Features: June 20th, 2008

By Robert Maragh.

There is a growing view that services need to be shaped by and responsive to children and young people – but what does this mean in practice? Robert Maragh, Head of Integrated Children’s Commissioning in the London Borough of Newham, explains how his team makes sure that children and young people are involved at every stage of the commissioning process, and why services are improving as a result.

In my view, commissioning is ultimately about doing what is best for children, and you can’t do that without understanding what their real issues are.

Five years ago, we decided to take a more structured approach to ensuring that we were providing the best services for children and young people. We put in place a system where an integrated commissioning team straddled both the PCT and the local authority. This ensured that there was no duplication of effort and opened up the lines of communication between the two organisations.

This has also allowed us access to a huge amount of data, which previously would have sat in silos in the two organisations. In this way we have built up a much more comprehensive picture of the needs and outcomes of the young people in our area. However, we also wanted to hear the views of our end-users and those most affected by the services provided – namely, the children and young people in the area – about what was working well, and what the priorities should be going forward.

I’ll admit, initially the idea of consulting directly with children and young people was daunting for many of the people involved. There are around 73,000 under-19s in Newham. The sheer number of young people and difficulties associated with dealing with younger children in particular meant that anything we did had to be age appropriate, yet also not too time consuming or laborious.

When commissioning services for children and young people, we tend to break the process down into four stages: analysing; planning; doing; and evaluating. We were keen that children and young people were involved in all stages to ensure that the services provided deliver the best outcomes for them, and these are just some of the steps that we took to do this.

Analysing

We have found that asking children what they want has been particularly useful for certain vulnerable groups. As such we have set up individual ‘reference groups’ for children and young people with similar issues. So far, we have set up reference groups for looked-after children, children who have been victims of crime, children and young people affected by HIV, teenage parents, disabled children and for those who are carers themselves.

The looked-after children reference group is made up of around 35 children and young people – some of whom have now left care – and a number of them meet once a month to discuss current care provision and areas for improvement. In a recent meeting we discussed what else children in care felt they needed to help them in school, and it was agreed that bursaries for travel would mean one less thing to worry about. In our role as the corporate parent, we agreed that this would be a good use of resources, and steps have now been put in place to ensure that all looked-after children in the borough can benefit.

As well as the smaller, monthly meetings, the looked-after children reference group reports back to regular meetings with the Assistant Director to ensure that all of the children, and their carers, have the opportunity to feed into the process.

Aside from these reference groups focused around particular groups of children, we have also set up a Youth Council in Newham to ensure that all children get to have their say. Two students from each school are elected to represent their classmates’ views and the Council meets quarterly. More recently, we have also introduced an elected Youth Mayor and Cabinet. The Youth Mayor has a budget of £25k to spend as the Youth Council sees fit, and he/she also has the power to call managers to account. It is incredibly motivating to see that when you give young people the power to change things for themselves, they really do bring a new passion and energy to the job that I think it is quite hard for adults to replicate.

Planning

The findings of these groups shape our priorities, and the next stage is to decide which services to commission to help us achieve these.

When we were creating our five year Children and Young People’s Plan, we had an idea of our priorities but wanted to talk to a group of children of all ages to garner their views, and see if there was much correlation. It soon became apparent that the fear of crime and bullying was much more of a priority for young people than we first realised, and this directly impacted on our plans. We reviewed our priorities so that crime was moved from fifth to second on the list, and increased the total number of priorities to 15, to ensure that we were tackling all of the issues that children and young people cared about. We went beyond the plan and young people were directly involved in devising service specifications.

If we hadn’t consulted, no doubt we would have had a much more ‘manageable’ number of priorities – but that isn’t the point. Our original priorities were based on our perception of what children needed – rather than the reality – and the services we provide would have suffered as a result if we had stuck to them.

In this case we sat around a table with the children to discuss the priorities, but this is not always the best way to work. For example, to develop our play strategy we needed the views of under-10s, which required actually playing with them and making the process ‘fun’. Disabled young people were engaged in developing the sports delivery plan and were consulted on the sports activities they wanted to do. When engaging with some of the older teenagers we have found that the setting is important too: they talk far more openly about what they need in Nando’s than they would do if stuck in a room in the Town Hall with a projector screen and notepads. It’s all about making the consultation appropriate for the groups you are talking with.

Doing

We don’t involve children and young people in every decision that impacts upon them. It is important that senior managers feel empowered to take their own decisions without having to check with a child first. However, there are some parts of the commissioning process where children can bring a completely different perspective, and I think that this should be harnessed wherever possible.

For example, when we were recruiting for our Director of Children and Young People’s Services we had a young person’s input in the process.

In another case when we were recruiting for a Commissioning Manager, towards the end of the process we interviewed one candidate who impressed the panel immensely – with one exception. The young person involved was quite adamant that when you analysed what they had said in the interview, and how they said it, it was clear that they would have had some difficulty working directly with young people. It wasn’t something that any of the other panel members had picked up on, but she was quite right, and we decided that that particular candidate wasn’t suited to the job.

We’ve also involved young people in the training of relevant staff. For example, another issue raised by the looked-after children reference group was that the people involved in their reviews should be better trained to encourage the active participation of the young people in their reviews. This was agreed, and the young people helped design a training course which over 150 professionals have now attended. The overall participation of looked-after children in their reviews has also increased as a result.

Evaluating

For me, getting children involved in the evaluation stage is crucial. They are the only people who can tell you whether the service provided has been tailored correctly for their needs and delivered what they need it to deliver. In the past we have asked young people to design their own questionnaires about particular services, such as career planning, which have been given to other young people.

Through the commissioning of services we also used young people as ‘mystery shoppers’. They go into the local centres and tell us what the experience was like. It can be something as simple as the young person feeling that the receptionist ‘blanked them’ that deters them from going back, so we use this feedback to work with our partners to ensure that all aspects of service delivery are as good as they possibly can be.

By getting children and young people involved in all aspects of the commissioning process, we have changed the services we deliver for the better, and have also given young people a sense of ownership and responsibility. In a recent Youth Satisfaction Survey in Newham, over 75% of young people felt that they had the opportunity to participate in decision making and over 80% felt that their views, suggestions and complaints were listened to. This is something we’re immensely proud of and intend to build on in the future.

Robert Maragh is Head of Intergrated Commissioning (Children and Young People), London Borough of Newham/Newham PCT.

He can be contacted by phone: 020 8430 5242. Or by email: Robert.Maragh@newham.gov.uk