20 Apr 2012

Vulnerable children ‘need the best possible start’

The social and emotional wellbeing of vulnerable under-fives should be at the heart of early intervention services, according to draft NICE guidelines published today.

The social and emotional wellbeing of vulnerable under-fives should be at the heart of early intervention services, according to draft NICE guidelines published today. (Getty)

Draft recommendations issued for public consultation by the National Institute for Health and Clinical Excellence focus on the importance of better coordinated strategic and local early years services.

They propose a series of interventions designed to identify early vulnerable children, such as those living with parents with mental health or relationship problems. Key recommendations include –

• health and wellbeing boards should ensure that the social and emotional wellbeing of vulnerable children is recognised as an effective way of addressing health inequalities
• health and early years professionals should develop trusting relationships with vulnerable families
• women in need should be offered a programme of home visits by specially trained professionals
• health visitors/midwives should consider using interactive video to improve maternal sensitivity, mother-infant attachment and the child’s behaviour
• children should have the opportunity to attend high-quality childcare and early education services
• in early education, those involved should ensure vulnerable children have the chance to attend high-quality pre-school education

NICE’s Professor Mike Kelly said: “We feel they have the potential to make a real difference to ensure all children get the best possible start in life.

“As always with our draft public health guidance, we welcome and encourage comments from stakeholders and look forward to receiving feedback. This will help us to shape our final guidance, which we expect to publish in October this year.”

But some are concerned that it will be difficult to reconcile the ambitions contained in the guidelines with the reality of cuts to children’s services.

“My first reaction is that all sounds lovely. But on the ground, a lot of these services are being cut. Children’s services often are under the cosh, particularly services where there’s great need,” Alison Roy, lead child and adolescent psychotherapist for East Sussex, told Channel 4 News.

Thinking of the Baby P case, one of the findings was that there weren’t professionals observing the distress of the child. Alison Roy, child psychotherapist

“I’m aware of child and adolescent mental health services where provision to the most vulnerable children and families is severely stretched. When this comes in, that’s all great – but what I’ll be interested in is how they’ll match those ideals and clear statements with providing services.

“And we should make sure that people have the right kind of training to pick up on those dual needs of the young child and parent. Thinking of the Baby P case, one of the findings was that there weren’t professionals observing the distress and communications of the child.

“Effective training can really bring some insight into what’s going on for the child – but also for the parent.”

The National Institute for Health and Clinical Excellence is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health.

The public consultation process over the draft guidelines published today will take place until 15 June 2012. Final guidance is expected in October 2012.