Transforming Blackpool Together: Blackpool’s 5th Annual ABS Conference

I was delighted to be asked to attend Blackpool Better Start’s fifth annual conference on the 14^th November ‘Transforming Blackpool Together: How Evidence is Changing our Town’, as part of the A Better Start Shared Learning and Development programme delivered by NCB on behalf of The National Lottery Community Fund.

Held at Blackpool’s iconic Winter Gardens, and in the impressive Empress Ballroom, we were provided with a wealth of Early Years knowledge and learning. The event not only underlined the impact of the past five years of A Better Start in Blackpool, but also gave a clear vision of where the team and local authority aspire to be in a further five years’ time.

Merle Davies, the Director of both Blackpool Better Start and the Centre for Early Child Development, opened the conference by outlining the amazing progress in Blackpool across a range of programmes; and Professor Frank Oberklaid presented on the evidence base supporting practice and programmes.

A choice of workshops were provided throughout the day, and I chose to attend two which focused on integrated services and systems change: ‘Better Births’ – implementing the NHS Long Term Plan’s clinical change programme for maternity services; and ‘For Baby’s Sake’ – a domestic abuse support programme..

Better Births in Blackpool

The Better Births team in Blackpool are the local driving force pushing forward the maternity transformations outlined in the NHS Long Term Plan and the National Maternity Review five year forward plan.

The vision for this work is that maternity services for parents are safe, personalised, kind, professional and family friendly, where parents have better relationships with their midwives. The vision also outlines the importance of maternity staff who are innovative, committed to continuous learning, and willing to break down professional boundaries.

The Better Births work includes a number of strands, and the conference workshop focused on a few of these. ‘Continuity of Carer’ is a key element of Better Births. This means that the mother is supported through her pregnancy by a small team of midwives that get to know the mother-to-be well. This approach is safer for mother and child because:

• The mother is seven times more likely to be attended at birth by a midwife they know.
• They are 16% less likely to lose their baby during pregnancy as women report concerns about their pregnancy sooner when they know and trust their midwife.
• They are 90% less likely to lose baby before 24 weeks.
• They are 24% less likely to experience a pre-term birth.

In Blackpool, there are three groups of high-risk women who will receive this ‘continuity of carer model’: women with diabetes; women who require a planned caesarean section; women with complex social needs in pregnancy. A fourth group will soon be added: women who smoke in pregnancy.

The workshop also showed some of the prevention work that is being undertaken in Blackpool under the leadership of the Better Births team.

In Blackpool, 25% of women smoke during pregnancy as compared to 10.5% nationally. Smoking in pregnancy has been identified as the main modifiable risk factor for a range of poor pregnancy outcomes, including miscarriage, pre-term birth, sudden infant death syndrome, heart defects and low birth weight. Reducing smoking among pregnant women is therefore a key priority for the Better Births team. The team have introduced incentive schemes, behaviour change schemes, nicotine replacement models, and the Midwifery Health Trainer Model – all of which are being monitored for impact.

The team are also committed to increasing the percentage of mothers choosing to breastfeed after birth. It is widely known that breastfeeding helps to mitigate some of the risk factors in child development related to poverty, and while the national breastfeeding rate after birth is 74%, in Blackpool it is much lower at 59%.

The team is therefore providing a range of measures through the Infant Feeding Network including:

• A training curriculum for the whole of the Early Years workforce to support them in breastfeeding awareness.
• Amending policies and procedures across local early years services so that breastfeeding support is more readily available.
• Promoting directly to parents not only the health and development benefits of breastfeeding, but also the positive impact on the mother-infant relationship.

For Baby’s Sake

For Baby’s Sake is a service developed by the Stefanou Foundation that will launch in the Blackpool Better Start area in early 2020. It is a manualised programme that works with families where domestic abuse is taking place. It starts ante-natally, and works with the whole family – victim and perpetrator, whether living together or not – to break the abusive cycle.

Blackpool has the highest rates of domestic abuse nationally, with 70% of the social care caseload being impacted on by domestic abuse. This programme reduces the risk of abusive behaviours by equipping parents to provide a nurturing environment. The programme uses a trauma-informed and attachment-based approach, and has been refined over the last four years when it was originally delivered in Hertfordshire and parts of London.

The programme notes that 70% of parents in abusive relationships have experienced four or more Adverse Childhood Experiences (ACE’s) in their own childhood - and that to break the cycle, parents need to be given the opportunity to process this trauma before going on to be able to support a new baby’s emotional development. The programme is a long-term one, which starts ante-natally, with the whole family being supported until the child turns two.

The programme puts safety first, and works with safeguarding teams and other local support services, or services already involved with the family, to constantly assess risk. The programme builds self-esteem in both parents, and focuses on healthy adult relationships. The programme looks not at ‘what is wrong with this parent’ but ‘what happened to this parent’ and staff provide unconditional positive regard to build a relationship with both parents and support them to develop self-regulation, to allow them to be prepared to meet the needs of their baby.

Once baby is born, the programme uses VIG (Video Interaction Guidance) to allow parents to observe and build on their interactions with their baby – impacting positively on the attachment and bond between parent and child.

The programme has already identified their first cohort of families and goes live in January 2020. An evaluation team led by Kings College London will be monitoring the impact.

Useful resources

• National Maternity Review: Better Births https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf
• NHS Long Term Plan https://www.england.nhs.uk/long-term-plan
• For Baby’s Sake : https://www.stefanoufoundation.org/

About A Better Start

A Better Start is a ten-year (2015-2025), £215 million programme set-up by The National Lottery Community Fund, the largest funder of community activity in the UK. Five A Better Start partnerships based in Blackpool, Bradford, Lambeth, Nottingham and Southend are supporting families to give their babies and very young children the best possible start in life. Working with local parents, the A Better Start partnerships are developing and testing ways to improve their children’s diet and nutrition, social and emotional development, and speech, language and communication. The work of the programme is grounded in scientific evidence and research.

A Better Start is place-based and enabling systems change. It aims to improve the way that organisations work together and with families to shift attitudes and spending towards preventing problems that can start in early life. It is one of five major programmes set up by The National Lottery Community Fund to test and learn from new approaches to designing services which aim to make people’s lives healthier and happier

The National Children’s Bureau is coordinating an ambitious programme of shared learning for A Better Start, disseminating the partnerships’ experiences in creating innovative services far and wide, so that others working in early childhood development or place-based systems change can benefit.

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