Agenda item

For the Health and Wellbeing Board to receive an update on the work of the Brent Children’s Trust and a forward look at upcoming work.

Nigel Chapman (Corporate Director Children and Young People, Brent Council) introduced the report, which provided an update of the Brent Children’s Trust (BCT) work programme covering the period July 2023 to March 2024 and set out a proposal to redefine the purpose and vision of BCT for 2024-2026. Some of the key points were highlighted as follows:

• The report covered the progress and challenges of BCT as they related to health matters.
• As well as monitoring by the Health and Wellbeing Board, there was other scrutiny that occurred for the three BCT work programmes. The arrangements for Looked After Children and Care Leavers were reviewed at Corporate Parenting Committee, arrangements for children with SEND were considered at the Community and Wellbeing Scrutiny Committee, and Early Help and Intervention was subject to government oversight through the Supporting Families Programme.
• Time had been spent to develop a refreshed approach over the next 2 years, looking at how BCT operated as a Trust and continuing to focus on those three key work programmes; Looked After Children, SEND, and Early Help. The work would also monitor the effectiveness of the ICP priority workstreams as they affected children, such as the mental health and wellbeing workstream and Brent Health Matters (BHM) and their new remit into children’s work to reduce health inequalities affecting children and families.
• How the Trust worked was underpinned by 3 pillars – shared accountability, better performance information and improved communications and engagement.
• The Trust felt they were in a good place organisationally in a complex landscape to respond in an agile way to issues that arose, and this was thanks to the good relationships between providers, the local authority and Brent Integrated Care Partnership (ICP).
• Robyn Doran added that the Trust had now agreed that it would benefit from having third sector partners around the table, so would begin work to find a way to represent that voice.

In considering the report, the following points were raised:

·       Members felt that the report needed further information on where the challenges were, what the Trust was looking to improve, and what the metrics against those issues were. Nigel Chapman agreed to provide performance information across a range of indicators as they affected Looked After Children, inclusion, and early help for future reports. Those metrics were monitored and reported corporately as part of the Borough Plan Key Performance Indicators and could be drawn into this report. In addition, the Board requested future reports to bring out the voice of the child.

·       The Board were informed that there was now a Clinical Lead within BCT, Dr Anne Murphy, who was working hard and collaborating with partners.

·       The Board asked about the interface with mental health services for young people and SEND and how mental health and SEND interfaced with the criminal justice system. They were advised that there was a close interface between SEND and mental health and wellbeing. The Children and Young People Department was running a programme called ‘Delivering Better Value’, funded through the DfE, which helped to early identify where there were SEND needs and any potential interface with mental health and wellbeing, which could be a porous boundary. There was also an intervention first programme aiming to early identify SEND needs and better help professionals working in schools to understand where there may be undiagnosed mental health needs as opposed to SEND needs. The expansion of mental health support teams in schools had helped to support that work. In relation to the criminal justice system, there was a Mental Health Practitioner within the Council’s Youth Justice Service. When young people became known to the Youth Justice System, they would undergo an assessment which included an assessment of any undiagnosed mental health needs, and when those assessments went before the courts they could draw upon the input of the Mental Health Practitioner. The Mental Health Practitioner also provided intervention and counselling and navigation into other specialist services where needed. It was highlighted that the caseload was relatively low for the Youth Justice Service and had been dropping over the last 5 years thanks to sentencing practice and diversion. Performance reports for this aspect of children’s services were presented to the Safer Brent Partnership.

·       Robyn Doran highlighted some of the areas of concern for the Trust. Asthma was a concern in relation to health inequalities and children and young people and was outlined in the JSNA as an area needing focus. School Nurses were also doing a lot of work to support children to manage their asthma as they were seen to be best placed to identify the early need for support. Dentistry was also a challenge for children both nationally and in London to get access to good dental support, so the Trust were looking at how the system could work together to improve that. Dr Melanie Smith highlighted that Brent was seeing a small but real improvement in children’s oral health as a result of the Public Health Team getting more fluoride on teeth, but there were still issues in access to NHS dentistry for children, who should be seeing a dentist a minimum of once a year. A report on dentistry, optometry and pharmacy would be brought to a future Board meeting.

·       In relation to mental health, the Trust was focused on earlier intervention, where there was currently limited resource. This also formed part of the BHM inequalities work.

·       The Board asked what the future plans were for extra support in schools with funding now available for schools. Robyn Doran advised members that recruitment to the BHM team was underway to provide that extra support to schools, targeting those schools where the Trust knew there were particular issues. There was also a recognition that if schools did not get right the support for children with complex diabetes this caused challenges. The Trust were working on some case studies around this and would bring that back to a future Board meeting.

As no further issues were raised, the Chair drew the discussion to a close, asking the Health and Wellbeing Board to note the strategic oversight activity of the Brent Children’s Trust for July 2023 to March 2024. For future reports, the Board requested an expanded document that had asks of partner agencies and further information around the challenges and metrics for BCT.