Health and Wellbeing Board	8^th May 2024
Report of the Social Mobility Project Manager, City of York Council

Learning from Early Talk for York

Summary

1. The Health and Wellbeing Board have requested a summary from the Early Talk for York team of the key aspects that have made the approach successful. In developing this paper, the author has reached out to partners working across the Early Talk for York approach to provide their responses to the question:  ‘What can other local initiatives learn from the success of Early Talk for York?’  These responses form the main content of this paper and this approach is demonstrative of a central theme to the answer: genuine partnership working.

Background

2. Early Talk for York is an evidence-based approach to improving the speech, language and communication outcomes of children aged 0 – 5.  Good communication skills at 5 years of age are strongly linked with a range of positive outcomes in later life including: reading and writing skills; employment prospects and mental and physical health and wellbeing. Through its own evaluation Early Talk for York has demonstrated that the approach improves these outcomes for all children but has a particularly significant positive impact on outcomes for children experiencing socio-economic disadvantage in York.  York has a long-standing persistent challenge with inequalities that start young and Early Talk for York is a key step in the local area’s approach to changing this.  

Main/Key Issues to be Considered

3. In their report ‘Leading and delivering early childhood services: 10 insights from 20 places across England and Wales’, the Early Intervention Foundation share a model that closely aligns with the evidence-based approach taken through the development of Early Talk for York.  The key point being that ‘evidence’ to develop an effective intervention needs to come from a wide variety of sources as expressed in the diagram below.

Early Intervention Foundation, Feb 2022, Leading and delivering early childhood services 10 insights from 20 places across England and Wales

4. Through consultation with partners the list below (5 – 16) summarises the key learning identified from Early Talk for York that could be applied to other aspects of the local partnership’s work:

5. Being clear from the outset and throughout about the outcomes that we were seeking to improve and why with common consensus across multi agency partners that this was worth collaborating on.  Developing a shared ownership of this as a priority by consistently focusing on the messaging.  This focus was tight enough to realistically achieve impact through to child level outcomes.

6. Taking time to thoroughly investigate the ‘problem’.  The process of exploring the current picture of early language development in York and possible solutions took at least 9 months.

7. Developing a possible ‘solution’ that aligns with existing local strengths and amplifies them – instead of being the next ‘new’ thing, identifying the practice that was already working well and amplifying it

8. Making high quality, evidence-based implementation as much of a priority as the ‘what’ of the approach.  For example, not relying on up front training alone to deliver changes in practice and outcomes.

9. Starting small with an experimental approach that included co construction across partners with opportunities to change and flex along the way as we learnt more

10. Building relationships across the partnership.  The universal and specialist workforces in particular have really valued the connections made and the greater understanding of the interconnectedness of their work and learning as a result.

11. Developing a multi component Theory of Change that tested out where assumptions were being made about the translation of activity through to outcomes. This is not an ‘action plan’ but an opportunity to scrutinise the detailed theory of intended change.

12. Having clear evaluation schedules that allowed us to understand whether the intervention was having the desired impact and generating data that was useful to help continue to shape the work

13. Clear leadership of the work working in a collegiate way – bringing multi agency partners along together and in ways that worked for them - prioritising relationships within this.

14. Once tested, developing a clear framework with a staged approach and common language, resources and approaches that are accessible for partners to understand and follow.

15. Being flexible and responsive to emerging needs.

16. Viewing the deliberate celebration of success as a core implementation strategy

17. Early Talk for York is not without its problems and challenges but the above non exhaustive list puts it in a good place to be able to collectively respond to these as they arise.  In November 2023 Early Talk for York won an award from Children and Young People now which is well deserved recognition for all partners involved in the approach.  There is significant interest in Early Talk for York from across the nation and the local partnership should be proud that it is leading by example in this work.

18. There are lots of examples of teams that have changed their practice to in line with the Early Talk for York principles and this gives it greater chance of continued success.  However, if Early Talk for York is to be sustained then the local partnership need to consider:

a. How it can continue to be a priority at a time of competing pressures

b. Ensuring sufficient capacity for continued high quality leadership

19. Early Talk for York is a specific example of how ‘waiting well’ can work in practice.  For many children who are on a waiting list to see specialist services, there is often lots that can be happening to support their development effectively whilst they wait.  Even when children see a specialist there is still an expectation that much of the support will be offered by others more proximal to the child with oversight of a specialist.  Through Early Talk for York we are aware of a growing number of children who have been removed from the waiting list by the referrer because of the accelerated progress they have made through the additional support from others.  The recent development of the Request for Helpline from York and Scarborough Teaching Hospital Trust is a specific positive example of greater opportunities for collaboration between the universal and specialist workforce that is fundamental to Early Talk for York.

20. As referenced in paragraph 10, through the development of a more mature relationship between the universal and specialist workforce we have seen a culture change about the role of specialist services and the expectations that others have of them.  During the exploratory phase in 2018 it was clear that there was a common view that where children had additional needs that making a referral to specialist services was the main supporting action.  In the 6 years since then there has been a significant shift in this view. However it should be noted that a vital ingredient is that specialists are accessible to the wider workforce to support decision making and provide advice, support and guidance.   

Consultation

21. The above has been produced through consultation with a wide range of partners across the Local Authority, NHS and education providers.

Options      

22. This paper is not designed to present options for the Health and Wellbeing Board but to respond to the request to provide a chance to reflect on some learning from an effective example of partnership working that has resulted in improving outcomes for children.

Analysis

23. York’s Joint Health and Wellbeing Strategy sets out the local area partnerships high level ambitions, including reducing health inequalities in the population, over the next ten years.  The Early Talk for York example demonstrates that achieving these ambitions is possible when there is clarity about specific focus areas underneath the headlines of a strategic plan.  The purpose of sharing this learning is to help the Health and Wellbeing Board consider the ways in which it is aiming to deliver against this strategy in an evidence-based manner.     

Strategic/Operational Plans

24. This paper relates to the York Joint Health and Wellbeing Strategy 2022 – 2032 and City of York Council’s ‘One City For All’ Council Plan 2023 – 2027 by offering an example of how inequalities can be addressed through effective partnership working.

        Implications

25.

· Financial There are no financial implications

· Human Resources (HR) There are no HR implications

· Equalities There are no Equalities implications

· Legal There are no legal implications

· Crime and Disorder There are no crime and disorder implications

· Information Technology (IT) There are no IT implications

· Property There are no property implications

· Other (State here any other known implications not listed above)

        Risk Management

26. This section should be the penultimate one in the report (before Recommendations) and should include an assessment of risks associated with any recommendation to be made below.

        Recommendations

27. The Health and Wellbeing Board are asked to consider the learning from this paper and the way in which it might be applied to other aspects of partnership working.

Contact Details

Author:	Chief Officer Responsible for the report:
Rob Newton Social Mobility Project Manager Education, Skills and SEND City of York Council 07789653669	Maxine Squire Assistant Director: Educations, Skills and SEND City of York Council 07990793483
	Report Approved	√	Date	24.04.2024
Wards Affected:					All	X