Nottinghamshire County Council: Year 1 update

Background to area

• In Nottinghamshire, in general, outcomes for children and young people are similar to the national average, however, there are large disparities within the County with some children and young people facing greater disadvantages than others
• Localities where there are higher numbers of families on low incomes are those localities where children and young people are less healthy and do less well at school. Some children and young people may face particular disadvantages and so need more support to fulfil their potential.
• Deprivation levels in Nottinghamshire are comparable with England. However, within Nottinghamshire there are communities with both some of the highest levels of deprivation in the country and some of the lowest levels of deprivation. The most deprived areas are Mansfield, Ashfield and Bassetlaw. People living within the more deprived areas of Nottinghamshire have higher levels of unemployment, lower levels of qualifications, less healthy lifestyle choices and poorer health and wellbeing outcomes
• Nottinghamshire has levels of child obesity which are statistically similar to the England average. However, this masks inequalities in the prevalence of child obesity between the county’s seven districts, these disparities are correlated with deprivation at the neighbourhood level with a 5.8 per cent “inequalities gap” in childhood obesity prevalence at Reception age between the least and most deprived areas of Nottinghamshire, which increases to 13.5 per cent by Year 6 (2014/15 to 2016/17 data). This inequalities gaps at year 6 has increased significantly since 2007/08-2009/10 when it was 9.3 per cent.

What is the project trying to achieve?

• Nottinghamshire County Council (NCC) plan to build on their broader whole system approach around the community food environment, to develop food skills, access and support for families with children in the early years.
• They will test out how Children’s Centres can be developed as community food assets by utilising the school catering services supply chain and other potential local food suppliers to offer low cost, healthier foods and recipes enabling families to develop their food skills and knowledge.
• With the commitment of their Food for Life, Gold Standard school catering service, they will trial expanding their supply chain to childcare providers to facilitate provision of healthy food in line with nutritional guidance and familiarise families at pre-school age with the school meals offer to increase uptake of school meals.
• Nottinghamshire will explore the potential of using Healthy Start Vouchers innovatively such as through recipe boxes procured through the supply chain to increase local uptake. They will also support staff in the early years and childcare sector to develop food preparation and menu planning skills and promote consistent messages to families around foods and healthy eating.

Progress (July 2019-June 2020)

• Developing and building on relationships with local stakeholders
• Developed project governance infrastructure, including local stakeholder project team meetings, to steer and progress project milestones and COTP Governance meeting involving senior leadership from different parts of the Council.
• Presented to Council committee structure across Adult Social Care and Public Health Committee and Children and Young People’s Committee
• Agreed specific children’s centres that will be engaged in the project and the specific activities that will be built upon in project year 1
• Established a task and finish group involving members of the project team to consider the Public Health England example menus for Early Years/Eat Better Start Better Guidance.
• Utilised the related technical guidance enabling Nutriplanner to input nutritional data specifically for early years into their database, as a result the School Catering Food Development Manager can now run recipes/menu’s through the database to ensure the menus to be tested are nutritionally compliant for Early Years setting and can be combined with nutritional guidance for children and adults to form family meals. This was the starting point to enable recipe boxes, supply chain development and logistics to be prototyped
• Two Public Health Support Officers were recruited to work on the programme and aligned local Healthy Start scheme, including vitamin work. Both bringing wealth of experience and expertise in this sector and co-production approach
• An Early Years Questionnaire was developed to engage the sector which was tested with the council’s early years stakeholder group and was disseminated to all Early Years providers in Nottinghamshire with over 262 completed responses.
• Four themes/strands have initially been identified from the questionnaire to test further: 1) Healthy Start promotion, 2) Early Years Food for Life accreditation, 3) School meals supply chain, 4) Community of Practice
• Established two working groups in the Children Centre’s where initially work is focusing (Ravensdale in Mansfield and Harworth in Bassetlaw), engaging with local stakeholders and the community.  Initially the sub-groups were facilitated to map out the user journey at each stage of the recipe bag concept process (advertising, launch event, service delivery, sustainability). This information was collated and synthesised and shared at the Trailblazer Learning Assembly
• Working alongside the Communication and Marketing team at NCC the School Meals Development team has started to develop the concept of the meal bag/box, including marketing/branding concepts & menu/recipe card to reflect both established school meals branding and new Children’s Centre’s branding
• Developed evaluation approach and framework with support from ICF
• A baseline for Healthy Start has been established in each district.  Awareness raising of the scheme has taken place across districts, primarily through establishing links with District Council Health and Well Being Officers/Partnerships
  • Information has been developed Department of Work and Pensions to help raise awareness of Healthy Start with work coaches, enabling conversations during meetings with clients
  • Links have been built with Midwives and Healthy Families Teams to develop and implement ‘starter packs’ containing Healthy Start vitamins, Healthy Start information and general advice re the importance of vitamins and good nutrition in pregnancy/early years
  • Information has also been included in a letter from Notts CC Early Years to all parents not taking up funded childcare place for 2-year olds, as many of these may be eligible for Healthy Start
  • COVID-19 has seen a surge in applications in Universal Credit and therefore people that may be eligible for Healthy Start. Working with the Department of Work and Pensions, Citizens Advice Bureau, and other advice services to ensure continued awareness of the programme and encourage people to submit applications.

Learning

• Childminders do not need food hygiene training as part of the service delivery
• Baby-led weaning looks overwhelming and needs to be translated carefully into practice
• The space that the Trailblazer has provided for cross council working and exploration of levers has enabled further collateral benefits
• Realising benefit of working with other departments within the County Council e.g. Children’s Early years Commissioning team are a valuable asset for engaging with the Early Years Sector
• A number of practicalities that need to be considered for a Children’s Centre to become a community food asset e.g.
  • Environmental Health requirements (food storage, allergens)
  • Administration (Taking payment etc)
  • Managing volunteers
  • Supportive of other initiatives e.g. promoting services
• Partners within the project group are learning from being part of this Trailblazer, they are working with different people, reinvigorating interest and passion and using skills and techniques in other areas of their work
• When the situation requires, systems can work quickly to respond to the requirement to meet critical need. There are many examples of the removal of political barriers to achieve this, for example the changes to the Healthy Start scheme
• Changes to the Healthy Start programme nationally have enabled easier access to the scheme as health professionals are no longer required to sign the application form. This was shared through a wide variety of networks including the COVID19 Food Supply Group as well as with the COVID 19 community hubs to adapt the script for incoming calls to customer service advisers to identify pregnant women and parents with young children
• The increased number of families facing food insecurity as a result of COVID-19 has given Public Health an opportunity to align the relationship between families facing food insecurity and those being targeted to improve their access to healthy and affordable food. This will help inform the future direction of the Trailblazer

What next?

• Re-establish links with project stakeholders individually and re-establish project team meetings (post COVID-19)
• Scope Family Action Model (food club) as a combined Intervention alongside school meals
• Commissioning of Soil Association Food for Life (FFL) early years’ service and identifying six settings to work with on FFL accreditation
• Procurement of evaluation partner and specialist marketing support
• Embedding Healthy start with Healthy family team, Children’s Centres and wider partners
• Deliver two focus groups (test & learn approach incorporated alongside project delivery)
• Delivery of food bag scheme in two Children’s Centres
• Establish Community of Practice and increasing ways of promoting consistent healthy eating messages within the sector
• Full Healthy Start promotion campaign.