Improving the health of our most vulnerable families is one of the most complex, but potentially rewarding challenges we face. However, it cannot be tackled in isolation. It requires services to be joined up around the family, intervening at an earlier stage, and tackling health concerns of whole families as part of a bigger picture of employment, education and housing.
Last week’s launch supports our work in the Troubled Families programme where there is an even greater focus on health. Originally launched in 2012, the Troubled Families Programme aims to support 120,000 families who face multiple problems including involvement in youth crime or anti-social behaviour, truancy, and parents receiving out-of-work benefits.
The programme represents a significant step forward in taking a family-centred, rather than service driven, approach to supporting families to turn their lives around. The commitment of the health system in transforming the lives of thousands of families across the country through earlier intervention and tailored support to improve health outcomes is critical to the Programme’s success.
Recently published data underlined the importance of strengthening the role of health by highlighting the scale of the issues faced by families on the programme, including:
- 71% of families included someone with at least one health problem;
- 46% had an adult and 33% had a child suffering a mental health problem;
- 32% had adults while 20% had children with a long-standing illness or disability;
- 14% included an adult dependent on alcohol whereas the national estimate for alcohol dependency in England is 4%
- 20% had children with a clinical diagnosis of attention deficit hyperactivity disorder (ADHD) as compared to an estimated 2-5% of the UK population.
As Marmot sets out in Fair Society, Healthy Lives the poor health of families can impact on other areas of family life, making it harder to find and hold down a job or stay in school, or negatively impacting on self-esteem and emotional wellbeing.
The second phase of the programme announced last year, will see up to an additional 400,000 families supported by 2020. It will continue to focus on significantly improving outcomes for families with multiple high cost problems as well as having an increased focus on driving the transformation of public services. The programme aims to reach families with a broader range of multiple problems – including those with younger children, those affected by domestic violence and families where mental and physical health problems are prevalent.
To make the most of this opportunity, Public Health England have been working with the Department of Communities and Local Government, NHS England, Local Government Association and Department of Health to support a greater focus on improving the health of families in the programme. The publication of our joint Leadership Statement sets out how local areas and health partners can work together and interim guidance on the effective sharing of data to help overcome the existing complexity faced by local teams.
Through working with Troubled Families teams based in local authorities over the past few months, we know of some innovative practices already in place to ensure health is a core part of locally-led approaches.
One great example we have seen is the local Troubled Families Programme in Birmingham, called Think Family, which epitomises this integrated approach. Birmingham’s Director of Public Health is a member of the Think Family Board and the Think Family Agenda forms a crucial part of Birmingham’s overall public health strategy. As a result families’ needs have been included in Birmingham’s commissioning arrangements for substance misuse services, and substance misuse workers are placed within children and family teams. This shows what can be achieved through collaborative working locally and a focus on health needs.
So as a health or care professional, whether you work in the NHS or local government, what could you be doing to help troubled families in your area?