Early help for children and families

  • Richard Selwyn
    Richard Selwyn FRSA MEng Independent Consultant. Conflicts of interest: previously employed by Birmingham NHS CCG, Ministry of Housing Communities and Local Government, and Suffolk County Council. Currently under contract to Oldham Council
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Published:January 04, 2022DOI:https://doi.org/10.1016/j.paed.2021.12.002


      Prevention is better than cure. Early help for children is the total support that improves a family's resilience and outcomes, or reduces the chance of a problem getting worse. Early help has been likened to a fence at the top of the cliff, rather than the ambulance at the bottom. However, many healthcare systems have tended to under invest in services that reduce demand to acute services. In the UK it has been difficult to plan a whole system approach to early help across a local area. Austerity and the COVID-19 pandemic have brought further challenges to disadvantaged families, NHS, local authorities, police, schools and other local partners. However, a new model of early help is emerging, in collaboration with partners, with communities and with families. By pro-actively reaching out and compassionately supporting families before their needs escalate, through a new category of service delivery, we are able to reduce future demand as well as providing more human engagement and help. This paper includes an overview of early help design, emerging changes that paediatricians will contribute to in their localities, the national vision, and an example from Birmingham Children's Partnership that shows how an early help response supported families through the pandemic.


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      1. Allen G, MP. Early Intervention: The Next Steps. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/284086/early-intervention-next-steps2.pdf.

      2. Munro E. Munro Review of Child Protection. www.gov.uk/government/publications/munro-review-of-child-protection-final-report-a-child-centred-system.

      3. HM Government. Troubled Families: early help system guide. www.gov.uk/government/publications/troubled-families-early-help-system-guide.

      4. Ackoff R. Systems Thinking. http://environment-ecology.com/general-systems-theory/380-systems-thinking-with-dr-russell-ackoff.html.

      5. MHCLG. Building Resilient Families: Third annual report of the Troubled Families Programme 2018-19. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/790402/Troubled_Families_Programme_annual_report_2018-19.pdf.

      Further reading

      1. Birmingham Children’s Partnership, Vision for Children & Families, www.localofferbirmingham.co.uk/professionals-and-education-settings/birmingham-childrens-partnership/birmingham-childrens-partnership-vision-for-children-and-families/.

      2. Early Intervention Foundation, The cost of late intervention, www.eif.org.uk/report/the-cost-of-late-intervention-eif-analysis-2016.

      3. Powell T, House of Commons Library, Early Intervention briefing paper, https://researchbriefings.files.parliament.uk/documents/CBP-7647/CBP-7647.pdf.

      4. Selwyn R, Outcomes & Efficiency, www.amazon.co.uk/Outcomes-Efficiency-Leadership-Richard-Selwyn-ebook/dp/B007QE3LB8. Blog at https://richardselwyn.org.