DfE publishes updated “Working Together to Safeguard Children 2023”

On Friday 15 December, the Department for Education (DfE) published its updated version of “Working Together to Safeguard Children 2023”. The Department consulted with key stakeholders on proposed changes through an open consultation process between June and September this year.

To support the consultation, the Institute of Health Visiting engaged in meetings with DfE officials and submitted a written submission to the consultation in September 2023. Our considered position was developed in partnership with frontline practitioners, service leads, safeguarding representatives and our iHV Expert Advisers for Safeguarding, and through an iHV Roundtable event in August 2023 – you can read our written response to the consultation here.

“Working Together to Safeguard Children 2023” focuses on strengthening multi-agency working. It brings together new and existing guidance to emphasise that successful outcomes for children depend on strong multi-agency partnership working across the whole system of help, support and protection including effective work from all agencies with parents, carers, and families. We support this position – safeguarding is everyone’s business. There is a clear imperative to strengthen services to ensure that the most vulnerable babies, children and young people in our society are supported to achieve their full potential and are protected from harm.

This statutory guidance sets out key roles for individuals, organisations and agencies to deliver effective arrangements. It covers the legislative requirements, a framework for the three local safeguarding partners (local authorities, Integrated Care Boards and police), and a framework for child death reviews. This revision has a renewed focus on how organisations and agencies provide:

Early help
Safeguarding and promoting the welfare of children
Child protection.

Of relevance to health visiting, the guidance introduces changes to the lead practitioner role. It clarifies that a broader range of practitioner can be the lead practitioner for children and families receiving support and services under section 17 of the Children Act 1989 (Child in Need), and the requirements on local authorities and their partners to agree and set out local governance arrangements.
The guidance states:

“Once the referral has been accepted by local authority children’s social care, a social work qualified practice supervisor or manager should decide, with partners where appropriate, who the most appropriate lead practitioner will be and, with the lead practitioner’s agreement, allocate them in line with the local protocol.

The lead practitioner role can be held by a range of people, including social workers. When allocating the lead practitioner, local authorities and their partners should consider the needs of the child and their family to ensure the lead practitioner has the time required to undertake the role. The lead practitioner should have the skills, knowledge, competence, and experience to work effectively with the child and their family. The lead practitioner should always be a social worker for child protection enquiries.”

Our response to the Working Together consultation sets out our position on this. To ensure that the key preventative public health role of health visitors is not compromised, we strongly recommend that implementation and prioritisation decisions take account of the full breadth of the Health Visiting Model for England, and support delivery of the Healthy Child Programme in full. Health visitors deliver important ‘health’ functions within a whole system approach that cannot be overlooked. These support clinical pathways across the NHS (urgent, primary and secondary care) and education (child development, school readiness and Special Education Needs and Disabilities (SEND)), alongside child safeguarding. For example, supporting parents to manage minor illnesses (read our latest evidence review on the crisis in urgent care for children 0-4years), providing interventions for families affected by perinatal mental illness and a range of physical needs in the postnatal care pathway, reducing risk factors for preventable disease (addressing smoking, poor nutrition, alcohol risks and physical inactivity) and early identification and support for children with developmental delay and SEND.

We recognise that there may be occasions when having a health visitor as the lead practitioner might be in the best interest of the child and we set these out in our consultation response – in summary:

We do not support the case that health visitors should be the default lead practitioner for all babies and young children categorised as “Child in Need”.
Designation of the lead practitioner needs to be agreed on a case-by-case basis, in the best interests of the child, and only when the health visiting service is sufficiently resourced (not as a sticking plaster for an under-resourced children’s social care department). For example, when a family is being supported through a preventative public health, health visitor-led, intensive home visiting programme like the Family Nurse Partnership Programme or the Maternal Early Childhood Sustained Home-visiting (MECSH) programme, or through a targeted programme of health visiting support for a child with Special Education Needs and Disabilities (SEND).
However, care needs to be taken as there is a significant risk that, without sufficient resource, focusing health visitors’ efforts on statutory Child in Need cases will further accelerate their role drift away from preventative public health and earlier intervention (this was flagged as a national risk in our “State of Health Visiting” survey, published in 2023). Health visitors’ important “upstream” role is focused primarily on preventing, identifying and working with families to address problems before they reach crisis point. This takes pressure off children’s social care and is less costly in the long run. Health visiting is the only agency that proactively and systematically reaches out to all families with babies and young children from pregnancy and through the earliest years of life – this is a safety-critical function that needs to be protected at all costs. Without sufficient resource, eroding this “safety-net” further strips out the mechanism to identify vulnerable babies and young children.

The “Working Together to Safeguard Children 2023” guidance also includes:

New national multi-agency child protection standards which set out actions, considerations and behaviours for improved child protection practice and outcomes for children.
Clarification of roles and responsibilities of health practitioners, with specific duties for child safeguarding.
Domestic Abuse Act 2021 legislation and the National Framework statutory guidance that supports a child-centred approach.
Updated guidance and terminology on the management of child deaths and the language around the responsibility of professionals where relevant, to inform relevant safeguarding partners and the Child Safeguarding Practice Review Panel.
Guidance on Improving practice with children, young people and families which provides advice for local areas to embed working together to safeguard children and the children’s social care national framework in practice.

Funding:

The Department for Education (DfE) has announced that it is investing more than £7 million, over the next 2 years to support local areas. This consists of £6.48 million grant funding in January 2024, for safeguarding partners to:

Make changes to multi-agency safeguarding arrangements in light of the revised Working Together to Safeguard Children statutory guidance.
Build a shared understanding between agencies of what the national framework means for multi-agency working.

This funding does not cover the costs of service delivery and sustainability. The guidance sets out an expectation that “leaders are ambitious about helping, supporting, and protecting children in their area and jointly prioritise and share resources accordingly”. If fully implemented, it is clear that these changes will place additional burdens on the health visiting workforce, shifting responsibilities from children’s social care to other services.

We are concerned that, as the costs of child protection continue to soar, budgets will not be redistributed to offset the additional burdens that this guidance places on organisations taking on the lead practitioner responsibilities. Prioritisation is likely to favour statutory responsibilities. Without addressing funding and health visiting workforce issues, services will be pressurised to prioritise “Child in Need” cases at the expense of preventative public health, leaving more families without the support that they need in other areas and proving much more costly in the long run.

This guidance presents an important opportunity to improve the care, support and safety of babies, children and young people. Its success will depend on its implementation as part of a whole system approach that also includes prevention and early intervention. As this directive represents a new national policy, we strongly recommend that its implementation is subject to the scrutiny of the Office for Budget Responsibility to ensure that it is fully costed and any additional burdens placed on services are managed with a commensurate budget uplift, workforce planning and action to address the current postcode lottery of health visiting service provision.

Next steps:

NHS Safeguarding is developing a safeguarding workplan to support the implementation of this guidance (we understand that the draft plan is due in mid-January 2024). At the iHV, we will be working closely with officials in the Office for Health Improvement and Disparities, NHS Safeguarding, and partners in other professional bodies and organisations including the School and Public Health Nurses Association, Association of Directors of Public Health and Local Government Association, to consider the specific implications of the Working Together 2023 guidance for health visiting and to support its implementation in practice.

The full suite of Working Together 2023 documents is available here:

Read iHV written response to the DfE - Working Together to Safeguard Children: changes to statutory guidance consultation

iHV publishes submission to Working Together to Safeguard Children consultation

Earlier this month, the iHV submitted a written response to the Department for Education’s Working Together to Safeguard Children: changes to statutory guidance consultation.

Working Together to Safeguard Children is the multi-agency statutory guidance that sets out expectations for the system that provides help, support and protection for children and their families. It applies at every level from senior leaders to those in direct practice with families, and across all agencies and organisations that come into contact with children. It gives practitioners clarity about what is required of them individually and how they need to work in partnership with each other to deliver effective services.

Updating ‘Working Together’ forms a central part of the Government’s plans to transform Children’s Social Care, set out in Stable Homes, Built on Love. The plans aim to strengthen multi-agency working across the whole system of help, support and protection for children and their families, with greater emphasis on earlier help and strong, effective and consistent child protection practice.

The Working Together consultation ran from 21 June 2023 to 6 September 2023 and views were sought from children and young people, parents and carers, and others who are ‘essential to children’s safety and welfare’. Officials at the Department for Education contacted the iHV with a direct request for a response to the proposal that health visitors might become lead professionals for children subject to Child in Need – section 17 arrangements. Our submission is therefore focused on the questions that relate to this proposal.

Our response was formulated with support from members of the iHV Working Together Safeguarding Roundtable Event that was held on 21 August 2023. The group met specifically to consider the impact of the proposed changes to the statutory guidance on health visiting practice. Further practitioner intelligence, and views on the proposed changes, were also collated from direct emails that the iHV received from members and discussions with partners during the consultation period.

Read our response here

What happens next?

The results of the consultation and the department’s response will be published on GOV.UK in Autumn 2023.

With special thanks to Trish Stewart, iHV Expert Advisor for Safeguarding and Associate Director for Safeguarding and Children’s Public Health Nursing at Central London Community Healthcare NHS Trust; Georgina Mayes, iHV Policy and Quality Lead; and members of the iHV roundtable event for their valuable input and support with this submission.

iHV submits response to Children’s social care strategy and consultation

The Institute of Health Visiting submitted its response to the Children’s social care strategy: Stable Homes, Built on Love on 10 May 2023. The Department for Education (DfE) has been seeking views on their proposals to reform children’s social care. The vision for reform of children’s social care responds to recommendations made by three[1] independent reviews. The vision is underpinned by the fundamental principle of the Children Act 1989 – that children’s welfare is paramount.

The vision aims to rebalance children’s social care away from costly crisis intervention to more meaningful and effective help for families, so that it achieves the outcomes that children deserve. Achieving this will require a major reset that puts love and stable relationships at the heart of what children’s social care does.

DfE has promised to take action across six pillars to transform children’s social care:

Pillar one: Family Help provides the right support at the right time so that children can thrive with their families
Pillar two: A decisive multi-agency child protection system
Pillar three: Unlocking the potential of family networks
Pillar four: Putting love, relationships and a stable home at the heart of being a child in care
Pillar 5: A valued, supported and highly-skilled social worker for every child who needs one
Pillar 6: A system that continuously learns and improves, and makes better use of evidence and data

The consultation focuses on their proposed response to various recommendations including:

Support and protection for children and families
Support for kinship carers, and wider family networks
Reforms to the experience of being in care, including corporate parenting
Support for the workforce
Delivery and system reform

In our response, we recognised that this consultation provides an ideal opportunity for much greater collaboration and a joined-up cross-departmental approach to child safeguarding and early help between the Department for Education and the Department of Health and Social Care. Whilst there is reference to the importance of ‘close integration with the wider support system’ in the proposals, more weight needs to be given to the ‘upstream’ functions of prevention, early identification of need, and early intervention below the threshold for children’s social care. These represent a significant gap throughout the whole vision. We urged the review team to take advantage of this opportunity to develop a whole system response for babies, children and families from the heart of government to frontline practice, including a dedicated budget for prevention and early intervention to support more seamless and integrated support for families and at the scale needed to respond to growing levels of need.

You can read the iHV’s response to the Children’s social care strategy and Consultation: Stable Homes, Built on Love here.

The iHV would like to say a huge heartfelt thank you to our iHV Safeguarding Expert Advisers for their expert advice and guidance when writing this evidence submission:

Dr Michael Fanner – Strategic Advisor – Global Safeguarding, Specialist Research, Education and Training and Safeguarding in Health
Trish Stewart – Associate Director of Safeguarding for Central London Community Healthcare NHS Trust

Read iHV’s response to the Children's social care strategy and Consultation: Stable Homes, Built on Love

[1] The three reviews are: The Competition and Markets Authority’s Children’s Social Care market study 2022; Child Protection in England 2022; and the Independent Review of Children’s Social Care 2022.

Extension of Temporary Changes to Law for Children & Young People with Education, Health and Care Plans

The Secretary of State for Education has issued a notice to extend the temporary changes to the law on what provision has to be made currently for those children & young people with Education, Health and Care (EHC) plans.

The temporary changes to the law have been in force since 1 May and are now extended to 30 June. Once the notice expires, the Secretary of State can issue a further notice for a period of up to a month if it would be appropriate and proportionate to do so in the context of coronavirus.

The Department for Education (DfE) will keep this under close review.

DfE has also taken the opportunity to publish an updated version of Changes to the law on education, health and care needs assessments and plans due to coronavirus.

Your views are needed to help shape SLC training for health visitors

As part of the government’s commitment to reducing the word gap, the Department for Education (DfE) and Public Health England (PHE) are leading a joint programme of work as part of the Social Mobility Action Plan (SMAP). One element of this is that the Institute of Health Visiting has been commissioned by PHE to develop training for health visitors to:

promote a strengths-based approach to supporting parents and carers of pre-school children with their child’s speech, language and communication development;
to support early identification and appropriate signposting to speech language and communication services.

We need to establish a baseline in relation to health visitors’ current knowledge of speech, language and communication. This will help us to shape the planned training and the development of resources which we will be rolling out in 2019.

Your participation in this survey is entirely voluntary and this short survey will take no more than 10 minutes of your time.

Go to Speech, Language and Communication Survey

iHV delighted to support children’s early communication skills

The Institute is delighted to be part of an exciting multi-million investment to support children’s early communication skills as announced by the Department of Education this week – commissioned to deliver new training for health visitors in speech, language and communication.

The government announcement launched projects to improve children’s early language and literacy, and boost parents’ confidence with home learning. It will fund educational games, apps and text message ‘tips’ for parents and carers from disadvantaged backgrounds, helping them to interact with their children when at home or out and about, making everyday activities an opportunity for learning.

It also includes funding for additional training for health visitors which the Institute has been commissioned to deliver. The new speech, language and communication training for health visitors will help to identify speech, language and communication needs early on, helping to address and support concerns when they can have the most impact.

Read the full Department for Education press release