Child protection and support in “urgent need of reform” due to increased risk of serious harm

Incidents of serious harm to children under five where abuse or neglect is known or suspected have increased during the early months of the pandemic, and many other signs of children being at risk may have been missed due to disruption in the usual pathways for referring children to services, a new evidence review has found.

The review, ‘Protecting young children at risk of abuse and neglect’ from the Nuffield Foundation, finds that children’s services are already under pressure as a result of increasing rates of child protection interventions over the last decade, particularly for children living in the poorest areas.

In the same period, preventative services to support families have also been cut, and many young children who are at risk of abuse or neglect do not come to the attention of services at all.

The authors have called for “urgent re-evaluation of the current system” with a focus on how public services and agencies can adopt a holistic and collaborative approach to support young children at risk of abuse and neglect, prevent harm, and promote positive outcomes.

The report argues that “the time is right” for such a re-evaluation, given the current Independent Review of Children’s Social Care in England has been commissioned by the government as ‘a once-in-a-generation’ opportunity to reform systems and services.

Incidents involving death or serious harm to children under five where abuse or neglect is known or suspected increased during the early months of the pandemic (April to September 2020), the report found.

Compared to the same period in 2019, such incidents increased by 31% for children under one (a total of 102 children) and 50% for children aged one to five (a total of 48 children). The average rate of increase for children across all age groups was 27% (a total of 285 children).

In addition, the pandemic has disrupted the usual pathways for referring children to services, meaning children at risk of abuse and neglect may be being missed.

These issues appear to be even more acute for infants and for babies born in the pandemic, with many children’s centres closing and health and GP check-ups happening via video link or telephone.

In some areas of the country up to 50% of health visitors in England were redeployed during the first 2020 lockdown, the review found, with only one in ten parents of children under two seeing a health visitor face-to-face.

Authors said this was particularly worrying given that, even prior to the pandemic, a considerable number of young children at risk due to their family circumstances are missed by services each year.

In 2019, 46% of children who died or were seriously harmed were not known to the child welfare system. It is estimated that there are over half a million children under five (17%) living in a household with domestic abuse, parental mental health problems or parental substance misuse.

The review also found worrying long-term trends in the numbers of children taken into care, alongside shrinking funding for preventative measures.

The proportion of babies under one year old subject to care proceedings in England increased from 51 to 81 per 10,000 children between 2008 and 2016. For babies under one week old, the rate more than doubled (from 15 to 35 per 10,000 children).

During this same period, spending on preventative services to support families who are under pressure and struggling in England has fallen from £3.8 billion in 2010 to £2.1 billion in 2018 (with less severe reductions in Wales), while spending on statutory and acute services, such as provision for children in care has largely been protected.

Authors say this is at odds with evidence that shows interventions at the right time in early childhood can protect children and support their families to help them thrive, particularly when offered as a holistic, ongoing package of support across different children’s and adult services.

Young children subject to child welfare interventions were also found to have poorer early language development and this gap persists as they start school.

Children who are, or have been, in care score 24% lower in English, maths and science at Key Stage 1 (aged 7) than children who have not received a social work intervention. For those who have ever had a Child in Need Plan, these scores are 14% lower.

The authors said opportunities to address these gaps are being missed because too many children do not take up early education places. Warning that there is no national data on how many looked after children access early education, the review found analysis of selected local authority data suggested that amongst looked after children aged 2-4, 71% are in early education compared to a national average of 85%.

“The independent review of children’s social care services currently underway is recognition that our system of child protection and support needs to be re-evaluated,” Carey Oppenheim, co-author of the review and Early Childhood Lead at the Nuffield Foundation said.

“Over time, we have seen a shift away from provision of early support to help families who are struggling, towards later interventions that are more likely to separate families and which are more expensive to provide.

“Alongside this, there are young children at risk of abuse and neglect who need help and are not receiving it because they are not known to services. These concerns have been pulled into sharper focus by the pandemic, and its economic consequences are likely to mean more pressure on council budgets and services at exactly the point families need them most.”

The review also warns that a lack of data makes it impossible to fully ascertain the extent to which the increases in child protection and welfare interventions are because of actual increases in abuse and neglect, more reporting, more risk-averse social work or cuts to preventative services.

However, there is evidence that the chance of experiencing a child welfare intervention is not experienced equally across all families and that poverty is a driving factor.

Children living in the poorest neighbourhoods are at least ten times more likely to be in care than children in the richest neighbourhoods, and this relationship is stronger for pre-school children, the review found.

There are also inequalities between ethnic groups in the proportions of children being looked after in England, although little attention has been paid to these inequalities by policy makers and there is a lack of evidence to sufficiently understand and explain them, authors said.

Oppenheim added that social work and family justice are “only one part” of the solution.

“Poverty remains a significant risk factor for children and alleviating the financial pressure on families would make a difference in enabling young children to thrive, as would a more holistic and collaborative approach across public services and agencies.”