 main recommendations in the strategy?
The importance of networking across agencies and professionals asking questions outside their areas of expertise was raised. Joint training and training across the spectrum in the third sector was flagged.It was commented that some organisations are already delivering this sort of message. Accountability was also felt to be important in rolling the strategy out and necessary for its successful implementation.
The importance of breaking down barriers, sharing data, expanding remits and being open to new ideas was also discussed. With regard to data issues around information sharing were flagged as was the need to avoid duplication.
It was felt to be important that professionals know who is out there/what services are available to share information, knowledge and skills. It was deemed important for services to be more cohesive and link in more. This was a common theme across groups. Consistency was also deemed important with all organisations being aware and on the same page. It was felt to be important to have one framework to work to promoting early years development for all. Parents’ needs were also discussed. Time is usually limited and services may need to be flexible with working hours to promote inclusion and invest in parents.
The importance of sharing information early with parents and providing them with the correct information was and prevention was discussed. The value of schools giving development guides to parents and ideas for activities within this guide was discussed. (Some NPT Schools are already using this tool to indicate where children are meant to be developmentally). It is important to focus on wellbeing as well as literacy and numeracy. Information for parents was a common theme among the groups. Another group suggested a basic outline/profile on the role of the parent should be produced as a basic universally recognised statement that all parents could aspire to.It was also felt to be important to build trust before engagement. One group suggested engaging parents to spread messages about the benefits of involvement.
The importance of protecting early years services was noted. One group flagged the importance of increasing parental involvement but felt that the strategy did not necessarily reflect this. The group felt that there was a disconnect between the recommendations and the statement. The group felt that it would be useful to have something in the strategy about how people get across what is needed. Timeliness and a quick follow up for parents was also highlighted. (One group cited an example of parents waiting 5 months before receiving a letter).
Another group stated that it was important that community champions had the knowledge that they were supported by the strategy. This will build a sense of responsibility and sense of purpose.