Ekta Mehta, Author at CACI

Unmet needs and data driven decisions: how Milton Keynes uses technology to support vulnerable young people

Posted on: 12 December 2023

In the first part of our case study with Milton Keynes Youth Offending Team we explored how the team uses ChildView. We examined how the system supports the team’s administrative functions such as reporting, and how the YOT is supported by CACI. In this, the second part of the case study, we sat down with Diz Minnitt, head of youth justice and support service at Milton Keynes, to look at the benefits ChildView has brought to the council outside of its office walls. How does ChildView support work with vulnerable young people in a rapidly expanding population? What tangible difference does flexible reporting bring to the YOT? How does technology help to join the dots in each young person’s journey to provide a single view of them, helping to improve outcomes and reduce elements such as reoffending? How can systems support in identifying more unmet earlier, to help with prevention?

We start by taking a broader perspective on the multi-agency approach within Milton Keynes. The MK Together Safeguarding Partnership brings together senior leaders from key agencies in Milton Keynes to agree ways to co-ordinate local safeguarding services, act as a strategic leadership group in supporting and engaging others and implement local and national learning, including from serious child safeguarding incidents. It has created an improvement in communication and accountability with the right people routinely updated.

“Working within this context has provided an opportunity for us to advocate on the part of people and families that the local authorities are working with,” begins Diz. “These are very vulnerable people and families; children in care, children in need and youth with unmet needs who are in the criminal justice system. We’re really starting to realise the importance of unmet needs and increasing our understanding of what stronger partnership working can achieve.”

Unmet needs – speech, language and communication needs (SLCN)

Following research and partnership work with the Association of Youth Offending Team Managers AYM in 2016, Diz told us about his original focus on identifying speech and language needs and developing what the YOS could do to help. “Following professor Karen Bryan’s original study in 2007, which identified 60% of children in contact with YOTs as having speech, language and communication needs, in 2008 we undertook our own four-month study with a speech and language therapist.

“We focused the assessments on key sub-groups in the service, those with repeat offending, disrupted education history or no education provision and those with suspected SEND (special educational needs and disabilities), and what we found was that 88% of these groups had significant SLCN – significantly higher than professor Bryan’s 60%.

“This was much closer to Prof Bryan’s figure of 60-90% for young people in custody, but what it highlighted was that there was a majority of those in contact with the service who had undiagnosed SLCN. Furthermore, these needs are very difficult to spot without a full assessment and hence are often referred to as hidden disabilities.

“Having effectively tested and proved the findings of professor Bryan’s academic study as a local reality in the high risk groups, particularly among young people who are repeat offenders, it was clear to me that such crucial unmet needs should inform youth justice and prevention practice across the entire system. Communication and the understanding that comes from this is key to thinking, processing, anticipating and understanding consequences. If we carried on as if children automatically have these skills, when it was clear they don’t, this was a recipe for failure carrying consequences for these children and for the rest of society.”

Connecting multiple agencies and teams

“It’s essential to reflect the importance of interconnection to this, too,” says Diz. “Most organisations, even those within the same local authority, frequently operate in siloes. They focus and prioritise the work that they need to do, that applies directly to them. However, achieving shared applied learning across the whole system to real life situations is the real world challenge and ultimately helps in achieving the goal of improving outcomes for vulnerable children.

“For example, it’s very clear that there’s an increased chance of a child with unmet needs entering the youth justice system. With the right focus this risk can be significantly reduced. Where people do not take a holistic view of this known risk, opportunities get missed and all professionals and departments don’t get the benefit from the insights and feedback that come from identification.”

Funding new projects, finding evidence

“For a new prevention project, you can only get funding once there’s a proof of concept,” explains Diz. “The SEND team at Milton Keynes initially picked up the bill for the speech and language therapy provision after the initial four-month funded period as they could see the benefits it would bring. Further funding for speech and language therapists was then obtained from NHS England, the Office for the Police and Crime Commissioner, the Home Office and most recently as part of Turnaround funding.

“This has consistently increased our screening and assessment capacity, meaning that we could identify SLCN earlier and can now clearly evidence that 88% of children and young people in contact with the service have SLCN. Milton Keynes is now one of a handful of youth justice services in the UK with speech and language therapists (SLTs) embedded in the team where an SLCN assessment is conducted by an SLT with every child.

“These assessments enable all of those professionals working with the child and their family to have greater insight, providing real opportunities for coherent, coordinated working with the child’s needs at the forefront.

“This complements the wider SEND focus and the understanding of needs arising from adverse childhood experiences amongst children across Milton Keynes. It also helps us to target interconnection with other parts of Milton Keynes’s services.”

“Like many Youth Offending Services we were in a position where we could see the impact as other services were cut due to the impact of austerity measures around funding. We had already begun to see the benefit of SLCN assessments and we had the evidence that children coming into the YJ system weren’t having their needs identified prior to contact with the YOT.

“As SEND support to schools started to be charged for we could see a nightmare scenario with the levels of children with previously unrecognised and unmet needs increasing as a direct consequence of schools being forced to make challenging decisions about how they use their reducing resources.

“To seek to counteract this predicted increase we started working with both secondary and primary schools offering SLCN assessments for their children who were at greatest risk of exclusion. With these assessments we discovered that 96% of those that schools had considered excluding have SLCN, confirming the ‘hidden disability’ impact of SLCN.

Promoting Reintegration Reducing Exclusion

“As well as providing free assessments to the schools, we also provided free specialist training around how to work effectively with children with SLCN and a host of other associated SEND needs. This removed a barrier as schools were no longer having to justify difficult choices with their budgets and enabled schools to develop better ways to support individual children and to adapt the whole school environment to enable swifter identification and support for those children with SLCN.

“This approach also supported a more compassionate way of thinking regarding challenging behaviour as we stress that, supported by the evidence, behaviour is an indicator of underlying causes that needs to be explored and understood.

“We have connected with different organisations to establish and evidence the research links and we saw more interconnects and overlaps with ACEs and SLCN. SLCN is not the only need, but its identification is frequently indicative of other symptoms of complex underlying needs. Identifying SLCN can trigger the process of further investigation.

“This overall approach is based upon our increasing knowledge of the needs that ultimately result in children finding themselves in the youth justice system. We can see clearly when this journey starts to arise and by definition the more we can go up these known tributaries to identify and meet needs earlier the more we can prevent children from being excluded from school, moved into alternative education or placed on part time timetables, finding themselves exploited or involved in offending behaviour.

“We need to use all of the information available to intelligently adapt the system collectively to identify and meet needs earlier. These children do not have the luxury of pausing, rewinding and replaying their lives if we collectively as professionals get it wrong or lack diligence and professional curiosity in our approach.”

“Childview has proved essential in enabling us to capture and extract the data needed for the evaluation of Promoting Reintegration Reducing Exclusion (PRRE) that has been undertaken by the Cambridge Institute of Criminology (CIC) in Cambridge University. The CIC are due to present their report imminently, but this was commissioned following some of the early indicators of PRRE which highlighted that we potentially see examples of unconscious adultification of children. The current systems in schools can become too focused on the behaviours without seeing beyond these to other symptoms and root causes of that behaviour. They can fail to understand reasons for the presenting behaviour and therefore can act to exclude prematurely.”

Data driven decisions

“With the introduction of the Early Support Project in 2018 we saw a 25% reduction in first time entrants to the youth justice system in its first 12 months.

“Milton Keynes is growing rapidly as a city and our resources haven’t always been tailored to match this growth. There has been an increase in gang-related activities post-Covid with an increase in the number of children coming into the system who were previously unknown to our services and those of key partner agencies. This reinforces the importance for us to act earlier.

“Milton Keynes also has a very young population which means a larger population pool of potential first time entrants into our youth justice system. Following an increase in knife related offences we developed a new strand of the ESP, ACT-Now which is focused explicitly on this area. Our ACT-Now model works by establishing direct contact with a young person whilst they are still in police custody within 90-minutes of us being contacted by the police. We then have a follow up visit with the young person and parents/carers within 48 hours to agree how we can work with them voluntarily. This has led to very positive engagement and a very low level of reoffending to date by those children who have been supported using this model. None of the reoffending to date (around 5%) has related to further knife carrying.

“The ACT-Now work has been funded by the Police and Crime Commissioner and the initial success led to the same approach being funded by him to operate in Slough and other parts of the Thames Valley area are being considered for further expansion. ACT-Now is being viewed very positively by the Home Secretary who is monitoring progress with the approach and it has recently been shared as a model of best practice amongst the network of police and crime commissioners.

“As well as significantly increasing timeliness of dealing with these offences, which is crucial for young people to understand the consequences of their actions, we are seeing improved outcomes for these young people and reduced reoffending rates.

“The cost argument is very effective for the police. Their approach is different to ours, but the outcomes are mutually beneficial. It’s cost effective and demonstrably reducing repeat offending. Reduced crime means fewer victims and we can demonstrate this from our data captured in detail in Childview.

Using ChildView to tackle capture and analyse data for tangible action points

“The Early Support Project aims to measure the reoffending rate over two years. The rate for young people who have been through the service is currently 1.81% and we have worked with c.500 young people. We know that the methodology, therefore, works. Correctly identifying needs earlier greatly improves outcomes for these young people.

“Childview has been crucial in all of this in providing the opportunity to capture and analyse significant amounts of data on the different cohorts of children covered under the different strands of the Early Support Project. For many years we have used the prevention extended functionality which we purchased. The identify tool is extremely adaptable, enabling us to add different elements for the various strands, such as new screening and assessment methodologies. We can capture data about the different elements of the project work, most importantly providing verifiable evidence around the impacts and outcomes achieved.

“Further, Childview uniquely allows life event characteristics such as undiagnosed SLCN, trauma and ACEs to be captured and used to add value to the analysis. This enables us to create rich sub-sets of our prevention data and thoroughly learn about what impact we are having and what is working. We can look at the numbers, the work we are doing that makes a difference and the profiles in our Early Support Project, Turnaround, ACT-Now and PRRE.

“We need to analyse the pathways of all these cases via logging their identified adverse and trauma life experiences as well as referrals in and out of our projects. These include referrals for SLCN, SEND, substance use and mental health. ChildView is a flexible and adaptable system that enables us to track all of our different service and project approaches and methodologies.”

Youth Resilience Project

“Our Youth Resilience Project offers one-to-one mentoring at all stages of the youth justice pathway supplementing other models through support that is available end-to-end. It can be used at the beginning of their journey, for those children just starting to work with the service or those who already engaged with us, through to those transitioning out of the youth justice system.

“ChildView’s additional functionality helps us to differentiate needs from data captured and to enquire about the ways we can facilitate targeted prevention and help to children. It enables us to build practice-based evidence and utilise this information to inform where we need to build service system capacity and capability to reduce or eliminate criminal behaviour. Having the flexibility to shape and use our data from local project work is essential to us, this helps to reveal patterns and insight from our work and therefore to evidence and highlight the resources needed.

“However, ChildView also provides a standard framework for monitoring youth justice, for example first time entrants, offending and reoffending to ensure we create consistent information about impact. We aim to always focus on improving outcomes and data is essential to achieving this. The outcomes for children are ultimately what matters.

“All members of the team can access the data and interpret it. It’s transparent and accessible across the service. Because we share a common system with many other services in Thames Valley we can share our methodologies, learning and customisation with other youth justice services. This helps us to pool and build knowledge and approaches to improve outcomes for children in our domain.”

How do ICBs successfully prepare for future changes in costing?

Posted on: 27 November 2023

Integrated care boards (ICBs) were born to bring the NHS together locally to improve population health and establish and achieve shared strategic priorities. Although ICBs are vital to the future delivery and improvement of healthcare systems, their introduction has not been without hurdles.

Earlier this year, NHS England challenged ICBs to reduce their running costs by at least 20% in 2024/25 and 30% by 2025/26. This comes with heightened challenges of digital and data not being prioritised at board level in most areas, with only 38% of ICBs having an Executive Director focused on digital, data or intelligence.

With fast-approaching deadlines to meet, what can ICBs do to cut costs no matter the comprehension level of digital or data?

Where can ICBs make savings?

Reallocating & distributing funding

To supply optimal patient level care, ICBs must be equipped with an optimal patient level costing solution. Now more than ever, it is critical for ICBs to work with NHS providers to create a single view of population and personal health and collect and utilise high-quality data to drive cost efficiencies. ICS leaders remain concerned about funding available for patient treatments and recognise that this is essential to uphold the sector’s productivity. NHS funding has always been focused on treating single acute illnesses and single chronic conditions or injuries rather than preventing them. It is now more focused on treating the whole patient and considering the prevention agenda.

To direct patient treatment funding to the most effective setting, ICBs must innately understand the cost of each patient pathway across all settings in the system.

Organising critical data for optimal use

When it comes to organising critical data, it is integral that ICBs have a strong working relationship with local governments, providers and the VCFSE sector to faciliate this. A framework of data sharing standards should also be developed to achieve enhanced interoperability and data sharing across organisational barriers to further encourage cost efficiencies.

Third-party support to meet priorities and achieve strategic objectives

ICBs unite stakeholders across the healthcare sector to address immediate and long-term priorities and challenges to improve health outcomes. Effectively addressing this requires ICBs to enhance their self-sufficiency and self-improving systems by working with the NHS and third-party partners to develop robust shareable models and fine-tune skills locally. Considering this, ICB leaders are continuously seeking out new opportunities ways to leverage system providers’ skillsets and contributions, and remain positive about system providers’ commitment and contribution. Increased self-sufficiency and self-improvement will also free up NHS funding for ICBs to better address priorities and challenges.

Data sharing

While ICSs exist because of collaboration and partnerships between their providers, sharing usable data between the providers isn’t straightforward. If ICBs could safely and securely share data, connect data and run true system data analysis from required data sources, they would be able to accelerate their work in various activities from improving patient and staff care and outcomes to optimising the productivity of the wider health and care system at cost.

Delivering training & knowledge sharing opportunities

ICBs have been strongly encouraged to enhance their existing peer review processes to allow for inter-ICS benchmarking, best practice sharing and accountability strengthening to drive cost efficiencies. NHS Trust leaders have felt incredibly positive about ICBs’ role in fostering a sense of shared responsibility and collective endeavour among system partners, their collective problem-solving abilities and their sharing of practices on patient care and outcomes are key to future system and healthcare improvements.

Making the future of costings successful with CACI

Although the journey towards cost efficiencies for ICBs undoubtedly comes with hurdles to jump, CACI’s expert team are equipped with the necessary industry knowledge and experience in data transformation to support and enable a revolutionary journey to a successful SMART result.

To find out how we can help prepare your ICB for a successful journey, please contact one of our experts, Susan Brooks.

The benefits St. Helens Youth Justice Service realises from CACI’s fully managed hosting solution

Posted on: 24 October 2023

St Helens Youth Justice Service has been using ChildView from CACI for over 15 years. In May 2020 it decided to utilise CACI’s fully managed hosting solution to support its work. In this case study, we speak to Helen Williams, St Helens Youth Justice Service’s Information Officer about why the council decided to use the service and the benefits that it has brought about.

“One of the main reasons we decided to use the fully managed hosting service was to take the burden off the council’s internal IT department,” explains Helen. “Previously, any upgrades and issues went through that department. Being the council’s team, they are always very busy. We had to log issues with the internal helpdesk and take it from there. Given the scope of the council’s operations and the fact that we’re a small part of it, it often depended on who you got to speak to within the IT team as to whether they would fully understand the software and the problem. Now, when we go through CACI’s helpdesk, we know that we’ll be speaking to someone who fully understands the software and can help us immediately with the problem.

“Another factor was storage and server space. We hold a lot of data and this was taking up a lot of space in the council’s server room. The council was trying to reduce the number of servers it was hosting internally, so the offer from CACI to host our data was an appealing one. This also meant that we were able to utilise CACI’s security arrangements, whilst at the same time reducing the amount of space we were taking up in the council.”

Security was another factor for St Helens Youth Justice Service. CACI meets rigorous international security standards and is routinely tested to identify potential weaknesses. This enables customers to leverage CACI’s security spend in protecting their own data.

“We recently suffered a cyber-attack at the council which shut down most of our systems and we, as a council, lost access to a number of databases,” says Helen. “Because ChildView is hosted separately, however, we were still able to access the system and our data. This meant that we could continue to focus on our work, improving outcomes for the young people in our services.

“It also highlighted that we always have easy access to our data. I can grant access to the data to other people as required very easily and securely. The data works across other systems that we work with, too, making it easy to call upon and rely on.”

Efficiency is often a buzzword in local services. How can it be achieved? St Helens Youth Justice Service no longer has to wait for internal mechanisms to be run before upgrading ChildView or resolving any issues in the system. “Everything is much quicker now,” says Helen. “Any updates that we need are scheduled and done, there’s no hassle.

“Previously there was a lot of back and forth on available dates and when would be best to conduct the updates. Then there were times when our internal IT team were unsure of exactly what they needed to do. It’s now just much quicker.”

“It’s the same as the CACI helpdesk. I can grant them remote access to my desktop and they can fix issues instantly. There’s no more logging the issues with our internal IT department and hoping that someone can fix it quickly. It just gets done now.”

Finally, there’s the issue of cost benefit and cost efficiency. “The people operating above us, who sign off on expenditure such as this, can see the value in the service and are supportive of us using it, so there has been no issue on that front,” concludes Helen. “We have to justify the value, of course, but in terms of security, data access and space saved, it satisfies this. Our council understands the cost benefit of this and we’ve got support for it internally.”

For more information on how CACI’s fully managed hosting service supports youth justice services, please click here.

What do you get from your education software provider?

Posted on: 5 October 2023

The education software and integrated systems that you use to underpin your education services and processes are vital to the effective and efficient operation and oversight of your services. From early years to admissions and transfers, SEND/ALN to virtual school services, technology plays a fundamental role in efficient, effective and fair educational services to meet increasingly complex objectives. But what are your services getting from your software providers? From initial training through to ongoing support and maintenance, your providers play an important role themselves in sustaining your services.

Selecting the right technology means selecting the right partner. It’s not simply a case of buying a system and then switching it on. There’s an implementation to be planned and programmed, data to be exported, cleansed and imported. Then there are ongoing support needs and updates required over time to keep the system secure, compliant and supporting your evolving needs.

Getting started with your education software

Once a decision has been made, how are you going to get your team up to speed with your new education software? Ensuring that training is included in the procurement process is essential. So too is agreeing costs for any extra sessions, such as training and development.

Running parallel to this is ensuring that the configuration of local process covers everything you need. We’ve seen many cases where authorities have purchased the minimum viable product to meet procurement thresholds. They’ve then found layer upon layer of additional cost once they’ve gone live. These costs cover anything from additional infrastructure to third party licence agreements in order to get the system working.

Understanding these hidden extras can greatly help in gaining a more accurate cost of your education software. Building upon minimum viable products can be timely as well as expensive. Mapping this all out can minimise friction and disruption upon implementation. Better still, identifying a partner which has the experience and capability to work with local issues out of the box brings everything into scope upfront. Understanding how ongoing changes will be managed further helps to achieve your objectives over time.

How will your education software be updated?

Another issue we see repeatedly is the downtime associated with upgrades and maintenance. This covers everything from enhancements to the software to critical security patches. Standalone systems can help with this. They can help in greatly reducing the time your software is unavailable for. Any necessary work can also be conducted at times that best suit you.

Where your education software is linked to another piece of software within the same suite of products, updating one facet requires the downtime of everything else, too. So, for example, if your education software provider needs to update another system that is entirely unrelated to education and the work you do, but sits on the same architecture, it will mean that your software will be unavailable whilst their systems are updated.

IMPULSE Nexus – what you see is what you get

CACI has designed its IMPULSE Nexus education software to suit the needs of local authorities like yours. It is modular by design, so you can pick up and plug in the parts that you need. This means you’re free to use as much or as little of IMPULSE Nexus as your needs require.

All our pricing is upfront and transparent. You don’t have to pay for the bits of the software that you don’t need. This helps you manage your overarching software ecosystem that can use IMPULSE Nexus as part, or the heart of it.

Like everyone else, we do conduct upgrade work to IMPULSE Nexus. As a standalone system, however, we can work with you on the best time to conduct these. There are three every year, so there’s always advance warning and time to make arrangements. We also offer a hosting solution which means that we can carry out these upgrades for you as a fully managed service. This further reduces friction and minimises downtime.

Furthermore, as IMPULSE Nexus is a standalone system, any upgrade work won’t impact your integrated systems.

Where you need further support from the team at CACI, our costs are transparent and upfront. Our annual advisory service (AAS) days are bookable in advance or as and when you need them. These are designed to help you with everything from project management to additional training. You can find out more here.

IMPULSE Nexus is used by authorities across the UK, including Birmingham City Council. You can find out more about how it uses IMPULSE Nexus to handle its admissions process here.

If you would like more information on IMPULSE Nexus, please visit our website here.

Trauma informed practice – how a West Midlands coalition is changing things

Posted on: 20 September 2023

The idea of trauma informed practice has been around for a while now (SAMHSA 2014). It remains, however, a burgeoning area of practice. The West Midlands Combined Authority (WMCA) is attempting to take this forward into commissioning policy. Through a coalition of public service agencies, it aims to promote a framework for trauma informed practice in the region. Knowledge, practice-based evidence, data sharing, combined training and service inputs will set new pathways towards achieving better outcomes for all children in the region.

“Trauma informed practice is a journey, not a destination,” says Lucy Cavell Senior Trauma Informed Practitioner at Barnardo’s, the children’s charity which is coordinating the work of the WMCA trauma informed coalition which sets a policy direction. “There are different approaches in the seven constituent local authorities. For example, Birmingham City Council has a slightly different flavour to other organisations, having taken a holistic approach to training around trauma informed practice within children’s services and schools.

“We’re creating a community of practice on behalf of the coalition. There’s a sharing of knowledge and of best practice being implemented. The coalition is a reflective space with strategic support for locally based networks. It accepts the regional differences in localities such as Birmingham, Coventry and Wolverhampton, but it’s still early days, we’re still learning, gathering knowledge and promoting connections and promoting building the evidence base.”

Trauma informed practice in the West Midlands

The WMCA trauma informed coalition was established in 2022 in response to Punishing Abuse, to develop trauma informed practice in the localities. It includes the West Midlands police force, public health, primary care, local authority children’s services, schools, faith groups and charities including homelessness, temporary accommodation, drug, alcohol, domestic violence and mental health. The trauma informed coalition is borrowing from the learning about violence reduction and service developments in Scotland and other regions, such as in Wales, aiming to adapt this to the history and demographics of the WMCA.

“We saw the potential in being involved in such a coalition and the benefit that it can bring to so many vulnerable children,” says Lucy. “Punishing Abuse is a powerful piece of work that demands action. One of the primary barriers to this is siloed short-term responses. Services interact with children in the way that they see as being most appropriate and that makes sense to them. Children move in and out to other areas of the regional system with unseen and unmet needs and are dealt with in an entirely different way.” The importance of a more optimal and joined-up approach which is able to consider much more of the individual context of each child’s journey is something we’ve written about previously.

“One aspect has been the simple creation of training material to promote trauma informed practice,” says Lucy. “We’ve seen real leadership buy-in from the police, with training delivered to over 2,300 officers and staff so far. This covers the basics, from psychology and behaviours to appropriate skills in formulating partnership responses. This has seen a much more compassionate response from the police towards children, young people and families and their communities. Simply by understanding their behaviours differently it has increased the window of tolerance in police settings.”

What the future will bring

There is no blueprint for trauma informed practice and it remains a development area of work with vulnerable young people and their families. As Lucy outlines, there is no one-size-fits-all approach that will work.

“We hope that establishing a trauma informed framework via the coalition will at least set us on the path to end the punishment of abuse,” concludes Lucy. “The goal is to commission interventions that facilitate systemic resilience. Of particular interest and relevance to establishing a consistent unified approach across Educational settings is the Trauma Informed and Attachment Aware Schools regional certification model, informed by the work of ARC, Virtual Schools, Educational Psychology Services and Barnardo’s in the region.

“At the heart of the coalition is the intention to engage with adversity and trauma in regional localities to meet needs in an optimal way. Further, to promote evidence from effective collaborative partnership practice by capturing, monitoring and sharing relevant data and the context of individual, family and community adversity and trauma ethically. The objective is to make smarter service commissioning investments for the longer-term future of the region. There will be a need to step back to see what works and what doesn’t. It is, after all, early days.”

In the second part of this blog series, we will take a closer look at what success looks like for the WMCA trauma informed coalition.

Johnny’s Story – the importance of early intervention and trauma informed practice

Posted on: 11 September 2023

Not so long ago CACI produced a video titled Walk in Their Shoes: Johnny’s Story. You can watch it here. It follows the typical journey of a young person brought up in adverse circumstances, tracking a story everyone involved in youth justice and many in education will be familiar with. The relentless churn of life, the destructive tendencies this realises then the horrific prospect of where this can, at its worst, lead. The topics of early intervention and trauma informed practice crop up often, but how much ground has really been covered?

Yesterday’s issues still exist today. School exclusions still happen as a result of schools being ill-equipped to manage the manifestation of trauma in such children as Johnny. They move from school to school, home to home, experiencing instability at every turn. This leads to disjointed record keeping and tracking of their journey. Different schools approach things in different ways. The transition to different local authorities results in intervention from different youth justice teams. This means more people coming and going and the going over of old ground.

How can trauma informed practice change Johnny’s Story?

It’s one thing realising an issue, quite another solving it. To fully understand the journey that any young person has been on, joined-up record keeping and a consistent thread of information is vital. As the young person moves from school to school and/or area to area, it is important that their information is appropriately shared with their next school or local authority. If it’s not, context is lost. Trauma informed practice is impossible without knowledge of events in a young person’s life.

Joined up record keeping is crucial in even the most vanilla of journeys. Where youth justice teams are involved, the context of the journey is even more so. If a young person arrives with limited information, then it necessitates the going over of old ground with them. Repetition of questions limits responses and creates mistrust in the services that are there to help them improve their outcomes. This limits the opportunities for trauma informed practice.

YOTs are seeing just over 8,000 new children (aged 10-17) entering their services every year. Consistent and reliable record keeping helps them to process these vulnerable young people. Services can then focus on achieving the best possible outcomes for them.

The most dramatic aspect of Johnny’s Story, of course, is the fact that he commits a murder. Thankfully, this isn’t a common occurrence, but young people possessing weapons still is. There were just under 3,500 knife or offensive weapons offences in the 2021/22 reporting period. This shows the prevalence of young people in vulnerable positions carrying weapons that can result in loss of life. As Johnny’s Story serves to highlight, such weapons are carried for protection rather than intent, but it only takes a moment for that to change.

Are things heading in the right direction?

The good news is that the number of such offences – the carrying of offensive weapons – has fallen from a high of 4,500 in 2017/18. Similarly, the number of new children entering the services of YOTs has fallen 10% year on year and is down 78% on the 2011/12 period which saw a record high. There has been a steady downward trajectory ever since.

Whilst these are encouraging figures which clearly demonstrate that the hard work of YOTs, local authority leaders and police is working, there are other areas of concern.

The latest data published 18 May 2023 by the government shows that, “Local authorities identified an estimated 94,900 children missing education, that is not registered at school or otherwise receiving suitable education, at some point during the 2021/22 academic year.” Estimates, however, vary as to the exact number depending upon differing definitions of missing school, as you’ll see in the National Youth Agency document in the next section.

This is another area where joined-up thinking and a consistent and reliable thread of data are vital. Local authorities have an obligation to check up on children who are not being educated at school and are being electively home educated. Schools must inform the authority if a child is excluded, so there is an onus on the authority to follow up on such cases.

It is clear that many are falling through the cracks. The Covid pandemic undoubtedly played a role, with many children not turning up again when children returned to schools in September 2020. This leaves such young people open to the threat of exploitation.

How young people like those in Johnny’s Story can become exploited

The most prominent of this exploitation is County Lines drug dealing activities. Gang activity is central to Johnny’s Story and is something that offers many vulnerable young people an identity and a perceived escape from their position. Exact numbers are impossible to come by, but notable estimates exist as to how many young people are involved in County Lines activities.

The National Youth Agency summarises the estimates on page four of this document. They cite data from the Home Office that c.27,000 young people are involved in County Lines, with The Children’s Society estimating that 4,000 of those are in London alone. Of course, estimates again vary here. The Children’s Commissioner noted in a Channel 4 documentary Britain’s Child Drug Runners (sadly no longer available on the channel’s streaming service) that 50,000 children are involved. Either way, it’s an unacceptably high number and represents a significant challenge.

Early intervention is vital in improving Johnny’s Story

The advantage of a joined-up record extends beyond the individual. Identifying patterns from a culmination of journeys can play a crucial role in early intervention. By the time vulnerable young people are involved in activities such as County Lines, it’s all but too late. Identifying their vulnerability in advance of reaching that stage is where stories such as Johnny’s can really be turned around.

Technology is fundamental to this. Where manual records are kept, information becomes siloed into teams and, worse, individuals. Maintaining transparent, up to date records helps keep YOT workers and their teams informed of each journey of each young person in their services. Then, if they move on, either the worker or the young person, the record can be shared with the next YOT worker involved in the case, furnishing them with knowledge and understanding of that case straight away.

Systems such as CACI’s ChildView facilitate the full case data transfer of files when a young person moves on from a service. This means that their next locality has vital context regarding the case immediately. YOTs working in tandem with one another creates a rich tapestry of information at an individual and holistic level. This will help to inform one another of best practices and create data mapping that can be used to inform better practice interventions in the future.

Conclusion

Johnny’s Story is grimly familiar to so many of you. Maybe not all of it, but so many vulnerable young people have experienced at least part of it. From constantly moving home, having different adults in their lives all the time, failing to settle at school and getting shunted from one to the other, lashing out in the form of petty crime and damaging public property, to seeking identity and purpose in gang-related activities; it is a very easy trap for them to fall into.

The good news is that things are improving. There is greater awareness of the issues facing these young people and the burgeoning area of trauma informed practice, for example, promises a better informed future roadmap of service responses. Each authority needs to be interoperable with every other, however, to truly open the door to fully informed practices and services.

Technology will facilitate this. In order to avoid the constant repetition of Johnny’s Story, it’s vital that authorities and YOTs embrace the possibilities.

For more information on ChildView, please click here.

SEND safety valve funding and the aim of inclusivity and integration

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Government bailouts to the tune of £1bn are ensuring that councils across England can cut their deficits. In return for this SEND safety valve funding, a focus on inclusivity of educational services to children with identified special educational needs and disabilities (SEND) is demanded. The move is designed to move councils away from a reliance on costly special measures educations. With inclusivity, it is expected that children with SEND will be reintegrated into mainstream school settings. Those who have been previously excluded, will be reintegrated into the mainstream setting.

The packages and fine print are different for each council, but these are the overarching themes. Councils are expected to work towards inclusion and integration, whilst being more accountable for their processes. How can councils achieve this?

The role of technology in supporting SEND safety valve funding

In creating transparency and accountability, technology will be fundamental to councils. As part of many of the safety valve funding bailouts, the government expects to see results. Maintaining manual systems of spreadsheets or paper-based notes is inefficient and ineffective. Being able to call upon robust digital records with every course of action mapped will save time and create much needed transparency.

Education, health and care plans (EHCPs) are also central to the SEND safety valve funding aims. It is important that each child who needs one receives one. One complaint across the board has been the inconsistency of the provision of this service across England. It has become something of a postcode lottery. Reshaping EHCPs was a central component of the SEND Review in 2022. The safety valve funding provides another opportunity to meet this challenge.

An aspect of this is early intervention. Many children go with unmet needs for a long period of time. This can result in behavioural challenges, exclusions and even entry into the youth justice system. A study by the National Institute for Health Research in 2021 found that 60% of children entering a youth justice service had an undiagnosed developmental language disorder (DLD).

Applying special measures later down the line is a costly process both financially and societally. Early intervention is a vastly preferable way of handling such issues.

Technology will support councils in monitoring their work in all these areas. EHCPs require a robust and consistent thread of attainment and information that will follow the child from 0-25. How children are included and reintegrated will also require input from several touchpoints such as parents, schools and professionals. Creating a central data hub for each child will make provisioning for their education easier. It will also make evidencing action points straightforward.

How SEND safety valve funding will improve inclusion

Primarily by building capacity in mainstream schools, thereby reducing the dependency on specialist provision. The SEND safety valve funding is there to directly support this, providing additional support in mainstream schools to support children with SEND.

This can cover EHCPs, too, with identified SEND on the increase as awareness of unmet needs increases. Having the administrative capacity to oversee EHCPs for every child with SEND is a challenge. Again, this is where technology will play a crucial supporting role for councils and their educational facilities.

Of course, specialist provision will still be required in some circumstances. Rather than use it as a go-to, however, the government would like to see a reduction in this. Creating a strong base of evidence, with all of a child’s records and professional inputs, will make it easier for schools and councils when demonstrating why such a course of action has been taken.

How SEND safety valve funding will support integration

In a similar way, SEND safety valve funding will support integration and reintegration. Exclusions happen but understanding why is paramount. SEND safety valve funding won’t eradicate exclusions and there will be circumstances in which they are necessary. When a child is excluded, however, having the context around their journey can help to inform next steps. Where there is SEND and unmet needs, can a child be reintegrated into a mainstream school environment where extra provisions have been arranged?

For reintegrating previously excluded children, a robust data source is imperative. Why was the child excluded? What were the circumstances? What are the circumstances in that child’s life? Were there any unmet or undiagnosed needs? Can new arrangements satisfy their educational needs within a mainstream setting?

This is a topic we’ve explored in a previous blog. The role of councils and schools in gathering accurate and reliable data is important in understanding not only a child’s educational journey, but their circumstances beyond the school gates.

Conclusion

SEND safety valve funding offers councils and schools an opportunity to recalibrate their services. And their approach to children displaying challenging behaviours. Understanding these behaviours and enacting early intervention will help prevent exclusions and improve inclusion for children with SEND.

Deploying a robust technology ecosystem will be crucial to the success of safety valve funding and councils and schools meeting the challenges laid before them. Joining the dots between a child’s circumstances and their education will drive understanding. This, ultimately, will determine the success or failure of safety valve funding. Deploying improved SEND provisions is one thing. Evidencing their effectiveness and meeting the goals of inclusion and integration are another. A strong evidence base will further drive understanding of those measure which work and those which do not.

For more information on how IMPULSE Nexus from CACI can support your education services in meeting the challenges laid out in the safety valve funding initiative, please visit: https://www.caci.co.uk/software/impulse/

How InView regenerated Croydon Health Services’ data capabilities

Posted on: 18 August 2023

Background:

Croydon Health Services NHS Trust is a mid-sized hospital in Croydon that provides acute and community care through services and departments ranging from A&E, adult and paediatric critical care to outpatient and inpatient treatment and community services.

Prior to partnering with CACI over a decade ago, the Trust did not have their own data warehouse. Their in-house and bespoke systems were built using tools like Microsoft Access and SQL Server, which challenged their ability to load their structured data properly and time-efficiently. As a result, the Trust conducted a tender to enlist support for this, and after gauging the simplicity and ease with which CACI could help them meet their data warehouse optimisation needs, established a partnership.

Challenge:

Croydon Health Services’ entire in-house, bespoke system had been run by one person. This presented a risk to the organisation, particularly in the event of any changes made to statutory submissions or to the Healthcare Resource Group (HRG).

Husein Kermali, Head of Information Systems at Croydon Health Services NHS Trust, explained the Trust’s thinking in opting for a more organised route that would guarantee their protection by working with an organisation as opposed to an individual to oversee the entire system.

“One of our reasons we chose to go with [an organisation-led] warehouse in the first place was so things like the HRG group, the statutory submissions and anything that comes online from us from an NHS perspective would be something that we knew that warehouse would be capable of delivering.”

Solution:

The Trust implemented InView back in 2011-2012 as a one pass system. CACI created Extract, Transform & Load (ETL) processes through InView based on pre-existing system knowledge and an understanding of what Croydon Health Services endeavoured to do with their data from the point of partnership.

A few years later, in conjunction with their existing data provider, the Trust went from PIEDW extracts to Nautilus 835 extracts, which resulted in CACI taking over a significant amount of the ETL process for the Trust. The positive working relationship between the Trust and CACI built up the Trust’s confidence in the difference CACI could make for their data processing capabilities.

“We know that CACI is always there when we’ve got issues, we know that [CACI] knows the detailed processes very well. [CACI] also work for a multitude of Trusts… so they know they’ve seen all the issues that we’re having in other Trusts, and what all the Trusts are trying to do,” Husein explained. “I think with that kind of vision, [CACI] can see a lot more than we can. I think that makes CACI a great partner to be with.”

Results:

When the CDS010 was retired and 011 E CDS came online a few years ago, Husein flagged that “if [the Trust] did that in-house, that would have been a lot of work.” According to Husein, CACI had the extracts ready for this through InView, CACI’s modular data platform, easing Croydon Health Services’ involvement in the process.

“With the simple product upgrade of InView, [CACI] had all the elements within their product already. We just had to populate the fields that we needed. The output that was delivered was then ECDS 011 compliant, which saved us a lot of time,” Husein continued. “[CACI] did all the testing… we just had to make sure that we filled in the elements that we needed for the easy desk submission, so that was amazing because it saved a lot of time.”

Croydon Health Services has also benefitted from being involved in the ETL process throughout its development by CACI. The supplementary documentation provided at the end of any piece of work with CACI has given the Trust unrestricted access to changes made through InView or ensuring that everything they wished to capture had indeed been included.

The Trust has applied their learnings from CACI’s processes to successfully implement their own data quality (DQ) reports and dashboards that highlight potential problems and look up issues through a warehouse load process. The processes followed by their Data Quality team have also ensured that when data now goes through to the data warehouse, those issues disappear.

How Synergy4 simplified the merging of two Trusts into Black Country Healthcare NHS Foundation Trust

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Background:

Black Country Healthcare NHS Foundation Trust is a provider of mental health, learning disability and community support services. Following the merging of the Trust with Dudley and Walsall Mental Health Trust in 2020, Black Country Healthcare Trust was tasked with combining two vastly different costing systems and strategies into a singular costing service and line reporting system. This proved to be no easy task, as Dudley and Walsall’s costing system was Synergy3, while Black Country Healthcare Trust had their own bespoke internal system. The differences between the Trusts’ costing of their services further amplified these difficulties. However, a pre-existing contract with CACI proved to be the key to streamlining this uniquely complex circumstance.

Challenge:

Merging two Trusts into one. This major change came with extensively different processes that had to be identified and differentiated. Unifying two teams also proved to be extraordinarily difficult for the Trust while keeping up with the demands of day-to-day tasks.
Learning a new system. The different systems that the Trusts were on and the necessity to quickly move to a new, singular system was a colossal change for the team, with its difficulties augmented by the substantial changes made to costing methodologies.
Adjusting cost centres within the Trust’s childhood account. This included adjusting the lengths, descriptions and meanings of the cost centres to ensure information remained correctly organised and that no information relating to either Trust was removed.
Maintaining cohesion while importing. When running imports through the Trust’s activity or costing data, ensuring all elements were executed sequentially proved to be difficult.
Meeting reporting and national costing deadlines.

Solution:

CACI equipped Black Country Healthcare Trust with Synergy4, a comprehensive patient level information and costing system specifically designed for the NHS. This system made the environment available for the Trust to work with two separate methodologies throughout the transitional merging period and securely organise pre-existing child accounts and allocation methods. Through Synergy4, the Black Country Healthcare Trust could deliver accurate patient-level costing and accurately report on findings. CACI was also tremendously understanding of the Trust’s unique merging circumstances, which simplified the complex transition of unifying two systems into one.

According to Mandip Bal, Lead Costing, Reporting and Finance Systems Accountant at Black Country Partnership NHS Foundation Trust, “The support and understanding offered by CACI was substantial, which enabled us to transition onto that new system.”

CACI supplied unwavering training and support to the Trust throughout the entire project and merger, ensuring that the Trust was well versed in Synergy4’s functions. This support was crucial for the effective translation of knowledge with consultants, which began with a paper written by CACI outlining how the costing journey would progress throughout the merger.

“Upon reading [this paper], I was in immediate agreement from our Trust,” Mandip explained. “We were able to confidently advise on the seperation and visualise how the model would merge into one following the merging of the Trusts.”

Results:

Operating two unique systems was highly complex, and the impact that CACI’s support had on the transition period and successful merging of the two Trusts did not go unnoticed by the wider business.

“Working with [CACI] is always very pleasant… The support available along with the helpdesk, especially at the project implementation stage, was helpful,” Mandip explained. “After we went live, the support desk was particularly helpful for the business. Whenever I’ve asked questions or enquired about different developments, CACI has always offered solutions or more information. I can deal with everything now through CACI, so quite a few efficiencies in terms of administrative tasks were achieved as well.”

The Trust now confidently runs a single system and has consistently met reporting and national costing deadlines as a result. Following updates made to the National Cost Collection guidance, CACI also ensured the Trust’s system was up to date to further assist with minute details amidst the transitional merging period.

Future:

Black Country Healthcare Trust is keen to explore new developments to Synergy4 as they become available and continue to receive CACI’s support to further enhance their system in the coming years.

How Tameside Council uses ChildView’s full case data exchange functionality

Posted on: 14 August 2023

Tameside Council has been using ChildView from CACI since 2014 to support its vital work in supporting vulnerable young people across its services. One specific area of functionality within ChildView that Tameside Council finds particularly useful, is the full case data exchange.

The full case data exchange functionality enables Tameside Council to share and receive all the data held on a young person’s case. “It was taking so long to manually input the data associated with a full case,” explains Louise Hope, data and analysis lead. “Our business support function has been getting busier, with more work in referrals meetings and taking notes, resulting in less time for admin tasks such as this. We put together a business case for using the full case data exchange functionality and implemented it.

“Essentially we wanted to save time. It has also helped us to improve the accuracy of our data; the data otherwise is only as good as the person inputting it. If they make mistakes and miss things, then our data is poorer as a result.”

The full case data exchange functionality in ChildView enables youth justice services to send and receive all the data recorded on a young person with other youth offending teams (YOTs) using ChildView. If young people move services, then their record can move with them. “We use it to send and receive cases with other YOTs,” says Louise. “We would like to use it for everything but have found that there is some confusion around the process with other YOTs, whereby they only send us the asset rather than the full case. Once other YOTs understand the process, it will improve it further.”

One of the main benefits of the functionality is to save time and improve efficiency. At a time when services are getting busier, this is a helpful facet of the full case data exchange. “Absolutely we’ve saved time through using the functionality,” says Louise. “Although it’s tough to say exactly how much time because each case is a different size. I would say, however, that we save at least a couple of hours on a standard case. Also, if the data is being input manually, we would never ask someone to add all contacts, for example; they would be attached as a pdf. So, we get a richer base of information whilst saving an average of two hours.”

A richer base of information helps YOTs to pick up information more easily and understand the context and nuance of a young person’s journey. Where information gets lost or incorrectly recorded, vital information disappears with it. “It’s certainly beneficial to have all of the information and all of the contacts,” concludes Louise. “Having a rich seam of data makes it much easier to find information, too. Then, you can see where that information has come from, with an evidence base and contacts of who recorded what. If we have any questions, it makes it very easy to follow up with that person. There’s also increased confidence in the data that we have as a result of the improved accuracy of the data being added to our system. With accuracy and a trail of contacts, it makes each young person’s journey more transparent to us.”

For more information on how ChildView supports the vital work of youth justice teams across the UK, please visit: www.caci.co.uk/childview