Fife Early Years Collaborative

Learning System & Operating Model

To make Scotland the best place in the world to grow up in by improving outcomes, and reducing inequalities, for all babies, children, mothers,

fathers and families across Scotland to ensure that all children have the best start in life and are ready to succeed.

Reduce Stillbirths and Infant Mortality. A reduction of 15% in the rates of stillbirths and infant mortality by 2015

85% of all children have all the developmental skills and abilities expected of a 27-30 month old by the end of 2016

90% of all children have all the developmental skills and abilities expected at the start of primary school by the end of 2017

90% of all children in each Community Planning Partnership area will have reached all of the expected developmental milestones and learning outcomes by the end of Primary 4, by end-2021

Improving early years development of children in Fife

Raising educational attainment and reducing educational inequality

Improving the health of Fifers and narrowing the health inequality gap

Making Fife’s communities safer

EYC Priorities for Fife CPP4 Outcomes from Fife’s Community Plan

Fife EYC Execution Strategy Driver Diagram

Develop high impact interventions

Develop infrastructure and culture to create learning system

Build capacity and capability in QI

Children & families in Fife have the best

start

Aim Primary Drivers Secondary Drivers

I

Develop and share data and

measurement platform

Further develop leadership at all levels

Integrate EYC structures with existing governance structures in children’s services

Develop programme to support workforce development

Leadership at all levels

Develop systems to provide improvement support for key interventions

Develop communication systems to share progress and priorities across all services

• By 2017, 90% reach all expected primary school milestones

• By 2017 85% of Looked After Children will have a plan for permanence within 12 months of being accommodated.

• By 2017, increase to 86% proportion of children categorised as healthy weight at P1 health check

• By 2021, 90% reach all expected P4 milestones and learning outcomes

Priorities for Fife CPP Key Drivers Improvement Projects

Transitions

Attachment & Child Development

Reducing Inequalities 100% of children attending Sunflower Nursery participate in 30

minutes physical activity 3 or more times a week by June 2015

100% of children in Levenmouth have the option to start on day 1 at nursery (3hours 10mins) by August 2016

100% of Fife nurseries delivering one universal parenting intervention by June 2015.

100% Protected Places awards will be planned in conjunction with the children using the What Matters To Me engagement tool by December 2015

By August 2016, 95% of Pr. 1 children at Capshard Primary School will achieve ES in reading

90% of children at Methilhill primary school achieve their expected learning outcomes by 2018

90% of children at Kirkcaldy West achieve their expected learning outcomes

Early Learning

100% of children attending Sunflower Nursery participate in 30 minutes physical activity 3 or more times a week by June 2015

• By 2015, reduce the rate of stillbirths to 5.9 /1000 • By 2015, reduce the rate of infant mortality to 4.6 /1000

live births

• By 2016, 85% of children reach all expected milestones at 27-30 months

• By 2017, 90% reach all expected primary school milestones

• By 2017, 41% of Looked After Children will be looked after at home or in kinship care arrangements

• By 2017 85% of Looked After Children will have a plan for permanence within 12 months of being accommodated.

• By 2017, minimise the percentage of babies requiring treatment for illicit substance misuse withdrawal to 6.5%

• By 2017, increase to 27% children exclusively breastfeeding at 6-8 weeks

• By 2017, increase to 700 number of children benefiting from a risk management plan through MARAC.

Early Support for Pregnancy & Beyond

Parenting & Family Learning

Workforce Development

Priorities for Fife CPP Key Drivers Improvement Projects

Transitions

Attachment & Child Development

Reducing Inequalities

Increase no of women <25 living in the Lochgelly area who have a form of contraception recorded by 10% by March 2015

30 Fife EYC practitioners are trained and are confident in using the MFI and other quality improvement tools to deliver change projects by December 2015.

By January 2016, 90% of parents who have knowledge of the Before Words 4 key messages, will report they have adapted their interaction with their baby.

80 vulnerable families in Dunfermline with children under 3 are engaging and sustaining attendance at community groups by June 2015.

100% of Fife nurseries delivering one universal parenting intervention by June 2015.

Increase to 50% by end of 2018 children in Fife taking Healthy Start Vitamins

100% Protected Places awards will be planned in conjunction with the children using the What Matters To Me engagement tool by December 2015

Increase breastfeeding initiation rate in D & WF CHP by 5% by December 2015.

To improve avoidable repeat rates by 80% in newborn blood spot screening tests by June 2017

Leadership at all levels

Fife EYC Stretch Aims - Progress

Ensure all children reach their developmental milestones at start of primary school

Stretch Aim WS 3

90.45%

End of P1

Learning Outcomes

(Above or beyond expected CFE level)

93.3%

End of P1

Learning Outcomes

(Above or beyond expected CFE level)

90% in 2017

Ensure all children reach their developmental milestones and learning outcomes by end P4

WORKSTREAM 4

83.05%

Learning Outcomes

(Above or beyond expected CFE level)

86.9%

Learning Outcomes

(Above or beyond expected CFE level)

90% in 2021

Stretch Aim WS1Stretch Aim WS1

WS2

Building capacity & capability (2014 & 2015)M

ay

14

Jun

e 1

4

July

14

Au

g 1

4

Se

p 1

4

Oct

14

No

v 1

4

De

c 1

4

Jan

-15

Fe

b-1

5

Ma

r-1

5

Ap

r-1

5

Ma

y-1

5

Jun

-15

Jul-

15

Au

g-1

5

Se

p-1

5

Oct

-15

No

v-1

5

0

10

20

30

40

50

60

70

80

RAFA schools sup-ported & WS4 estab-

lished

UCL

LCL

Quality Assurance framework for projects

introduced

Fife EYC - Recorded QI activities

C chart

Num

ber

Introductory training to MfI: 240 participants

Bootcamp 2014/15: 7 participants

Bootcamp+: 1 participants

Fife QI programme: 32 participants

Improvement Advisors: 2 in training

Cohort 1 (October 2014 – December 2014)

Service & (number of participants)

Cohort 2 (April 2015 – November 2015)

Service & (number of participants)NHS Health Improvement (3) NHS Health Improvement (1)

NHS Maternity Services (1) NHS Maternity Services (2)

Early Years & Partner Support (1) Early Years & Partner Support (2)

NHS Speech & Language Therapy Service (2) NHS Speech & Language Therapy Service (5)

NHS Children’s Services (2) NHS Child Development Centre (3)

Barnardos (1) Schools (9)

Family Nurture Approach (1) Police Scotland (2)

Workforce Development - Quality Improvement Mentors Programme

Fife CPP Aim - Improving the health of Fifers and narrowing the health inequality gap

EYC Stretch Aim – 13 Early Learning & Childcare providers distributing Health Start Vitamins by June 2015

Jul-1

3

Sep-1

3

Nov-1

3

Jan-

14

Mar

-14

May

-14

Jul-1

4

Sep-1

4

Nov-1

40

200400600800

100012001400160018002000

Health Start Vitamins Supplies NHS Fife

Womens HS Vi-tamins

No

of

vita

min

s su

pp

lied

23-1

0-13

25-1

0-13

28-1

0-13

4-11

-13

11-1

1-13

18-1

1-13

25-1

1-13

2-12

-13

9-12

-13

4-2-

14

14-4

-14

21-4

-14

28-4

-14

5-5-

14

12-5

-14

19-5

-14

26-5

-14

2-6-

14

9-6-

14

16-6

-14

23-6

-14

50

55

60

65

70

75

80

85

90

95

100

Perc

enta

ge

% children at Sunflower Nursery taking HSV on a weekly ba-sis

Dates (Weekly)

Starting small at one nursery 2013/14

Health board direct vs community pharmacy distribution of children's Health Start Vitamins

April 2012 – Sept 14

Phase 1: Exploring and Preparing

Phase 2: Planning and Resourcing

Phase 3: Implementing and Operationalising

Phase 4: Business as Usual

Stakeholder buy-in and champions identified

Qualified team, delivery model and key responsibilities identified

First time innovation into effect, on-going support, feedback

Innovation mechanisms mainstreamed, fully operational, culturally embedded, outcomes evaluated

Only 64% of survey respondents agreed that the EYC ‘identifies a project structure’ (Phase 1 requirement), suggesting that many respondents were not aware of the overall structure and delivery model of the EYC

Only 55% of respondents disagreed that ‘Resistance to change such as cultural barriers’ (Phase 3) were impeding development. This suggests that resistance to the EYC ethos or improvement model is still a significant barrier

% Agreement with items in Phase

85% 79

% 64% 39

%

Fife EYC carried out a progress evaluation summary between January & March 2015 to assess the planned implementation of Fife EYC against actual delivery using a National EYC implementation model. This executive summary is drawn from a larger report available on request from the authors.

Fife Early Years Collaborative Progress Evaluation Executive Summary

Max French PhD Researcher, University of Stirling

Faye Richardson CLD Intern, University of Dundee

Craig Morris Fife EYC Programme Manager

Some 82% of respondents believed that there was ‘Positive ethos towards the vision of the Early Years Collaborative’ (Phase 4) suggesting a broadly held alignment in ambition

-

-+

Results suggest Fife EYC is currently located within Phase 3 of the national implementation model, and that significant work still lies ahead before Phase 4 is reached. Drilling down into the data reveals some aspects of Phase1 and Phase 2 which are deficient, while progress is seen in some aspects of Phase 4 (see right)

Ensure that EYC workforce understand the MFI as a tool of empowerment, not as an additional process on top of existing workload or just as a form of quality improvement.Further integration of the EYC within existing governance structures to help its spread ensure its long-term sustainability

Outcomes Respondents to the survey believe the EYC is working: 78% agreed there is evidence that Fife EYC is improving outcomes for children & families

StructureStructure and management in are place – those who are in the EYC know who’s who. The role of the programme manager has been seen as invaluable to many research participants

Commitment There has been broad commitment from all participants to EYC goals and priorities. There is a strong will to be involved

Development Workforce development opportunities have been successful in upskilling practitioners and increasing confidence in carrying out improvement work

Using Tools There has been demonstrable success at both practitioner and senior levels in using ‘model for improvement’ with the right support (they must have the knowledge and not perceive it as extra paperwork)

Resistance to Change

Project Methodology

Many survey respondents were not clear of the EYC’s project structure (they know who’s in place, but not how it’s supposed to work). Practitioners have sometimes noted that they were not aware of the ‘bigger picture’ of the EYC

Co-production

The role of service users as a resource and source of innovation has been important in improvement work analysed, but has not been explicit in EYC guidance or the Model for Improvement

What’s working? What needs work?

Recommendations

Further engagement should be made with middle-management within Fife EYC to enhance and increase their knowledge of the EYC and commitment to its vision.Packages of workforce development should be continued to engage early years practitioners, including middle-managers, in the vision and methodology of the EYC

For all enquiries regarding this research, please contact:

Max FrenchPhD ResearcherUniversity of Stirlingm.n.french@stir.ac.uk

Craig MorrisFife EYC Programme ManagerFife Councilcraig.morris@fife.gov.uk

Resistance to change and a lack of support is still often inhibiting improvement work, particularly among practitioners. Many have complained of ‘isolation’, which can kill commitment to improvement work

Key inputs & outputs

Fife EYC carried out a progress evaluation summary between January & March 2015 to assess the planned implementation of Fife EYC against actual delivery using a National EYC implementation model. Part of the recommendations & conclusions highlighted that “further integration of the EYC within existing governance structures is need to help its spread and ensure its long-term sustainability

Fife EYCKey elements for integration 2015/16

1. Strategic Governance

EYC Project Management

Champion & Programme Mgr

Project Manager

Workstream Leads

Data Management

Away Team

Home Team

Improvement Support

Workforce Development

Strategic & Operational

Workstreams & Key Change Areas

Reporting & Communications

Key Areas for integration

2. Improvement Support

Support Appointments

Project Manager

Scottish Government IAs

3. Workforce Development

Introduction to MFI

Overview of Collaborative

Specialist QI

Mentors Training

QI Masterclasses

National IA/SCIL programmes

4. Workstreams &

Key Changes

WS meetings

Leads

Stretch Aims

Key Change workshops

5. Reporting &

Communications

EYC Communication Plan

Reporting to Scottish Govt &

Local Elected Members

Ongoing profile of EYC

developments

Strategy Groups