Nottingham experiences some of the worst levels of deprivation in the country. 2009 statistics speak for themselves, with 62 per cent of under-18s in the city living in a family where no adult works or where total household income is less than £16,500. The Nottingham North constituency also has the highest teen pregnancy rate in Western Europe.
The community costs of anti-social behaviour and chronic underachievement seemed to be rising, but over the past five years the city's Local Strategic Partnership (LSP) - which combines health services, police, schools, business, children's services and the voluntary sector - has been inspired on a new mission of 'pre-emption, prevention and early intervention'.
HISTORY
In November 2005, Graham Allen, Labour MP for Nottingham North, was asked to become chair of Nottingham's Local Strategic Partnership. Mr Allen led a drive for local partners to make a new start, pooling their expertise and budgets into targeted projects.
They renamed the LSP 'One Nottingham' and in April 2008 they launched Nottingham as the UK's first Early Intervention City.
'I became an advocate of early intervention from 23 years as a constituency MP, seeing that sticking plasters on doesn't work,' Mr Allen told Nursery World. 'You need a long-term strategy to tackle the inter-generational nature of these problems. An LSP pulls everyone together; first you get everyone sat around a table, then set your goals and then get on and do it.'
His cross-party campaigning for early intervention with Conservative MP Iain Duncan Smith, now Secretary of State for Work and Pensions, demonstrates a wider trend. The last few years have been a turning point for the strategy's status, as evidence points to real long-term achievement and fiscal savings when compared with familiar late intervention policies.
One Nottingham became a citywide early intervention co-operation to create initiatives across every level of the inter-generational cycle of deprivation, from preconception to age 18.
Mr Allen says, 'Before I was chair, the LSP was simply about grant-giving. It met occasionally and had no central strategy. We established regular meetings and chased things through. You have to get a buy in from all the top people and then communicate the partnership aspect to everyone. We had a list of over a thousand e-mails to keep everyone in the loop. Keeping that sense of mission alive in everyone is an important everyday battle, and it involved a lot of energy and effort.'
ACHIEVEMENTS
Paul Ennals is chief executive of the National Children's Bureau, which plays a lead role in researching and promoting early intervention. He says, 'Nottingham have a real ambition and have rigorously looked at what's worked elsewhere, introducing programmes which have been evaluated and shown to be effective. The biggest challenge any area faces is how they can justify spending on something that will not show any benefit for years. Nottingham is trying to fund today what will bring real benefits in 2020.
'One innovative and imaginative aspect is that the police are engaged at all levels. The police are often the most embedded in challenged communities and so understand what can make a real difference to them. You can achieve more when they are properly involved in thinking what we all can do now to avoid the babies of today becoming the criminals of tomorrow.'
INNOVATIVE SERVICES
What these projects have in common is a commitment to breaking cycles of inter-generational disadvantage. Aims of projects have included: instilling attendance at the earliest stage; supporting the children of offenders; providing housing for teenage mothers; pre-conception counselling in children's centres; mentoring schemes for pre-teens; and supporting children exposed to domestic violence. Another goal is to provide drugs and alcohol education for every 11-year-old to prevent dependence and abuse patterns emerging. Together with mainstream services like children's centres, which serve over 15,000 families in Nottingham, these programmes offer life-changing opportunities.
David Mellen, lead councillor for children's services, says, 'Our 18 Children's Centres are doing wonderful work, so hopefully the Conservatives will keep funding Sure Start. The innovations we see are more targeted, like the Sanctuary Project, which makes homes secure for children who have experienced domestic violence. Often children have to leave their home and their school to escape domestic violence and this enables them to stay in their social network, which of course is much better for the children.
'Up to 100 houses have now been made safe. But the project is funded through our early intervention budget, which is now very much under threat. It has been ringcut.'
CHALLENGES
'It is going to be very difficult,' says councillor Mellen. 'Our three-year grant to fund all early intervention projects is finishing in one year's time and the council has just announced a 24 per cent cut in the education and children's services budget, following central Government cuts. We will have to be very careful what we choose to fund.
'We have a very strong data-tracking strand making reports all the way along every project so we can offer as much data as possible. But many of these projects, like working with families of persistent and prolific offenders, will not see their major impact until the next generation grows up.'
THE FUTURE
Every aspect of the programme is intended to be about the future, not least a relatively new concept of making sure a teenager is 'child ready' as we now think of making sure a child is 'school ready'. It is about preparing children from 0-18 for the best life they can achieve.
Mr Ennals says, 'The new Government has been very strong in their support of early intervention. One positive point is that Iain Duncan Smith is now secretary for Work and Pensions and a vocal supporter of the Nottingham programme.
'But now we have to persuade impatient local authorities and councillors that these programmes are worth fighting for and investing in - because it is at a local level where the cuts are going to come, and they are going to have to make some very difficult decisions.'
CASE STUDY: FAMILY NURSE PARTNERSHIP
The Family Nurse Partnership programme was developed from a successful US model from Denver, Colorado. It aims to produce long-term improvements in the health and well-being of teenage, first-time parents and their children from pregnancy until the child is two years old. Programme supervisor Susan Link recalls one memorable case.
A 16-year-old girl living in a children's home was referred by the Community Midwifery Service to the programme when she was 12 weeks pregnant. Her partner was in police custody awaiting sentencing for a stabbing. She had been in care for two years as her mother had severe mental health problems and was unable to cope.
It was apparent that the girl had many issues, including drugs, anger and violence, but that she also possessed an overwhelming love for her unborn baby and wanted to learn as much as she could about parenting.
The Family Nurse worked with the girl on a twice weekly basis during her pregnancy. She always attended visits and engaged well. Sometimes she became angry about her mother, social workers and the system, but was encouraged to explore her feelings about these and about what she wanted for herself and her baby. This was to have her own house, return to education to get a good job and provide for her baby.
During the sessions her own experiences of being parented and her relationships were explored, as well as her anger issues and health habits. She moved into a mother and baby hostel and then her own council residence.
Now she is calmer and able to negotiate her needs without anger. Her diet has improved and she has drastically reduced her smoking and has given up drugs. She is now able to go to her mother for advice about parenting and is beginning to understand that her relationship with her partner is abusive. She has applied to start college using children's centre childcare. Moreover, she is an excellent mother, who not only meets all her baby's physical needs but emotional needs too. Her baby is a healthy, sociable and happy child.
This programme costs approximately £3,000 a year to deliver over two and a half years. The cost of putting the girl's new baby in care would have been £2,500 per week. Added costs would have been for the young person still in the care system, youth offending and drug rehabilitation, not to mention the costs to the benefits system.
The cost savings are significant, but the social benefits of this girl parenting her child and having aspirations for their future together must also be taken into account.
Further information
'Nottingham, Early Intervention City', www.nottinghamcity.gov.uk/index.aspx?articleid=303
