Health, Education and Social Services put together to protect children

1,200 children in the borough are in need; the second highest rate in London.

The local reality

It is estimated that approximately 3% of children in the Borough (1,200) are in “high” need.

Black children, particularly boys, are significantly “over represented” amongst children being “looked after” (in care), on the child protection register and being excluded from school.

Teenage pregnancy rates are comparatively high.

Immunisation rates for children are comparatively low.

There is a comparatively large number of families in poor / over
crowded accommodation.


Approximately £17m is spent on children’s social services alone (excluding expenditure on asylum seeking children and families).

At any given time social workers are working with more than 400
families, and health visitors and school nurses with more than 300 families, where the children are considered to be “at risk”.











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A single structure for child protection bringing together local health, education and social services will be set up in Hammersmith and Fulham within months. In total, 35 Children's Trusts pathfinders will be created around the country, following the recommendations of the Laming Report, which investigated into the death of Victoria Climbie.

Hammersmith and Fulham have the second highest rate of children in need among all the London boroughs (Borough Profile 2002). It is estimated that approximately 3% of children in the Borough (1,200) are in “high” need. This includes young people
who are persistent offenders, children who are on the child protection register, disabled children, children who are looked after and children who are chronically ill. There are also those considered “vulnerable”, defined as being children who are at risk of adverse outcomes without some intervention, support or service; perhaps as a result of their parents separating, or because of an episode of ill–health.

The Laming Report was very critical about the lack of co-ordination between child protection and child welfare services, which contributed to the service failure resulting in Victoria's death. In Hammersmith and Fulham, lack of co-ordination and poor communication between a plethora of structures and services are problems already identified. "Children are still potentially at risk because of the liability of the services to fail to communicate properly and co-ordinate intervention. There is also duplication of effort. Children and families sometimes experience the system as difficult to access and user-unfriendly", says the report by the council.

The new structure in the form of the Children's Trust would provide a single system for the identification, referral and tracking of children considered to be vulnerable and in need of help to prevent them from experiencing exclusion, disadvantage, harm or being involved in crime or drug abuse. The Trust would develop a system for ensuring that children would be subject
to a single assessment process; and have one "case manager" responsible for co-ordinating the child's support programme.

The report with the proposal for the creation of a local Children's Trust was presented and analysed by Health & Social Services Scrutiny Panel and Leader's Committee. A brief of the report bellow.

Why do Hammersmith and Fulham Council want to create a Children's Trust?

- Resources have had to be transferred from preventive
provision for vulnerable children to children with high levels of need. (Vulnerable children are those who are at risk of adverse outcome without some intervention, support or service. Children have high levels of need because they face significant and lasting difficulties or disadvantage.)
- Although there is much more investment by health, education and social services in provision for children in high need, it is not well coordinated.
- At the high need end of the spectrum, services are often crisis orientated and not necessarily designed to bring about lasting improvements in life opportunities for vulnerable children.
- There are a plethora of structures and services upon which vulnerable children and children with high levels of need depend. These children's needs are complex and so it is inevitable that a range of provision will be required. Nevertheless the end result can be poor communication and poor co-ordination between services, resulting in children's needs not being met and (at worst) children suffering preventable harm.
- Parents and carers complain of their children and themselves suffering as a consequence of this poor co-ordination of services. The Best Value Review of Services for Disabled Children and Children with Special Needs stated that parents and carers of disabled children report that their children experience repeated reassessments and that the parents constantly have to be the "broker" between education, health and social services in the arrangement of services by different agencies.
- Foster and adoptive parents report that they cannot access schooling or child and adolescent mental health services. Schools, Health Visitors and GPs report that they cannot obtain social work support for children experiencing social difficulties. Social workers report that they cannot engage GPs in child protection cases. Whilst these experiences are by no means universal, these reports are sufficiently frequent to indicate that they are sufficiently common place for us to be concerned about the co-ordination of services in the Borough.

How would it work?

- At the core would be the establishment by the three partner agencies (health, education and social services) of joint commissioning, planning and development of services for vulnerable children and children in high need.
- The Childrens Trust will have a single system for the identification, referral and tracking of children considered to be vulnerable and in need of help to prevent them from experiencing exclusion, disadvantage, harm or being involved in crime or drug abuse. The Trust will develop a system for ensuring that children would be subject to a single assessment process; and have one "case manager" responsible for co-ordinating the child's support programme.
- The Trust will be accountable to the Council and The Primary Care Trust.
- Management Board will consist of elected members of the Council, PCT Board Members, the Managing Director, Director of Social Services, Director of Education, Chief Executive of the Primary Care Trust, Director of Childrens Trust, representatives of the Police and representatives of parents / carers. These arrangements may be revised as plans for the Trust develop.
- A consultation forum representing children and young people will be established. This will be organised by the Childrens Rights Officer.
- The Childrens Trust will also consult on a regular basis with parents groups, carers groups and through the Children's Strategic Partnership (which is to be developed from the existing Children's Fund Partnership).