Scottish Government publishes updated National Framework for Child Protection Learning and Development

On 1 March 2024, the Scottish Government published its updated version of the National Framework for Child Protection Learning and Development which will be relevant to health visitors working in Scotland.

This updated Framework replaces the previous version, published in 2012 to support the design and delivery of child protection learning and development. It provides a resource for all learning and development relevant to child protection, regardless of which agency practitioners work in and can be used flexibly and alongside single agency frameworks for learning to emphasise the key themes of the National Guidance for Child Protection in Scotland 2021 – updated 2023 .

The longstanding key message is that safeguarding is ‘Still Everyone’s Job’. All practitioners have a responsibility to remain aware of changes to legislation, policy and practice that impact on how frontline services should respond. The updated Framework incorporates recent legislation and several key policy documents:

The National Guidance for Child Protection in Scotland 2021 – updated 2023 (NGCP2023) highlighted important themes for practice, and these will be key to updating all learning and development resources within the ‘Getting it right for every child’ (GIRFEC) continuum – wellbeing to welfare to protection – supporting a proactive, preventative approach to practice. Key themes are:

rights-based approach (supporting and embracing UNCRC)
needs-led/strengths-based approach (supporting relationship-based practice)
trauma-informed/enhanced practice (supporting understanding of childhood adversity and trauma)
holistic assessment (supporting strengths/resilience, identifying risk/concerns within a child’s experiences)
recognising diversity and inclusion (supporting sensitivity of language, culture and communication differences).

The Framework aims to provide a resource which clarifies child protection learning needed at four levels – “Wider Workforce, General Workforce, Specific Workforce, and Intensive Workforce”, to:

promote collaborative multi-agency practice to support children’s wellbeing, welfare and protection
support the multi-agency task of assessing, managing and addressing identified need or risk to children, young people or parents/carers
provide a multi-agency learning and development framework adaptable for local learning and development strategies and evaluation
contribute to best practice through the development of a competent and confident workforce
support the design, implementation and evaluation of multi-agency child protection learning
establish agreed competencies, identifying the relevant knowledge and skills required, according to the roles and responsibilities of the various groups that make up multi-agency workforces, including those likely to encounter children, young people and their families as part of their day-to-day work
emphasise the importance of shared learning and collaborative practice to achieve better outcomes for children

Read the revised Framework in full here

Scottish Government publish their new Best Start Foods evaluation report

This summer, the Scottish Government published their Best Start Foods evaluation report which contains transferable learning that will be of interest to all UK nations and those working to improve access to nutritious foods for low income families. This report presents an evaluation of the benefit of the programme and its contribution to the Scottish Government’s immediate and short-term policy outcomes and their long-term aims (e.g. reduced health inequalities).

The Social Security (Scotland) Act 2018 introduced a range of new benefits devolved to Scotland, including Best Start Foods which replaced the UK Healthy Start Vouchers in Scotland in August 2019. Best Start Foods is designed to provide financial support for low-income families and help them to access nutritious food at the point of need.

Best Start Foods is delivered via a payment card, which can be used like a normal bank card with contactless or Chip & Pin features. The payment amounts are:

£4.50 per week for pregnant women and families with children aged 1 and 2
£9.00 per week for families with children aged under 1, to support both the mother and the child.

To maximise take-up of the benefit, the application form is part of a joint application for both Best Start Foods and Best Start Grant. People can also choose to apply for Scottish Child Payment using the same form.

Best Start Foods evaluation findings

The Best Start Foods evaluation findings are based on qualitative research that was commissioned and undertaken by ScotCen. This involved interviews with Best Start Foods recipients, healthcare professionals who support applicants, and retailers who participate in the Best Start Foods scheme. It also draws on Official Statistics and a survey of benefits applicants which was undertaken by Social Security Scotland.

The evaluation considered the policy outcomes of Best Start Foods in relation to the benefit’s impact on people who receive the payments in relation to:

Promotion and take-up of Best Start Foods
Understanding and knowledge of Best Start Foods
Improving the application process for Best Start Foods.

There are two reports – the main evaluation and the Annex report (both available on this link).

Key findings from the report include:

Over the period April 2020 to June 2021, take-up of Best Start Foods was estimated to be 77%.
Overall, recipients prefer Best Start Foods to the previous Healthy Start Vouchers system, because they feel the payment card is more discreet. They feel less embarrassed and stigmatised using the card in shops.
Recipients report that Best Start Foods can be used in more shops than Healthy Start Vouchers. This enables recipients to shop around and find the lowest prices.
Recipients also report that the card is easier to use and more convenient than vouchers because it facilitates contactless payments and the ability to self-checkout in shops. People who do not speak English also prefer it because the format is familiar to them, and they do not need to speak or read English to use it.
The qualitative evidence suggests that people use it to mainly buy cow’s milk, baby formula, fresh fruit, and vegetables. Some also use it for other recommended items (for example: eggs, pulses, and frozen or tinned fruit and vegetables).
The evaluation also shows that recipients purchase healthier snacks for their children, instead of processed foods like crisps, and some use payments to experiment with new healthy recipes.
Recipients also mentioned other positive health and wellbeing impacts of Best Start Foods, including observing their children eating more fruit and vegetables, which they feel is good for them nutritionally and supports their development.

Despite these positive outcomes, some recipients have reported challenges, some of which include:

Recipients finding it difficult to afford the same number of healthy foods when their children turn 1, and they return to the lower rate of Best Start Foods.
Healthcare professionals raising concerns about reducing payments when children turn 1, and the impact it will have on healthy food shopping.
Some recipients experiencing difficulties using the Best Start Foods card for the first time because it is not yet activated. Some also report that contactless payments do not work on their card, meaning they must use Chip & Pin.
While recipients appreciate the financial support offered by Best Start Foods, they feel the impact would be greater if eligibility was extended until their child starts school. Some recipients share that they would find it difficult to cover the costs of nutritious food after Best Start Foods comes to an end.

The evaluation shows that Best Start Foods has largely achieved its immediate and short-term policy outcomes (which were: Promotion and take-up of Best Start Foods; Understanding and knowledge of Best Start Foods; and improving the application process) and has made progress towards its medium-term policy outcomes. It is therefore likely to have contributed positively to the Scottish Government’s long-term aims (such as reduced health inequalities and reduced child poverty).

The report concludes with 10 policy implications which can be found here.

Scotland: Child Disability Payment pilot opens for new applications

The new Scotland Child Disability Payment has opened for applications from people living in three pilot areas.

Families of children with a disability or long-term health condition living in Dundee City, Perth and Kinross and Western Isles council areas who need financial support should apply to the new system.

This is the first application-based disability benefit to be introduced by the Scottish Government and will be administered by Social Security Scotland. The benefit replaces the UK Government’s Disability Living Allowance for children.

The pilot will be followed by a nationwide roll out in the autumn and is for families applying for the first time for this benefit. Those already in receipt of Disability Living Allowance for children do not need to apply and their cases will be transferred in future.

Find out more

Help give all of Scotland’s babies a Fair Start in life

Calling all health visitors in Scotland…sign up to join NSPCC Scotland’s hustings on 26 April (10:00-12:00) to give all of Scotland’s babies a Fair Start in life.

See their invite below:

What?

NSPCC Scotland, supported by Children in Scotland, are hosting a virtual hustings on Monday, 26 April, 10-12noon, focused on safeguarding and support in the early years.

The event will raise awareness of the distinct needs of babies and their families, as we emerge from the pandemic, with parliamentary candidates in advance of the Scottish elections.

The panel will include representatives from all of Scotland’s political parties, including the Minister for Children and Young People, Maree Todd.

They have also invited families, health visitors, midwives, social workers, early years staff, third sector partners, family nurse partnership teams and specialist perinatal and infant mental health services to raise issues from practice with political parties.

Why?

Babies need us to fight for them. They are a uniquely vulnerable group of children; they are completely dependent on adults for their care and protection, and cannot verbalise their needs or seek support.

Around 50, 000 babies will have been born in Scotland since the start of the COVID-19 pandemic[1], born into a society of heightened anxiety and stress. While we might think infants will be too young to remember, we must not overlook the impact the pandemic will have had on them and their families.[2]

There is extensive evidence showing early experiences have profound effects on lifelong development. Yet, last year in Scotland, around half of the children on the child protection register, and over a third of children coming into the care system, were younger than five years old[3].

The Promise[4] has as a key foundation the provision of better and more responsive scaffolding for families. Despite a decade of policy frameworks which recognise the importance of the early years, of early intervention and prevention[5], the scale of ambition is not matched by the scale of investment.

They believe getting it right for families in the early years is the most efficient and cost-effective way to realise Scotland’s long-held aspirations around equality and prevention.

Following incorporation of the UNCRC, they want to hear how political parties will deliver a rights-based approach to budget setting and decision making to ensure early years services are holistic, preventative and integrated to better support families.

How?

Book your place at the virtual hustings here

They look forward to seeing you there😊

[1] Based on previous year birth rates. See https://www.nrscotland.gov.uk/files/statistics/rgar/2019/Pages/bir-sec.html

[2] https://www.bestbeginnings.org.uk/news/the-babies-in-lockdown-report

[3] https://www.gov.scot/binaries/content/documents/govscot/publications/statistics/2021/03/childrens-social-work-statistics-2019-20/documents/childrens-social-work-statistics-scotland-2019-20/childrens-social-work-statistics-scotland-2019-20/govscot%3Adocument/childrens-social-work-statistics-scotland-2019-20.pdf?forceDownload=true

[4] https://www.carereview.scot/wp-content/uploads/2020/02/The-Promise.pdf

[5] EY Framework; https://www.gov.scot/publications/early-years-framework/pages/4/

Introducing National Bereavement Care Pathway working

9 – 15 October, Baby Loss Awareness Week #BLAW2018, sees the publication of a significant piece of national collaborative work to develop a National Bereavement Care Pathway (NBCP).

Statistics for #babyloss tell us that around 15 babies died before, during or soon after birth every day in the UK in 2015. Of those, 9 babies a day were stillborn¹. Additionally, one in four women will experience a miscarriage in their lifetime and one in one hundred will endure recurrent miscarriages (more than 3 in a row)². Many of these women and their partners will go on to have a successful pregnancy and others may already be parents. Therefore, as health visitors we will already be working alongside many families affected by baby loss, and will contribute to the delivery of quality care to support new parents through a devastating time.

iHV has been honoured to be part of the National Bereavement Care Pathway (NBCP) work for England over the past year, meeting alongside 13 or more different national charities and professional bodies (Bliss, Lullaby Trust, RCM, RCN, etc) on the project led by Marc Harder for SANDS, with the support of the Department of Health and the All Party Parliamentary Group on Baby Loss. The aim for the project is to ensure that all bereaved parents are offered equal, high quality, individualised, safe and sensitive care in any experience of pregnancy or baby loss, be that miscarriage, termination of pregnancy for fetal anomaly, stillbirth, neonatal death, or sudden unexpected death in infancy (up to 12 months).

The NBCP Core Group has overseen the development of specific pathways to support each experience of loss described above, with the Training sub-group creating a training toolkit to support dissemination. There has been a Wave 1 pilot of the pathway in 32 sites from October 2017 and a further 21 sites in Wave 2, including one area of Harrogate and District NHS Foundation Trust that employs health visitors. Valuable feedback from hundreds of professionals and parents has fed into the project and shaped this vital work to ensure that it supports the delivery of consistently confident, parent-centred, empathic and safe care when a baby dies.

Go to: www.nbcpathway.org.uk to review the Sudden and Unexpected Death in Infancy (up to 12 months) pathway. See also: National Bereavement Care Pathway – standards.

The work is now heading towards national roll out and will bring huge benefits to parents and professionals alike. Please share this work amongst your health visiting colleagues and managers to discuss how the pathway and standards might be implemented in your area. Dissemination is key – help spread the message as widely as you can with all your multi-agency colleagues (GPs, Midwives etc) and check they are aware of the emergence of the national pathway.

Of note there is also work commencing in Scotland this month to bring the NBCP project to Scotland. Please contact [email protected] if you are an HV and would be interested in contributing to the Scotland project.

New publication from RCN Scotland – Measuring Success

RCN Scotland has launched their latest publication today: Measuring Success: principles for a new approach to improving health and wellbeing in Scotland.

Go to publication - Measuring Success: principles for a new approach to improving health and wellbeing in Scotland

The paper follows on from the sustainability statement the RCN published last year with the Academy of Medical Royal Colleges and Faculties in Scotland. In that there was a united call for visionary change and bold action to make services sustainable for the future.

This new publication, developed through open and frank discussions with partners across sectors and professions, sets out nine principles which the RCN believes could, and should, form the basis for a new approach to measuring success in Scotland’s health and wellbeing services.

You can join in the discussion on Twitter – @RCNScot #inthespotlight

Scotland – new reports about preconception health, education and care

Two new e-publications on preconception health, education and care in Scotland. These e-publications are intended to raise awareness about preconception health, education and care, particularly within the Scottish context. This, it is hoped, will lead to many positive actions (large and small; national, local and individual) that prospective mothers and fathers across Scotland find informative, valuable, empowering and supportive as they make their decisions about parenthood. While individual choices are crucial, it also is the case that larger societal forces, political choices and structural issues can powerfully shape what is true for individuals and couples.

The main report “Missed Periods: Scotland’s opportunities for better pregnancies, healthier parents and thriving babies the first time . . . and every time” is a 45-page evidence-based report (including links to extensive references and international resources).

Missed Periods: Scotland's opportunities for better pregnancies, healthier parents and thriving babies the first time . . . and every time

A brief version of this report “Prepared for Pregnancy?: Preconception health, education and care in Scotland” is an introduction and overview of the above more detailed report. This also includes the advance reviews by a leading public health professor in Scotland and the senior advisor on preconception health to the U.S. Centers for Disease Control and Prevention (CDC). Scotland’s Chief Medical Officer, Dr Catherine Calderwood (herself an obstetrician) also reviewed this report in advance and has been publicly supportive of it.

Prepared for Pregnancy?: Preconception health, education and care in Scotland

These two e-publications were commissioned by NHS GG&C’s Public Health Director, Dr Linda de Caestecker.