York Health and Wellbeing Board

Health and Wellbeing Board	15^th September 2021
Report of the Social Mobility Project Manager, Head of Public Health (Healthy Child Service) and Head of Early Years and Childcare of City of York Council

The future direction of York early years partnership’s collaboration with Nesta.

Summary

1. York’s early years partnership, the Early Years Improvement Board, is entering into a 3 – 5 year innovation collaboration with Nesta, led by City of York Council. The aim of this partnership is to work across the early years system to find ways in which to address the inequalities that exist in our communities and start from the earliest years of children’s lives.

In order to maximise this opportunity this paper is asking the Health and Wellbeing Board - who hold collective responsibility for improving outcomes in the early years - to consider how they can best support the partnership with a particular focus on governance arrangements in relation to the Early Years Improvement Board.

Background

2. Whilst the headline outcomes around ‘school readiness’ (age 5) in York are good and consistently better than national averages the inequalities that exist are stark and the ‘gap’ between children who come from disadvantaged backgrounds and their peers is consistently larger than national averages. In 2017 it was the largest gap for any Local Authority in the country.  This data can be seen in Annexe 1 ‘Good Level of Development – end of Early Years Foundation Stage’.

In November 2020, the Local Government Association (LGA) conducted a ‘peer review’ of York’s early years services.  The report from this review can be found in Background Paper 1 but the headline recommendation is:

Ensure the Health and Wellbeing Board (HWB) priorities are seen to drive the vision for Early Years (EY) in collaboration with partners: the HWB strategy has “First 1001 Days” as a top priority within the Starting and Growing Well theme. Partners need to be fully engaged in designing and delivering the EY strategy and services to achieve this aim. The Early Years Improvement Board (EYIB) should develop more robust terms of reference so that it provides the vehicle for partners to become more involved and held to account for their actions. Outcomes on actions undertaken should be regularly taken to the HWB so that EY is seen to be an intrinsic element of the council’s delivery and ‘the best start in life’ is fully owned as a strategic, corporate objective (LGA, 2020)

In December 2020, York’s Early Years Improvement Board entered into a competitive process alongside 31 other Local Authorities to partner with Nesta (a social innovation organisation – website here) The opportunity was to work with Nesta over a 3 – 5 year period on an innovation partnership, focused on improving outcomes for children from disadvantaged backgrounds in the first five years of their lives. Three Local Authorities (York, Leeds and Stockport) were successful in moving through to the final phase of a trial partnership in which we have been engaged for the last four months. Agreement has now been reached that all three Local Authorities will continue into a full innovation partnership over the next 3 – 5 years.

More information about the innovation partnership can be found here but in summary:

Through this programme, Nesta seeks to build long-term innovation partnerships with local areas. This means bringing together a local area’s deep knowledge and new ideas – about their services, families, children and delivery contexts – with Nesta’s capabilities and experience of service innovation and improvement. The partnerships will form around the shared mission of supporting the most disadvantaged children to reach school with a good level of social, emotional and cognitive development. (Nesta, 2020)

Why Nesta are working in the early years:

Supporting children from disadvantaged backgrounds and giving them the fairest chance in life will be one of Nesta’s three major innovation missions for the next five years. The circumstances of our childhood set us on a path that affects the rest of our lives. Children born into disadvantage are far more likely to experience poorer health, lower earnings, and lower levels of happiness than their peers.

Nesta’s vision is for every child to have the fairest possible start in life so they can thrive and realise their potential. By improving the quality of a person’s childhood we can radically improve their future. We believe that we need innovation to do this. (Nesta, 2020)

Nesta has four specific areas of innovation expertise that they bring to our innovation partnership:

•   Data science: analysing large amounts of data to derive insights you may not be able to spot in other ways.

•   Behavioural science: the study of human behaviour to develop and test theories that explain why individuals behave the way that they do.

•   Human centred design and tech: designing services so that they are easy to access and give service users a positive experience as well as improving their outcomes.

•              Experimental research: a type of research to test approach A in comparison with approach B to discover which gets the best results.

During the last four months of ‘trial partnership’, our work has focused on understanding barriers to families accessing services for two year olds with a specific focus on the two year health review delivered by the Healthy Child Service and a secondary focus on uptake of two year old funded education places. During the course of this work we have:

· Engaged with families – via interviews and a text messaging survey - to better understand barriers and facilitators to accessing services

· Used data in new ways to better understand our communities and the needs they have

· Used both of the above to work with professionals to design a more responsive and targeted service

· Developed systems for ongoing use of real time data (both quantitative and qualitative) to allow service delivery to be more community responsive in the future

· Started the delivery of a small scale pilot to test out the new ways of working. This is showing signs of promise.

Through better access to and use of data (both quantitative and qualitative) we are gaining a better understanding of barriers to accessing services to improve uptake of the two year old offer which is a key element of improving outcomes for two year olds.  Further detail about what we have achieved during the trial partnership can be found in Annexe 2. 

We have demonstrated that the additional skill and expertise brought by the Nesta team can be of significant value to the local area and support us to understand our local communities much better and to target resources more effectively.

Main/Key Issues to be Considered

3. It is well supported by evidence that improving outcomes for our youngest children has whole of life benefits for many outcomes including physical and mental health, wellbeing, employment prospects and more.  The partnership with Nesta represents a significant opportunity to focus time, effort and resource on improving outcomes for the youngest and most disadvantaged in our city and to deliver the recommendations from the Local Government Association peer review (referenced above and Background Paper 1)

In order to maximise this opportunity we ask that the Health and Wellbeing Board consider how they can lend their significant and collective senior sponsorship and steer to the programme of work over the next 3 – 5 years.  Whilst we make some proposals below we also welcome additional thoughts on how the Health and Wellbeing Board might support this work. 

Consultation

4. The decision to apply to work with Nesta has been led by the Early Years Improvement Board who represent the diverse early years sectors across the city.  Support for the opportunity has been significant and this has been reflected in the ways people have convened rapidly to contribute to the work of the last four months.

City of York Council’s executive member for Children, Young People and Education and the executive member for Health and Social Care, the Director of Children’s Services and the Director of Public Health have all offered senior sponsorship to the partnership so far.  

Options      

5. In order for us to maximise the opportunity of partnership with Nesta we ask for:

1. Clarification and strengthening of governance of early years partnership arrangements.  The Local Government Association peer review recommended regular reporting from the Early Years Improvement Board to the Health and Wellbeing Board to ensure accountability around early years improvements.  This could happen at least twice a year to maintain momentum required.

2. Clarity of Early Years outcomes that sit underneath the strategic ambitions of the Health and Wellbeing Board Strategy 2017 - 2022 around ‘starting and growing well’.  The plan explicitly references the importance of improved outcomes in the early years and reducing inequalities with a top priority of the ‘first 1001 days’ (conception to 2).  There is strong evidence of the importance of speech, language and communication outcomes in the early years and their impact on whole of life chances.  We know that there are significant disparities across the city in relation to these outcomes.  Significant work has already taken place in York across the early years sector to work towards closing this gap and this is showing signs of promise.  Of particular note is the ‘Early Talk for York’ programme which is now showing noteworthy improvements in children’s outcomes and in the process of being scaled up further.  Given all of this we would ask that the Health and Wellbeing Board consider speech language and communication outcomes to be a clear strategic priority within the starting and growing well strand.

3. Early Years becoming a shared priority and ‘everyone’s business’ across each of the Health and Wellbeing Board partners; given the strength of evidence that outcomes in the early years have on whole of life outcomes.  For example, the peer review recommended for ‘Early Years to be an intrinsic part of the council’s delivery and ‘the best start in life’ is fully owned as a strategic, corporate objective.’

4. The commissioning of an early years specific Joint Strategic Needs Assessment (JSNA), enhanced with a live data dashboard, to be used by the Early Years Improvement Board to better understand need at community level and from which to inform integrated working amongst services working within the early years.

Analysis

6. Options 1 and 2: As the board that represents the diverse early years sector, the Early Years Improvement Board are well placed to lead the development of more specific improvement priorities to deliver on the ambitions of the Health and Wellbeing Board’s ‘Starting and growing well’ ambitions within the early years and have led the work on around speech, language and communication outcomes so far; including the Early Talk for York programme. They are also well placed to identify where the Nesta partnership work is best directed to deliver on these.  Stronger and more frequent reporting lines between the Early Years Improvement Board and the Health and Wellbeing Board would help support accountability and governance around this work and make sure that this was focused on delivering against strategic objectives set by Health and Wellbeing Board partners.  We would recommend that the Health and Wellbeing Board has early years improvement on its agenda at least twice a year.

Option 3: Probably the most challenging to achieve. With just one in four people across the country recognising the specific importance of the first five years of children’s lives (The Royal Foundation, 2020), despite the strength of evidence about the impact these years have.  This is made more challenging by the fact that responsibility for improving outcomes in the ‘early years’ spans multiple organisations locally and nationally as well as different government departments.  To achieve this would require significant, strong leadership with very clear messaging and would be best achieved locally via the Health and Wellbeing Board partners committing to this within their own organisational structures.  Regular and strong reporting and governance as suggested in Option 1 would support partners at the Health and Wellbeing Board keep early years ‘front and centre’ and also help identify aspects that are particularly pertinent to each partner’s area of work.

Option 4: It has become clear through the work we have done so far that individual organisations and services already collect and hold significant data in relation to early years aged children that, if pulled together, would help us better understand community need and design responsive service delivery alongside communities.  In the last four months with Nesta we have already built the beginnings of an interactive ‘live’ data dashboard that is giving us insight into community need that we have previously not had, allowing us to respond to the needs of our communities. Working with data science specialists at Nesta gives us an opportunity to develop systems and capacity locally to make better use of the data we have in a timely fashion.   Commissioning an early years specific JSNA will allow us to understand our early years place now and enhancing this with a live data dashboard gives us opportunities for the planning of responsive and timely targeted services to improve outcomes.

Strategic/Operational Plans

7. The proposals outlined in this paper are specifically related to and supportive of the delivery of the current strategic plans of the Health and Wellbeing Board, City of York Council, Vale of York Clinical Commissioning Group and York Hospital Trust all of which have ambitions around the best start in life for children, and several of which have ambitions around greater integration between services and co-production of services with communities. 

The work proposed also supports the ambitions of the new Integrated Care System (ICS) arrangements ‘to improve the health and wellbeing of our people and address inequalities in our communities’ with the potential to contribute specifically to the ‘Start well’ aspect of the ICS’s vision.

        Implications

8.

· Financial

The financial implications of this partnership with Nesta are a £66,000/year budget from Nesta to be spent on the development of project work.  No financial commitment from the local area is expected.  Innovation work will be designed to function within the resources available.

· Human Resources (HR)

There is an expectation that the project will be led from a local area perspective by a dedicated project manager for 0.5 of the week.  The plan is for this role to be fulfilled by a role currently seconded to and funded by City of York Council.  All other work would be built into partners’ existing capacity as aims are to develop solutions that are sustainable.  Additional capacity from Nesta’s core Innovation Team including dedicated capacity from Nesta’s Deputy Director, Mission Manager, Senior Analyst/Analyst, Data Scientist, Lead Designer/Designer and Behavioural Insights Specialist will equate to £75,000 of resources each year.  There will be access to a wider team of innovation expertise from across Nesta which is an additional contribution. A Peer Learning Network will be set up to exchange knowledge, enable peer challenge and for scaling opportunities.

· Equalities

The partnership work is underpinned by a strong, clear drive around Equality, Diversity and Inclusion and features as core consideration of the project aims and objectives.

· Legal

Other than a Memorandum of Understanding signed at Director level within City of York Council, there are no legal implications for this partnership work and non for consideration within this paper’s requests.

· Crime and Disorder

There are no crime and disorder implications.

· Information Technology (IT)

Collaboration from respective Business Intelligence departments will be required in order to progress a JSNA and data dashboard.

· Property

There are no property implications.

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

        Risk Management

9. This is an opportunity to partner with an organisation with international reputation and for York to lead the way in improving outcomes in the early years.  There will be interest in the process and development of the work and Nesta are keen that findings are used to share key learning to apply in other local areas.  The recommendations made are designed to mitigate any reputational risk by ensuring the foundations for success are laid at strategic level. 

        Recommendations

10. The authors recommend that the Health and Wellbeing Board agree to adopt all four options presented in this paper.  The recommendations are low risk with potential for significant gain on outcomes for children and their families. To not do so presents risks to the potential impact of the opportunity.

Recommendation 3 requires the greatest amount of time energy and effort from the board to achieve but if early years improvements were a regular item on the Board’s agenda, this could be developed over time.

Contact Details

Author:	Chief Officer Responsible for the report:
Rob Newton Social Mobility Project Manager Directorate of People City of York Council Tel No. 07789653669 Jodie Farquharson Head of Public Health (Healthy Child Service) Public Health City of York Council Tel No. 07415 645287 Barbara Mands Head of Early Years and Childcare Directorate of People City of York Council 07923235520	Maxine Squire Assistant Director, Education and Skills City of York Council Tel No 07990793483
	Report Approved	√	Date	19.8.21
Specialist Implications Officer(s) Richard Hartle Head of Finance: Adults, Children and Education City of York Council 01904 554225 Claire Waind HR Manager Performance and Change City of York Council 01904 554519
Wards Affected:					All	√
For further information please contact the author of the report

Background Papers:

Background Paper 1 – Local Government Association: City of York Council Early Years (Speech, Language and Communication) Remote Peer Review

Annexes

Annexe 1- ‘Good Level of Development – end of Early Years Foundation Stage’

Annexe 2 – York-Nesta discovery project summary report

Glossary