Manchester City Council

Children to be supported to Start Well in Greater Manchester

A plan to provide every child in Greater Manchester with the best start in life has been unveiled today (Thurs, June 30) by the Greater Manchester Health and Social Care Strategic Partnership, the bod

The Start Well vision will ensure every child grows up in a nurturing environment, with access to public service support helping youngsters to fulfil their potential as they move into primary and secondary education.

The primary objective of the plan is to increase the number of children in Greater Manchester who are ‘school ready’ by the age of five – a national measure of a child’s development.

Greater Manchester’s current school readiness figures are lower than the national average with the percentage of children achieving a Good Level of Development in 2015 at 62.4%, compared with 66% nationally. However, there are also significant differences across the 10 boroughs, with school readiness as low as 57.2% in some regions across Greater Manchester.

Start Well will tackle these inequalities by bringing together schools, nurseries, local authorities, NHS services, the voluntary and community sector and private providers to provide high quality education and coordinated support where necessary.

It is the first time that so many organisations and institutions have made a collective commitment to work better together to close the gap in health, education and social inequalities. This partnership working has been made possible through the advent of devolution.

Start Well aims to:

•         Increase the percentage of children achieving a ‘good’ level of development
•         Improve mental health of parents with infant children
•         Reduce the number of babies with a low birth weight
•         Reduce levels of obesity at age 4-5 years
•         Reduce the number of decayed, missing and filled teeth in children aged five. 

•         Reduce the rates of smoking at time of delivery

•         Reduce attendance at A&E for children aged 0-4 years. 

Wendy Meredith, Greater Manchester’s Director of Population Health Transformation, said: “We believe that every child deserves the best possible start in life and today we have outlined our vision for ensuring we can close the gap in health, education and social inequalities.

“Growing evidence shows that if we are to do just one thing to really improve health outcomes in Greater Manchester, it would be investing in the very first early years of a child’s life. That starts from before the child is born all the way through to nursery and up to the age of five.

“Those early years are absolutely vital and developing a system that supports happy and healthy children means that we are working towards the long-term prosperity and aspirations of the region. If we have higher numbers of school-ready children who are flourishing, eager to learn, able to share, and with good social skills they get off to the best start - so that they will have the skills to become fulfilled members of the community.”

You can read more about Wendy Meredith’s thoughts on the strategy in her supporting case study (attached). A second news piece (attached) shows how we will be following the life of one newborn, baby Alfie, up until the age of five.

The Start Well strategy provides a road map for transformational system changes that will see a long-term shift move away from expensive and reactive public services to an improved emphasis on prevention and early intervention.

It is a significant step in improving the long-term health and wellbeing of Greater Manchester and integral to the long term development of the region according to Lord Peter Smith, Chair of the Greater Manchester Health and Social Care Strategic Partnership Board.

Lord Peter Smith, Chair of the Greater Manchester Health and Social Care Partnership, said: “We need to recognise the importance of a child’s development and ensure they are given every opportunity to fulfil their potential, no matter where they are born or raised in Greater Manchester.

“We want to make the region a beacon for the young and improve the long-term prosperity for all.”

One example of an early intervention service is the Family Nurse Partnership which provides support to young first-time mums.

Clare Woods, A nurse with the Family Nurse Partnership (see supporting case study): “As part of the work we make sure we focus on the Mum’s dreams and aspirations. We do everything by breaking things down into manageable chunks and setting goals.

“Our role is almost as enablers. We work with the family so that they realise their own targets  - which then also helps the baby.”

The Start Well strategy is available to read in full via www.gmhsc.org.uk

Case Study:

Rachel’s story: How a carefree teen became the Mum of dreams

At a time when most teenage girls think can think about music, going out and seeing friends, Rachel Jones* from Bolton faced the daunting prospect of growing up overnight.

For, at the age 16, Rachel found out that she was pregnant – just after she had left school and was about to start a college course in childcare.

Now 21, Rachel recalls how overwhelmed she was as she contemplated a new path in life that would see her as a teenage parent, while still learning about the world herself.

“I was so scared,” she says. “I had no idea that I could be pregnant – and the fear was overwhelming to start with.”

However, after the initial shock, Rachel decided that she would keep the baby and do her best to be a good parent.

“I didn’t see any of this as the baby’s fault,” she explains. “I started to think that maybe I could turn a corner, be a better person and give my child a good life.

“I was lucky that my Mum and Dad were supportive too – even though they were very shocked. Their attitude made me stronger.”

And, that resolve – combined with the support of a service called the Family Nurse Partnership (FNP) – helped Rachel to power through her fear and make the changes needed to have and to look after a newborn.

The FNP service is one that gives support to young first-time mums so that both the mother and the child get the best outcomes possible.

In Rachel’s case, she came under the care of FNP nurse Clare Woods, who is based in Bolton. Together, Clare and Rachel went through all the aspects of looking after yourself – and a baby. They went through everything from health, social and financial needs – while also thinking about Rachel’s long-term aims for her education.

“As part of the work we make sure we focus on the Mum’s dreams and aspirations,” says Clare. “We do everything by breaking things down into manageable chunks and setting goals.”

Rachel credits this two-year support as being the driver that gave her the encouragement and guidance to be the best Mum that she could be, as she awaited the arrival of her son.

“I felt such love the minute I held Lucas,” she says. “I knew I would do anything for him and I just threw myself into it all, using all the help I had been given.”

Lucas’s birth also galvanised Rachel’s aim to go back to college – which she did to re-sit her GCSEs in English and maths.

However, just as Rachel she embracing the start of a new chapter of life, her own Mum found that she had advanced cancer and died just before Lucas was one – and Rachel was just 18. The grief was crushing, but Rachel says she is glad that her Mum was able to see how well her grandson was looked after.

“My Mum loved Lucas – and I know how proud she was that I was doing everything I can to give him the best possible start,” says Rachel.

Then tragedy struck again, as within a few months Rachel’s Dad also died unexpectedly of a heart attack.

“I didn’t want to fall apart,” says Rachel. “It was hard, but I had to keep going for Lucas.”

At each of these life-changing times the FNP service was there for Rachel, to make sure she had the emotional and practical support she needed.

“Our role is almost as enablers,” says Claire. “We work with the family so that they realise their own targets - which then also helps the baby.”

And that support has been invaluable for Rachel. Today, she is a happy 21-year old Mum – who went on to have a baby girl called Layla who is now ten months old. Rachel is still with the father of her children and she is also about to start a new job at a crèche  - but she still plans to go back to college and finish her childcare qualifications.

“When my kids are older I want them to look back and say my Mum did everything she could for us. I want them to say she never gave up and showed us that if you want anything in life you have to work for it – but it is possible,” she says.

I just look at my two children and think I’ve been blessed.”

*Surname has been changed.
Column:

Why being a good parent isn’t always as easy as ABC

Wendy Meredith Greater Manchester’s Director of Population Health, talks babies, early years and parenting experience – as the region puts more focus on getting children off to the best start in life.

"If we were to do just one thing to really improve health outcomes in Greater Manchester, it would be investing in the very first early years of a child’s life. That starts before the child is born all the way through to nursery and starting school.

"The evidence also shows that the development of early mental development is strongly associated with later educational success, better incomes and good health.

"The foundations for virtually every aspect of development – physical, intellectual and emotional – are laid in early childhood. From birth to age 18 months, connections in the brain are created at a staggering rate of one million per second. And we know that children who have positive, supportive and nurturing relationships with a parent - when their brains are developing so fast - learn better and fare better later in life. Those early years are absolutely vital as it’s when all the brain connections are developed.

"Sadly, evidence also shows that when a baby’s development falls behind during the first year of life, it is then much more likely to fall even further behind in subsequent years, than to catch up with those who have had a better start. At its most extreme, lack of attachment can lead to a lack of empathy and even criminal behaviour.

"Pregnancy and the birth of a child is a critical window of opportunity when parents are especially receptive to advice, support and guidance.

"All parents want to do their absolute best for their children. But, sometimes unexpected events or circumstances mean they struggle to cope.

"Our Start Well Strategy will ensure parents get the support they need to be the best possible parents they can be.

"In Greater Manchester we fully appreciate both the evidence and the need to focus on those pivotal early years. That’s why we have introduced and developed the Start Well: Early Years Strategy – which outlines the collaborative approach to commissioning and developing services in this area. This partnership working has been made smoother since the advent of devolution – where organisational barriers have come down so that people can work together.

"On a wider level we also recognise how having happy and healthy children means that we are working towards the long-term prosperity and aspirations of the region. If we have higher numbers of school-ready children who are flourishing, eager to learn, able to share, and with good social skills they get off to the best start - so that they will have the skills to become fulfilled members of the community and contribute to and benefit from the prosperity of Greater Manchester.

"In practical terms this strategy sees the commitment to removing some of the variation which currently exists. For example, instead of having 23 different early years assessments across the region, we have developed an eight-stage process which is parent-led.

"We also have an agreed range of evidence-based interventions – or ways of helping parents with additional support. Again, instead of having over 300 different types of interventions, we have narrowed it to the 20 most effective processes.

"Being a parent is the most important role you can have – but it isn’t easy. I have two teenagers – but I can still remember how hard those early years were with sleepless nights and the constant exhaustion.

"I was very lucky. I have a supportive partner and my Mum lived very close by – and she had four children – so she was a great help to me.

"But, not everyone has that type of support or guidance that helps them to bond with their baby. And that attachment - which is at the very heart and foundation of how a child will thrive in future life – is something that we can and must put at the centre of our services."

News in Brief:

Here's looking at you baby!

Just as Greater Manchester recently (April 1*) welcomed a new era in  health and social care, Kelly Mooney was also celebrating a brand new chapter  - with the birth of baby son, Alfie, pictured above.

Little Alfie John Birkett weighted in at 6lbs 8 oz at Royal Oldham Hospital on April 13.

New Mum Kelly, 39, from Castleton, Rochdale and partner John Birkett responded to our call for newborns to be the 'face' of devolution - and the work around improving early years care, so that more children in Greater Manchester are physically and emotionally ready for starting school. Kelly will help the team overseeing health and care devolution with feedback on Alfie's journey over the next five years, before he too enters the school system.

Kelly, who plans to be a stay-at-home Mum, said: "I fell in love straight away with Alfie - the feeling was just overwhelming. I wanted to be involved in this work because when I look at Alfie I want him to have good health, good education and to follow his dreams. I want the best of life for him and that starts with good health."

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