Agenda item

The Chair welcomed Chief Inspector Richard Blakemore, and Charlotte Drury, Service Manager - Well-being Family Support & Safeguarding.

Context:

To provide PSB Select Committee with an overview of the work that the public service board will develop to begin to address and mitigate the impact of Adverse Childhood Experiences (ACEs) on long-term outcomes/wellbeing.

Key Issues:

Adverse Childhood Experiences (ACEs) are potentially traumatic events that can have negative, lasting effects on health and well-being. These experiences range from physical, emotional, or sexual abuse, to parental divorce or the incarceration of a parent or guardian. The ACEs research tells us is that these adverse experiences are likely to have a significant impact on health-harming behaviours (such as problematic drug or alcohol use), mental health and chronic disease throughout adulthood. Clearly for a child to experience a single ACE is unwelcome, however, what the evidence shows is that children who experience fewer than four ACEs are more resilient to the long-term impact. There is a moral as well as a financial imperative therefore to work to limit as far as possible the ACEs children are exposed to and to mitigate the impact of ACES that they do experience.

There is a multitude of reasons why children become exposed to ACEs and many of these reasons will be interrelated. Incarceration is linked with poor education, poor education is linked with poverty, and poverty is linked to a higher incidence of involvement with social care, and so on. Experiencing ACEs makes an adult more likely to raise children in environments where they too experience ACEs. Mitigating the impact of ACEs is, therefore, an essential element within an ACE reduction strategy.

Attempting to identify simple solutions to such a complex set of problems is impossible. What is possible however is a consideration of those factors that agencies and services have influence over in order to collectively create an environment conducive to whole systems change. This will require us to think differently; away from a model where we assume that we can control outcomes and towards a model that seeks to identify key points of influence, where small changes can create a difference.

We are doing lots already, much driven by a statutory imperative. The focus of partnerships should be on achieving difference at a policy, planning and implementation level, including consideration of existing and new activity. Since ACEs are a complex issue, it will be important to focus on those factors where partners have most control/influence and those where there is evidence that intervention will make the most difference whilst accepting that not everything can be a priority.

To assist with this the Cymru Well Wales, Adverse Childhood Experiences’ Support Hub facilitated a session at the Programme Board meeting on the 1^st October 2018. The session provided an introduction to ACEs and the evidence base and a forum for starting to consider what a Monmouthshire response to mitigating and preventing

ACEs might look like (details included in Appendix 1).

Member scrutiny:

A Member commented that this legislation may be the triumph of hope over reality, and all agencies involved are struggling to make ends meet.  He added that it is a miracle we can keep services going, and with upcoming cuts this will only get worse.  He asked where we begin to address that in terms of the impacts of ACEs, and how performance is measured.

Concerns were raised around funding cuts and the effects on local agencies.

With regards to a recent workshop, there were concerns that some Members had not received an invitation.

The Community and Partnership Development Manager accepted that there are some real challenges, termed ‘wicked issues’ in this work and partnerships have been grappling with this for some time.  She explained that measures would be addressed in the next paper, but the measures for the activity with ACESs will develop in terms of the action agreed by the PSB

The draft action plan is a starting point of a complex area of work.  The new work could be resource intensive in some areas and officers are to explore how that could work in practice.

A Member welcomed the draft plan, and questioned if there is a real desire between all partners to work together, and if there is willingness to compromise on positions. He suggested that inviting other partners to discuss would be a great help.  In response we heard there is an undisputed willingness from partners to look at how we can come together to tackle these issues.

The Chair referred to a system pioneered by a colleague in Newport, where a child had suffered domestic abuse, the police officer would then contact the school to let the school know.  The Chair asked if we are signed up to this scheme in Monmouthshire.  The Chief Inspector was not aware but would look into this further.

Recommendation:

Members of the committee are invited to:

Scrutinise if there has been enough progress in relation to the well-being step ‘Tackle the causes of ACEs and the perpetuation of generational problems in families’.

Scrutinise the approach taken to develop this wellbeing step and draft action plan.

Scrutinise if the draft actions are the right actions for PSB to begin to explore the complex issue of tackling ACEs.

Committee Conclusion:

The Public Service Board Select Committee resolved to accept the recommendations.

The Chair concluded that important points had been made and the Committee are encouraged to see the Public Service Board really working together to identify what their objectives ae going to be given the challenging times regarding funding. 

The Committee thanked officers and looks forward to receiving more information.