Children’s Commissioner’s Annual Report 2015-16

09 November 2016

Article by Sian Thomas, National Assembly for Wales Research Service

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CC LogoOn Tuesday 15 November 2016 in Plenary, Assembly Members will debate the Children Commissioner for Wales’ most recent Annual Report (2015-16). This gives AMs an opportunity to discuss the latest issues and challenges affecting children and young people in Wales and hear how the Cabinet Secretary for Communities and Children, Carl Sargeant, responds to the report’s findings. The Welsh Government’s written response is due to be published following the debate. Last month, the Assembly’s Children, Young People and Education Committee heard directly from the Commissioner about the issues she raises in her report. You can see what was discussed on Senedd TV here.

The Commissioner and her role

Sally Holland is the third person to undertake the role of Children’s Commissioner, taking up her post in April 2015. The principal aim of the Commissioner in exercising her functions is to safeguard and promote the rights and welfare of children and to have regard to the United Nations Convention on the Rights of the Child (UNCRC) in everything she and her team do. The Research Service blog Children’s rights in Wales: an update 2016 provides further detail on the UNCRC and the position in Wales.

The Commissioner can:

  • Review the effects of policies, proposed policies and the delivery of services to children;
  • Examine the case of a particular child or children if it involves an issue that has a more general application to the lives of children in Wales;
  • Require information from agencies or persons acting on their behalf, and require witnesses to give evidence on oath;
  • Provide advice and assistance to children and young people, and others;
  • Consider and make representations to the National Assembly for Wales about any matter affecting the rights and welfare of children in Wales.

The Commissioner’s remit covers all areas of the devolved powers of the National Assembly for Wales relevant to children’s rights and welfare. Her remit covers children and young people up to the age of 18 living in Wales, or who normally live in Wales. It also includes those up to the age of 25 if they have previously been ‘looked after’. Her office undertakes direct casework on behalf of children and young people.

Which does the latest Annual Report focus on?

The Annual Report identifies a wide range of issues facing children and young people in Wales and categorises them under the following headings:

  • Provision: Mental Health; Education (including ‘Additional Learning Needs’ and ‘elective home education’); Social Care (including advocacy, adoption, and short breaks for disabled children).
  • Poverty: The Commissioner says ‘Too many children in Wales are being denied a decent childhood due to the limiting effects of child poverty.[…] Welsh Government urgently needs to intensify its efforts to tackle child poverty.’ (The most recent statistics, published in June 2016, show that 29% of children in Wales are living in poverty, the same as England and higher than Northern Ireland (25%) and Scotland (22%).)
  • Protection: Child Sexual Exploitation and historic abuse; Equal protection; Travel to school; Privacy in youth courts.
  • Participation: The Commissioner saysWhilst I have no legislative remit to make recommendations to the National Assembly for Wales, I want to reaffirm my intention to press for a reinstated national democratic space for young people, in the form of a Youth Assembly.’ (See the Llywydd’s recent announcement here).

What are the Commissioner’s priorities?

Following her ‘Beth Nesa’/ ‘What Next’ consultation undertaken to inform her priorities, the Commissioner published her Plan for all Children and Young People 2016-19. Sally Holland says that ‘by 2019 I hope that Welsh Government and public services will have made significant progress towards delivering the following improvements for children:

  • Children and young people will have access to the mental health services they need in a timely manner. There will be stronger programmes for promoting emotional health and wellbeing in place in our health and social services, schools and youth services.
  • Children’s contemporary experiences of bullying will be better understood and more schools will prevent and tackle bullying effectively.
  • There will be better access to play, culture and leisure activities by children who are most likely to miss out on these, particularly those living in poverty and disabled children.
  • Care leavers will have better access to safe and secure housing options and an active offer of a job, education or training place.
  • All young people requiring continuing health and social support will have improved transitions to adult services.
  • Children will have the same legal protection as adults from physical assault.
  • Children and young people will be better involved in public services, including my own organisation.’

Setting out some of the work she herself intends to undertake, the Commissioner says:

  • ‘Under 7s asked me to prioritise play opportunities during the next three years. I will promote children’s rights to play and access leisure and cultural activities, whatever their circumstances.
  • Children from 7-18 have identified bullying as their top priority. I will work with children and others to identify and promote effective ways of tackling bullying. The issue of bullying is also connected to mental health and wellbeing – the overwhelming concerns of professionals and parents.
  • In 2016-17, I will launch a three year project to improve the transition from childhood to adulthood for those who need support and services – this includes care leavers and those with chronic health conditions and disabilities.
  • I will work with children and young people throughout Wales and through both English and Welsh languages. I will ensure that I listen to children and young people who may have most difficulty in accessing their rights, including disabled children, looked after children and those from ethnic, linguistic and sexual minorities. I will measure how I engage with different groups throughout Wales so that I can be held accountable for this by children and young people.’

The debate is scheduled for 4pm Tuesday 15 November and can be watched on Senedd TV here.

Children’s Rights in Wales: An Update

17 June 2016

Article by Sian Thomas, National Assembly for Wales Research Service

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This is a picture of children holding hands

Image from the lonaginosuperman.wordpress.com. Licensed under the Creative Commons.

Last week, the United Nations gave its verdict on what progress has been made to deliver on children’s rights in Wales. Following a UK-wide review, it made more than 150 recommendations.

The UN’s recommendations refer to a wide range of issues that have featured prominently in previous Assemblies. Its recommendations cover subjects such as Child and Adolescent Mental Health Services (CAMHS); the attainment gap in education; looked after children; children with special educational needs; children’s play; and childhood obesity.

Referring specifically to Wales, the UN:

  • Is concerned about ‘high’ child poverty rates in the UK, which it says is affecting children in Wales and Northern Ireland the most. [Wales has the highest child poverty rate of all the UK nations at 31%, equivalent to around 172,000 children];
  • Expresses concern that ‘children’s views are not systematically heard in policy-making on issues that affect them’ and notes there is no youth parliament in Wales. It recommends that one should be established as a priority, so that children can effectively engage with the legislative process on issues that affect them.

[This week, the Campaign for a Children and Young People’s Assembly for Wales launched a consultation for children and young people on its ideas about which model a new youth assembly for Wales could look like];

Some of the UN’s views on UK wide issues include that:

  • It is ‘seriously concerned at the effects of the recent fiscal policies and allocations of resources’ on children’s rights and that they disproportionately affect children in disadvantaged situations;
  • There is a need to ‘prohibit as a matter of priority all corporal punishment in the family, including the repeal of all legal defences, such as ‘reasonable chastisement’, often referred to as a ‘smacking ban’. [In May 2016, the First Minister committed to taking forward, on a cross-party basis, legislation that will remove the defence of reasonable chastisement in Wales];
  • There should be a consultation on allowing 16 and 17 year olds to vote. [If the Wales Bill 2016 currently before Parliament is passed, the Assembly would have powers to change the age at which people can vote in Assembly Elections]
  • Infant and child mortality is linked to social and economic deprivation. [Children aged 0-17 living in the most deprived parts of Wales are almost twice as likely to die as those in the least deprived parts].

See our recent blog: Prioritising children and young people for further statistics on children in Wales.

Why is the UN having its say?

This will be the fifth time the UN has looked at the progress made in delivering the rights of children and young people since the UK Government signed up to the United Nations Convention on the Rights of the Child (UNCRC) in 1989. The UNCRC gives children and young people up to the age of 18 a wide range of rights, including rights to protection, health, family, education, culture and leisure. See a summary of its articles (PDF 19.62MB).

In 2011, the Welsh Government went one step further, receiving international recognition when it became the only country in the UK to incorporate the UNCRC into domestic law through its Rights of the Children and Young Persons (Wales) Measure. This has inevitably resulted in questions about what this relatively new law means in practice and what difference it is making to the day to day lives of children and young people living in Wales.

The UN Committee on the Rights of the Child is a panel of international experts on children and young people whose role is to scrutinise governments progress in implementing the UNCRC.

On what evidence does the UN make its judgement?

Its verdict is based on written evidence from the UK and devolved governments; all four UK Children’s Commissioners; national reports from Non-Governmental Organisations as well as evidence provided by children and young people. Representatives of the United Nations visited the UK and Wales to meet with stakeholders and children and young people. Subsequently Welsh and UK representatives went to Geneva to give further evidence and answer questions about what more the Westminster and Welsh Governments need to do to fully implement the UNCRC.

Of interest to Assembly Members and other stakeholders may be the range of written evidence about Wales which was submitted to the UN. This includes:

What next in Wales?

The UN last gave its verdict on children’s rights in Wales back in 2008. In response to its recommendations, the then Welsh Government published Getting it Right – a 5 year action plan. We are yet to hear how this new Welsh Government, and the new Cabinet Secretary for Communities and Children, Carl Sargeant, will respond to what the UN has said in this most recent report.

It’s notable that the cabinet for this new Welsh Government includes a Cabinet Secretary whose title specifically includes children. Announcing this in Plenary on 24 May 2016, the First Minister confirmed that ‘we’re identifying the interests of children as a distinct ministerial responsibility’. Given successive Welsh Governments’ stated commitments to children’s rights, the UN’s most recent findings are likely to provide the basis for further scrutiny during this Fifth Assembly.

Review of the Mental Health (Wales) Measure 2010

18 February 2016

Article by Hannah Roberts, National Assembly for Wales Research Service

Info-gThe Mental Health (Wales) Measure 2010 was implemented in phases between Jan-Oct 2012. Its aims were to secure earlier and easier access to services for people with mental health (MH) problems. The Measure is summarised in the diagram below. More details can be found in this public summary leaflet on the Measure.

The Welsh Ministers had a duty to review the Measure within 4 years of commencing implementation. The inception report described in detail how this evaluation would be carried out.

An interim report was issued in 2014 and stated that

[…] the pace of change required has presented services in some areas with challenges. Whilst the same legislation and guidance applies across Wales, local need and the previous configuration of services have influenced the implementation of the Measure.

Review report

The duty to review final report, published in December 2015, states that all health boards and local authorities are complying with the legal requirements of the Measure. The remaining findings of the report, on to what extent the implementation of the Measure is achieving its aims, are summarised below.

The report concluded that the change in culture required to ensure the intention behind the Measure is becoming more evident across Wales. It states that while there is room for ongoing improvement, health boards have given increased priority and focus to mental health.

Part 1: Local Primary Mental Health Support Services (LPMHSSs)

LPMHSSs, located within and alongside GP services, are meeting a significant, previously unmet demand. There is concern that this high demand is placing a strain on services and resulting in longer waiting times, particularly for psychological (or ‘talking’) therapies

Waiting times for assessment have decreased over the past two years and are now on target, whereas waiting times for an intervention are variable. Currently only 71% of patients commence their treatment within 28 days (target of 80%). This issue was raised by the Health and Social Care Committee’s post-legislative scrutiny of the Measure in 2014, and a national plan for the delivery of psychological interventions was developed in 2015. The review report recommends that data on waiting times for psychological interventions are routinely captured to monitor progress. It also notes a need to address the eligibility criteria for those able to undertake LPMHSS assessments. There will be a consultation on draft changes to the criteria in 2016.

The report found that a positive knock-on effect of Part 1 of the Measure has been a ‘significant expansion in the availability of self-referral psychological education programmes’, also known as Tier 0 services.

Part 2: Care and treatment plans

The target was that 90% of individuals receiving secondary MH services should have a Care and Treatment Plan (CTP), and this is being met by all but one health board. The report notes that the quality of CTPs varies, and not all service users feel involved in the development of their CTPs.

There are reported concerns that the bureaucracy involved in producing CTPs is creating barriers between primary and secondary care and impacting on the time that practitioners have for patient care. The report recommends that the form and content of CTPs be reviewed, and there have been calls for further training of care coordinators.

The eligibility criteria for who can take on the role of care coordinator are being reconsidered and further guidance regarding what constitutes competency for the role has been recommended.

There have been suggestions that the involvement of carers may also improve the quality of some CTPs, and there is work to be done in increasing the numbers of patients that are offered their CTP in Welsh or a language of their choice.

Part 3: Self-referral to secondary services

The report states since the implementation of Part 3, self-referral to secondary MH services by patients who were previously discharged has become easier, though it is unclear whether the increase in self-referrals has led to a corresponding reduction in emergency admissions and assessment. There are doubts as to whether timely reassessment of patients is being achieved; the report notes that more performance indicators need to be collected to measure this. It also states there is still a lack of information and understanding, amongst patients, GPs and secondary care practitioners, about the right to self-referral.

Part 4: Independent Mental Health Advocacy services

168 people per month now receive an independent mental advocacy service that was not available prior to the Measure. While the Measure has resulted in increased clarity and improved access to advocacy services, the reported uptake in general hospital settings is low. This is thought to be due to inadequate levels of awareness among healthcare staff; in one survey, 42% of patients felt that ward staff did not give an explanation of their entitlement to advocacy. The report notes that work also needs to be done on enabling access for those who lack the capacity to request it.

Children and young people

Other

Image from flickr.com by Joe Houghton. Licensed under the Creative Commons

The Health and Social Care Committee reported in their post-legislative scrutiny that the issue of ‘greatest concern’ was that children and young people were not benefitting fully from the Measure.

On this issue, the review report states that provision under Part 1 will be addressed within the Together for Children and Young People initiative, which was launched in February to review Child and Adolescent Mental Health Services (CAMHS). An update on the CAMHS review is included in a written statement on mental health services in Wales, 7 October 2015. The report also recommends that Part 3 be amended to include children and young people in order to comply with the UN Convention on the Rights of the Child.

The Assembly Children, Young People and Education (CYPE) Committee carried out an inquiry into Child and Adolescent Mental Health Services (CAMHS) in 2014. Further information can be found on the Committee’s webpage.

The experiences and opinions of patients and healthcare professionals

Patient satisfaction

90% of those receiving LPMHSS rated the services positively and most patients surveyed found their GP extremely or very understanding. On the other hand some patients have reported limited support or interventions that did not meet their needs.

Independent research found a range of experiences of reassessment – some patients felt it had been straightforward whereas others had encountered barriers to timely assessment.

Healthcare professionals’ perspective

The report notes that collating the opinions of healthcare professionals has been more difficult, with low response rates to surveys. 74% of GPs rated the LPMHSS positively, but as a result of the Measure GPs and primary care staff feel they have an increased work load, and many find this work difficult. Most GP practice staff surveyed said ‘they had hoped to learn more about how to manage patients with mental illness’. The report recommends that support and advice for GPs and other primary care staff is prioritised.

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Is the Welsh Government doing enough to assist young people age 16-24 into work?

19 May 2015

Article by Anne Thomas, National Assembly for Wales Research Service

This is a picture of a man carrying out some masonry work.

Image from Pixabay. Licensed under the Creative Commons.

Assisting young people into work: a report by the National Assembly’s Enterprise and Business Committee

The National Assembly’s Enterprise and Business Committee was concerned that if you are under 24 in Wales, you are three times more likely to be unemployed that if you are over 24.

So in autumn 2014, they decided to undertake a policy Inquiry into Assisting Young People into Work to look at how effective the Welsh Government’s policies are. This included scrutinising progress towards the goals outlined in the Welsh Government’s Youth Engagement and Progression Framework which is being rolled-out between 2013 and 2015.

During the Inquiry, Committee Members heard from employers, charities, Careers Wales, local authorities, training providers, colleges and school managers, as well as Julie James, Deputy Minister for Skills and Technology and the Wales Audit Office.

They held an informal round table discussion event with key people in Swansea. During the event, many charities, careers advisers and youth workers spoke about the problems that unemployed young people face on a day-to-day basis and the best ways to support these young people to help them become work-ready and ultimately get a job.

Most importantly, Committee Members heard from young people themselves, including at Info-Nation in Swansea. A short video of the comments by young people across Wales is available from the Senedd TV archive, 26 November 2014.

The Enterprise and Business Committee published their report and a summary of the findings on 19 March 2015. The Committee made 16 recommendations.

Both the Committee’s recommendations and the Welsh Government’s response will be debated by the whole Chamber in a Plenary session on Wednesday 20th May.

What young people told Committee Members:

The young people said that the biggest problems they face are a lack:

  • of confidence;
  • of individual careers advice;
  • of understanding how to navigate the local jobs market; and
  • of advice on application forms and interviews.

Another big problem they face is the cost and availability of transport, this makes it more difficult to find a job whether they live in a rural area or large town.

What employers told Committee Members:

The biggest problem for employers is young people not being ready to join the workplace. They said that some young people need better employability skills and attitudes, including punctuality and reliability; social skills and respect for work colleagues; customer care skills; and better essential skills including literacy and numeracy.

The Committee’s recommendations include:

  • Schools should teach ‘work-ready’ skills in all subjects, not just in “Careers and the World of Work”; and the links between employers and schools should be improved.
  • Work experience for learners should be made longer and the placements should be properly organised. Careers Wales should be responsible for making sure work experience placements meet Health and Safety standards and keep a central list of placements.
  • Cheaper travel costs for 16 and 17 year olds under the Youth Concessionary Fare Scheme should be made available to 18 to 24 year olds.
  • Careers Wales should provide face-to-face advice for every young person who needs it. There should be more lead workers to help young people have the support they need to find work.
  • The Welsh Government should work with those who provide benefits to stop young people losing their housing benefit if they start work in a job with low pay.
  • Some young people need more help to start work and keep a job. There should be flexible, potentially longer, courses to help these young people to become work-ready.
  • There are many ways in which charities receive money to help young people find work and increase their skills. This money should be spent wisely.
  • More should be done to promote apprenticeships.

The Welsh Government’s response to the Committee’s recommendations

The response from the Welsh Government is generally positive, saying that many of the recommendations are in line with the Government’s current policy direction and link closely with activities that they are already developing and progressing.

The Deputy Minister has accepted seven of the Committee’s recommendations, a further six were accepted in principle and the remaining three recommendations were rejected.

Some of the Welsh Government’s current policy activities that link with the Committee’s recommendations include: Professor Donaldson’s review of the curriculum; the revised Welsh Baccalaureate Skills Challenge Certificate (from September 2015); and the Numeracy Employer Engagement project (launched in 2013).

The Welsh Government’s future plans include: a review of “Careers and the World of Work” curriculum (including a review of work experience and placements) and an Enhanced Employer Engagement project.

The Welsh Government rejected two recommendations that they should review and evaluate the opportunities that young people have in school to choose vocational courses at age 14 and age 16 and decide whether this balance is appropriate for the modern Welsh economy. The Committee were concerned there still isn’t equal support and parity of esteem between academic and vocational courses and career choices.

In response, the Government said they had established an external 14-19 Task and Finish Review, The review of local collaborative provision at key stage 4, which included looking at the opportunities for young people to access vocational provision and were confident that they had taken appropriate action.

The Welsh Government also rejected the recommendation that the Deputy Minister should reinstate the responsibility on Careers Wales to undertake Health and Safety vetting of work experience placements and to provide a National Work Experience Database. The Deputy Minister said that employers have the primary responsibility for the health and safety of students on work experience placements; and that schools, not Careers Wales, are responsible for the provision of suitable work experience placements.

The Welsh Government’s full response is published on the Plenary agenda: Plenary Agenda Item 5: supporting documents and the Plenary debate will be broadcast live on Senedd TV during the afternoon of Wednesday 20 May 2015.

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Is the Mental Health (Wales) Measure 2010 making a difference?

04 March 2015

Article by Stephen Boyce, National Assembly for Wales Research Service

Steve-Blog-Eng

Today the Assembly is debating a report by its Health and Social Care Committee on the Mental Health (Wales) Measure 2010.  The report sets out the findings of the Committee on the impact of the Measure.

The Measure was welcomed as a positive development in mental health care when it was passed by the Assembly in 2010 as it seeks to ensure that people experiencing mental illness can gain earlier and easier access to treatment and support before their symptoms become more serious.  It aims to do this by providing better mental health services in primary care and better care planning and support for people in secondary mental health services.  It also increases the involvement of service users in their care and treatment and widens access to independent mental health advocacy.

The Committee wanted to know whether the Measure is achieving what was intended.  Last summer it requested written evidence from mental health service providers, voluntary organisations and others.  It also invited the Minister for Health and Social Services, Mark Drakeford AM, to give evidence at its meeting on 20 November 2014.

The Committee’s task was aided by the inclusion in the Measure of a requirement on the Welsh Government to review the effectiveness of the Measure within four years of implementation.  The Welsh Government published an interim review of the Measure in spring 2014 and is planning a final report by January 2016.

The Committee found that access to mental health care and support in primary care has improved overall; more people are now seeking help with mental health difficulties.  However, the demand for treatment, especially talking therapies, can mean long waiting times in some areas.

The Committee heard that care and treatment plans are now provided for more people in secondary care than before but that their quality is variable.  There was evidence that the provisions in the Measure to allow former patients to re-access treatment if they become unwell is poorly understood by some staff and patients.

More people are now receiving the support of an independent advocate than before, although there is a need to improve knowledge and awareness amongst staff to enable them to help patients gain access to advocacy.

When he gave evidence to the Committee, the Minister outlined his plans to address these issues, which include setting up task and finish groups to review each of the four parts of the Measure and an action plan for psychological therapies.

The issue of greatest concern to the Committee was that children and young people, who were brought within the scope of the Measure at a relatively late stage, are not benefitting fully from it.  The evidence suggests that the new and improved services have been designed around adult services which are not always best suited to meeting the needs of children and young people.   The Minister has announced a review of Child and Adolescent Mental Health Services (CAMHS) to address these and other issues, including those highlighted by the Children, Young People and Education Committee in its November 2014 report on CAMHS.

The Committee also looked at the financial aspects of the Measure in terms of whether the original cost estimates were realistic and whether the levels of funding are sufficient to achieve its aims.  There was little evidence on which to base firm conclusions but the Committee heard that a properly implemented Measure should produce long term savings as earlier treatment reduces the need for services later.  In its report the Committee emphasised the need for robust cost benefit analysis to assess the value of the Measure.

Post-legislative scrutiny is a relatively new area of work for the Assembly.  The lessons learned from the Mental Health (Wales) Measure 2010 will help to inform best practice in the making and implementation of future legislation.

The Committee made 10 recommendations.  Its report, the evidence it received, and the Minister’s response to the report can be read here.

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