Agenda item

To provide an update of the Brent Children’s Trust (BCT) work programme covering the period April to October 2024.

Nigel Chapman (Corporate Director Children and Young People, Brent Council) introduced the report, which provided an update on the Brent Children’s Trust (BCT) work programme covering the period April to October 2024. He explained that the document set out how the Trust operated and its governance arrangements. He added that, whilst it was unusual to still have a children’s trust in local authorities, Brent had retained its Trust as it was felt to be a good vehicle to ensure all issues affecting children and health related matters were contained within one place to avoid the risk that they become overwhelmed or subsumed within adult work. The BCT pulled together areas that needed greater attention and oversight. In presenting the update, he highlighted the following key points:

• During the reporting period the BCT had looked at the progress of the Thrive Programme in terms of improving and delivering better mental health services for children and young people and families in Brent.
• The Trust had also looked in detail at issues around SEND and how effectively services for children with SEND were commissioned, particularly in the health space. 
• Issues around school readiness and children having an appropriate level of development to be ready for school at reception age had also been considered.
• The fourth area the Trust had focused on was the actions being taken to deal with poor oral health and tooth decay in children.
• It was highlighted that the Trust was not solely a place for discussion but also set actions to be taken forward. Appendix B set out the current plans in place and actions against them.
• Nigel Chapman would now sit on the Integrated Care Partnership (ICP) Executive as the Corporate Director of Children’s Services to help strengthen future connections from a governance perspective.

Jonathan Turner (Borough Lead Director – Brent, NWL ICB) added that the partners within the Trust were working more closely together than ever before, taking joint ownership of issues across both the local authority and NHS together. Some of the issues surrounding SEND did involve a level of dialogue between the ICP and Integrated Care Board (ICB) as a lot of those services were delivered at NWL level, and there was dialogue surrounding where there were issues such as CAMHS.

Robyn Doran (Director of Transformation, CNWL, and Brent ICP Director) re-emphasised the benefit of integrating the BCT within the ICP structure to build a tighter interface between the ICP workstreams and children’s work. The Trust had providers and commissioners at the table, so all were responsible for delivering a better service for children in the borough.

The Chair then invited comments and questions from members, with the following issues raised:

• In noting the focus on reducing dental decay in children, the Board highlighted that this was a recurring theme reported to the Health and Wellbeing Board and was not improving in Brent or nationally. Members asked how the Board could support the improvements that were being aimed for. Dr Melanie Smith (Director of Public Health, Brent Council) responded that it would take time to see improvements in the number of children admitted to hospital for general anaesthetic for dental caries because some of that dental decay would have started up to five years before admittance. Public Health was monitoring and measuring the levels of dental decay in children, with early indications showing some improvement and a reduction in children being seen by the outreach team with dental decay. If that reduction continued then that was positive and there was optimism about the impact of that outreach, although it was too early to confirm with a small sample size.
• In relation to oral health, Dr Melanie Smith highlighted the importance of having a prevention first dental service, and felt there was more to be done to ensure that every child in Brent could access a child-friendly dentist offering preventative interventions from the moment they had their first teeth. She highlighted that dentists were working within the constraints of the national contract but she was pleased NWL ICB was addressing the issue and had retained the funding for dentistry within dentistry. She thought that the targeting of that funding could be improved with geographical targeting to areas of higher deprivation. There was also a need to continue to lobby NWL ICB to invest in dentistry and prioritise preventative dentistry within that.
• In response to when children should have their first dentist appointment, officers confirmed that Public Health advice was to take children to the dentist as soon as they had their first tooth or teeth. There was also messaging to ensure every pregnant person saw a dentist during pregnancy because it was free and dental decay could set in during pregnancy. It had also been found that once a parent had a relationship with the dentist then they were much more likely to take their child to the dentist when their first tooth appeared.
• The Board asked how likely it was that parents could get their child to see a dentist. Dr Melanie Smith responded that this was not where it should be at the moment but had improved. Children who were seen on the oral health bus were being directed to an NHS dentist that professionals knew had appointments and were confident was child friendly.
• Nigel Chapman added that BCT played a convening role in bringing together partners and could prioritise areas where there were known issues and look for solutions. BCT had used the opportunity of flagging up issues with children’s oral health as a way of bringing more schools into the space. As a result, those connections with school partners, the BCT had enabled colleagues to conduct a session for headteachers on the importance of oral health, resulting in more schools signing up for the oral health bus.

As no further issues were raised, the Chair drew the discussion to close and asked members to recognise the significance of oral health on the Brent children’s population. The Board noted the oversight activity for April 2024 – October 2024 and the work being achieved by BCT to bring partners together.