Using data on children’s well-being to plan and commission services

John Hill

Research and Statistics Manager

Children, Young People and Families Directorate

Birmingham LA

Birmingham Context

CONTEXTCONTEXT– 1 million population– 256,000 children & young people– 180,000 school age– 30% BME (50% of children)– 23% Under 16– 30% lone parent– 30% under 15 – where no adults

work– 2,000 plus Children in Care

Birmingham’s Brighter Futures Strategy To Improve Outcomes for Children and Young

People

• Clarity about outcomes• Guided by high quality evidence on children’s

well-being (Epidemiology)• Logic model approach (how activities relate to

outcomes), Outcomes Activities Investment Outputs

• Informed by robust evidence on what works• Rigorous evaluation

EpidemiologyPurpose:• To find out how well Birmingham children are

doing on the ECM outcomes and where we need to focus attention to improve outcomes.

• To use the results to plan and prioritise services.

• To monitor outcomes over time to see if they are improving as a result of interventions.

Methodology• Review of existing data on outcomes from partners.

• Questionnaires compiled by Dartington-i covering ECM outcomes - based on KIDSCREEN and Strengths and Difficulties questionnaires.

• Three versions: 0-6 year olds (for parents/carers to complete) 7-11 year olds (on-line, completed in school) 12-18 year olds (on-line, completed in school)

Questionnaire Sample • 0-6 year olds (representative sample of 500 parent/ carers

visited at home )• Representative sample of c6000 7-18 year olds used in

initial analysis. Questionnaire completed by c15,000 per year

• Version for children with learning difficulties to be piloted this term.

• Annual survey -schools can choose when they administer the questionnaire during the academic year.

Children’s Well-Being Survey

Example Questions

Physical Health (7-18)

In general, how would you say your health is?

Have you felt fit and well?

Have you been physically active (e.g. running, climbing, biking)? Have you been able to run well?

Do you eat ‘junk food’ daily (e.g. hamburgers, chips, crisps, fizzy drinks or sweets)?

Physical Health (12-18)

Do you ever smoke cigarettes/tobacco?

How often do you drink alcohol?

How often have you used any illegal drugs during the last month?

SafetyHave you been afraid of other girls and boys?

Have other girls and boys made fun of you? Have other girls and boys bullied you?

Have you been in an accident in the last 12 months that meant you had to go to Hospital? In the last 12 months, have you been in trouble with the police? I feel safe when I’m at home I feel safe when I’m at school  

Enjoy and achieve

Have you been happy at school? Have you got on well at school? Have you been satisfied with your teachers? Have you been able to pay attention at school? Have you enjoyed going to school? Have you got along well with your teachers?

Emotional well-beingI worry a lot

I am often unhappy, down-hearted or tearful

I am easily distracted, I find it difficult to concentrate

I am nervous in new situations. I easily lose confidence I am often accused of lying or cheating

I am restless, I cannot stay still for long

I get very angry and often lose my temper

I am usually on my own. I generally play alone or keep to myself

I take things that are not mine from home, school or elsewhere

Getting on with others

I am helpful if someone is hurt, upset or feeling ill

Other people my age generally like me

I often volunteer to help others (parents, teachers, children)

I try to be nice to other people. I care about their feelings

Examples of the survey findings

• Results are compiled to produce an overall City picture. Comparisons with national averages. Analysis by different groups (e.g.gender, ethnic group, LAC, SEN)

• Participating schools receive their own report on their pupils’ well-being that can be used as evidence for the school’s SEF

8% of 12-18 year olds smoke cigarettes

10% of 12-18 year olds drink alcohol ‘a few times a week’(25% for White, 2% Pakistani)

8% of 12-18 year olds have used illegal drugs in the last 12 months

22% of children ‘always’ eat junk food

n = 1,47712-18 yrs

Healthy Lifestyles& PLQ

physical health lifestyles

• 26% of children get very angry and often lose

their temper

• 9% often fight with other children or bully them

325 children are permanently excluded from

school each academic year

Levels of offending behaviour are falling -

the number of first-time offenders is down 3%

n = 5,858all (7-18 yrs)

SDQ & Birmingham data

behaviour

0.7 4.9

2.8

2.2

0.5 3.9

n = 5,858all (7-18 yrs)Britain (11-15 yrs)

SDQ

0

0

10

10

threshold

20%

11%

significant behaviouraldifficulties

behaviour

• 17% of children worry a lot

• 20% of children are nervous in new situations and easily lose confidence or are unhappy, downhearted or tearful

n = 5,858all (7-18 yrs)

SDQ

emotional health anxiety and depression

0.8 5.5

3.2

2.8

0

00.7 4.9

n = 5,858all (7-18 yrs)Britain (11-15 yrs)

SDQ

10

10

threshold

9%

5%

high levels of anxiety or

depression

emotional health anxiety and depression

6.4 18.2

12.3

10.3

0

05.1 15.5

n = 5,858all (7-18 yrs)Britain (11-15 yrs)

SDQ

40

40

threshold

12%

5%

impairment tomental health

mental health total difficulties

0.6 4.4

2.5

1.5

0.1 2.9

n = 5,858all (7-18 yrs)Britain (11-15 yrs)

SDQ

0

0

10

10

threshold

8%

2%

poor peer relationships

social literacy peer relations

9.3 5.1

7.2

8.0

9.7 6.3

n = 5,858all (7-18 yrs)Britain (11-15 yrs)

SDQ

10

10

0

0

threshold

10%

2%

unkind or uncaring

social literacy pro-social behaviour

Alongside their poorer emotional and

behavioural well-being, the social literacy of

children - their ability to get along with and to

support each other - is also suffering.

social literacy summary

School Birmingham

% of those with good physical health

94 90

% of those who feel very fit and well

64 58

% of those who are physically active

90 86

% of those whofeel very full of energy

73 61

% of children who say they drink alcohol at least once a week

4 7

% of children who say they smoke 4 6

% of children who say they have used drugs in the last month

5 7

National average

overall health score for the average child on 100 point scale (100 being good)

72 67 67

A BRIGHTER FUTURE FOR CHILDREN AND YOUNG PEOPLE

Physical health

Example School

Mental health

A BRIGHTER FUTURE FOR CHILDREN AND YOUNG PEOPLEExample School

School Birmingham Nationalaverage

% of those with significant behaviour problems

24 19 11

% of those with significant emotional problems

12 7 5

% of those who have poor attention and concentration

14 11 11

% of those with significant difficulties in their overall reported mental health

11 9 5

overall mental health score of the average child on a 40 point scale (0 being good)

12.4 11.7 10.3

About school life

School Birmingham

% of those who enjoy going to school most of the time

38 50

% of those who often or always get on well with their teachers

45 54

% of those who feel safe at school all of the time

43 51

% of those who are quite often bullied

17 13

National average

overall experience of being bullied on a 100 point scale (100 being good)

80 84 90

overall perception of school on 100 point scale (100 being good)

58 65 63

A BRIGHTER FUTURE FOR CHILDREN AND YOUNG PEOPLE

Example School

Physical health

Behaviour

Literacynumeracy

Job Skills

Social literacy

Emotionalhealth

What outcomes resulted?

Physical health

Behaviour

Literacynumeracy

Job Skills

Social literacy

Emotionalhealth

Physical health

Behaviour

Literacynumeracy

Job Skills

Social literacy

Emotionalhealth

Physical health

Behaviour

Literacynumeracy

Job Skills

Social literacy

Emotionalhealth

Physical health

Behaviour

Literacynumeracy

Job Skills

Social literacy

Emotionalhealth

Physical health

Behaviour

Literacynumeracy

Job Skills

Social literacy

Emotionalhealth

Physical health

Behaviour

Literacynumeracy

Job Skills

Social literacy

Emotionalhealth

Physical health

Behaviour

Literacynumeracy

Job Skills

Social literacy

Emotionalhealth

Physical health

Behaviour

Literacynumeracy

Job Skills

Social literacy

Emotionalhealth

-9 months - 5 6-11 12-18 19-25

Read

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Read

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Eq

uip

ped

to learn

Eq

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ped

to learn

Tran

sition

Tran

sition

AllAll

Children in need Children in need

GPs Hospitals Leisure Community Health ServiceHousing Libraries Play space

Quality pre -school

Health Visitor

Children’s Centre

Primary school

SEN

Secondary school

ConnexionsVocational education

SEN

Transition ServicesSecondary school

Leaving Care - DisabilityCurriculum ProgrammesParenting Programmes

CAMHS CAMHS

Developmental Framework

Where are we now?

• Preparation for Pilots

• Council Pump Priming Funding

• Governance Arrangements

Examples

•Nurse Family Partnership

•Parenting Programmes -Incredible Years,Triple P

•SEAL + (PATHS)

•LAC

•Integrated services for children with disabilities

Challenges of Implementation

• Selection of Pilots• Fidelity• Stakeholder Engagement• Communications• Workforce – Culture• Evaluation• Service Re-design• Commissioning/Decommissioning