This module is part of the background information section along with the Start for Life Offer and other policy and practice initiatives and Family hubs funding explained. We recommend you also read those modules before moving on to the strategic ‘golden threads’ section.
This module explains how family hubs can be the vehicle to deliver and integrated early help offer to local communities though a strengthened and more connected universal and targeted offer for families. It also outlines some of the existing evidence for integrated ‘hub’ models and the impact they can have on families, as well as some of the known benefits for families from a system-wide, integrated, whole-family approach to family support provision. As well as being founded on research evidence, it is crucial that the family hub model is rooted in family experience and local practice.
What are family hubs and how to they connect to early help?
The Family Hub and Start for Life Programme Guide, state that family hubs are a place-based way of joining up locally in the planning and delivery of family services. They bring services together to improve access, improve the connections between families, professionals, services, and providers, and put relationships at the heart of family support. Family hubs offer support to families from conception and two, and to those with children of all ages, which is 0-19 or up to 25 for those with special educational needs and disabilities (SEND), with a great Start for Life offer at their core.
The National Centre for Family Hubs, Anna Freud summarise this as, ‘a family hub is a system-wide model of providing high-quality, whole-family, joined up, family support services’.
The term integration is used throughout this summary and a more in-depth exploration of how we are applying it to family hubs using relational practice can be found in the integration and relational practice module.
Early help provides the framework. Family hubs is the approach, the way early help is delivered to local communities. This enables all the strands of government early help policy – start for life, supporting families, reducing parental conflict, youth provision (see below) – to be integrated under one governance structure and at the point of delivery through this new family hubs approach. It also links into the children’s social care implementation strategy and commitments around ‘family help’, which you can read more about in the 2023 report Children’s social care stable homes built on love consultation.
Put simply, early help is about identifying needs within families early and providing coordinated support before problems become complex. An increasing number of local authorities, like Westminster, are already delivering their early help offer through a family hub approach. This means that families experience a more joined up offer of support whether this is by going to their physical family hub, through outreach as a part of the family hub offer or accessing early help support through online family hub resources. Crucially, in the family hub model, the views and wishes of the family are put front and centre to the support they receive. It is a partnership with parents and family plans are co-constructed. By finding out what is working well for families and what areas they may be worried about, the family hub can help to build on families’ strengths and identify areas where further support might be needed. Organisations work together to provide this early help offer: the local authority children’s services; health visiting; school health; CAMHS; housing; maternity services and crucially the voluntary and community sector. All are equal partners in this family hub relationship.
Depending on what is most helpful for the family and their needs, the early help offer is adapted for each family’s needs and the outcomes map across the government initiatives covered in the next section.
Family hub delivery principles
There is a clear and simple way for families with children of all ages to access help and support through a hub building and approach.
- Services work together for families, with a universal ‘front door’, shared outcomes and effective governance.
- Professionals work together through co-location, data-sharing and a common approach to their work. Families only have to tell their story once, the service is more efficient, and families receive more effective support.
- Statutory services and voluntary and community sector (VCS) partners work together to get families the help they need.
- The Family Hub prioritises strengthening relationships and builds on family strengths.
- Relationships are at the heart of everything that is delivered in Family Hubs.
Frequently asked questions about the key characteristics of a family hub
Who should family hubs help?
A Family hub is for families, from conception, through the child’s early years, to later childhood, up to 19 years old (or 25 for young people with special educational needs and disabilities).
Family hubs provide family support services early, when families need them. These include universal and targeted services, including access to the intensive support of a supporting families keyworker where appropriate.
Family hubs can support all families, particularly in the first 1,001 days, but they are designed to be particularly accessible to families who may be experiencing socio-economic disadvantage, have special education needs or a disability or experience exclusion due to being from a minoritised group. You can read more in our Start for Life Offer and other policy and practice initiatives toolkit module.
Where should family hubs be delivered?
Family hubs deliver services in a variety of ways and at a range of locations; this reflects what the national centre has heard from families they want from family hubs. Hubs are not necessarily about creating new buildings but focus on bringing services together and changing the way family help and support is delivered locally. In practice, this will be a mix of using children’s centres and other local authority spaces, and repurposing other public buildings such as libraries, schools, even high street shops. A significant proportion of family hub services will be delivered virtually. Other services will be delivered in the homes of families themselves – outreach will form an integral part of family hubs, overcoming the access barriers many families experience in receiving the support they need.
What do family hubs provide?
Family hubs use a whole-family approach, providing a single access point to integrated family support services across health (physical and mental health) and social care, as well as council for voluntary service and education settings. A family hub makes these things come together. The integration of services into a family hub model may involve changes to the structure of local service provision, and may also involve a shift in how support is offered to families.
As the National Centre for Family Hubs, we will be working with DHSC and DfE to encourage all family hubs to include a specific Start for Life offer, which could include midwifery, antenatal education, health visiting, breastfeeding support, and parental mental health support. You can read more in our Start for Life Offer and other policy and practice initiatives toolkit module.
Family hubs are an important part of the Best Start for Life vision. Beyond that, family hub providers also have the autonomy to respond to specific needs in their areas based on local system assessments, population needs assessments and other local population data. This means that services included in a family hub will vary. For some, there may be a focus on homelessness, for others it might be youth mental health. It will be the seamless integration of universal services with targeted support that will be vital in determining positive outcomes.
Who needs to be involved in family hub delivery?
The development of a family hub should involve key stakeholders from your local area across health, social care, education, voluntary and community sector and council for voluntary service organisations, and it should be representative of the 0–19 age range This will include commissioners, service providers, frontline practitioners, parents, carers and children. Each family hub must meet the needs of the local community; a range of perspectives from the local area is therefore required to establish and deliver the best model of service provision for each hub.
Guidance on family hub development includes who should be part of the process to make it as effective as possible and to benefit families the most.
Why family hubs?
Family hubs are being developed in response to a number of challenges that affect the provision of support for children and families. In summary, challenges include: increasing child poverty and mental health problems; unaffordable childcare costs; staff shortages across health, social care and education leading to reduced provision; staff burnout; increased developmental delays due to coronavirus lockdowns; increased rates of social care referrals; inequalities in the wider healthcare system as well as prenatal and perinatal healthcare for birthing people and women from minoritised groups, particularly those who are racialised as Black.
Evidence shows that children who grow up in families experiencing socio-economic disadvantage, or exclusion due to being from a minoritised group, are more likely to have poorer outcomes across four key domains of child development, from conception to 19 years, compared to their same-age peers.
These four domains are:
- physical development
- behavioural development
- cognitive development
- social and emotional development
The research finds that children who experience early-life adversity have measurable adverse outcomes across all these developmental domains as early as two years of age, and that these developmental delays or difficulties are sustained into their teenage years and beyond.
Outcomes for parents and carers
Research by the UCL Institute of Health Equity suggests that there are intergenerational links in exposure to childhood adversity, which means that children who experience Adverse Childhood Experiences (ACEs), are more likely to have a parent who also experienced ACEs. Although there are some studies which suggest links between ACEs and parental stress and the impact on parenting, there are also many psychosocial and policy approaches which can mitigate this risk.
The Early Intervention Foundation (EIF) has estimated that the cost of late intervention is almost £17 billion a year, suggesting that providing family support early can lessen the demand for statutory intervention or acute services later on.
The principles of the family hub model have been developed based on existing evidence for various aspects of integrated ‘hub’ models. These are summarised below:
Providing support early in life
The increasing evidence base, presented in The best start for life, linking the adverse impact of early stress, trauma and adversity on child outcomes, from conception, during pregnancy and the early years, is now overwhelming. The review points strongly to the need to ensure that children have the best start in life and live in environments that nurture and protect them from risks from their very earliest moments. It also acknowledges that, in order to build back better from the coronavirus pandemic, the youngest members of society – and those who nurture and care for them – must be given the help and support they need.
Providing integrated family support across health, social care, voluntary and community services and education
- There is a strong consensus in evidence and practice, highlighted by the Early Intervention Foundation, that greater integration can benefit families. High-quality integration is supported by a single point of access that families can use to engage with services that meet the myriad of needs they may have.
- One of the key principles of successful family support services is multiagency working. Different service providers connect and coordinate, so that families get the support they need. This way of working is not just about making a series of referrals or interventions; rather, it is about professionals working together to make the differences that are needed for each family in a holistic way.
- Qualitative research tells us that integrated family support services improve the experience of families when they only need to tell their story once because services and professionals are appropriately working together to give them the right help. Better connected professionals reduce the burden on families of managing multiple relationships and appointments and means they should not have to continually retell their story.
- This kind of integration would address barriers to access that parents and carers say they face, as reported by Action for Children in Beyond reach: Barriers to accessing early years services for children. Integration is significantly supported through digital data-sharing to give professionals the tools they need to collaborate more easily as a ‘team around the family’. It also promotes a way of working that allows professionals to spend more high-quality time with families and less time on administration and lower-impact work, ultimately yielding better value for money and better outcomes.
- Another example of a well-evidenced integrated model of family support (specific to the 0–5s only) is the Sure Start initiative. An evaluation of Sure Start highlights the positive impact of integrated services on improving outcomes for children, in particular children and young people’s social development and an improved learning environment at home. One analysis explores links between Sure Start implementation and effectiveness for child and parenting outcomes. Its findings provide useful guidance on the design of child, family and community services.
Providing a service that is accessible to all families
- Current provision can present a complex service landscape that can be difficult for families to navigate in order to receive the often multilayered help they require. This fragmented nature of support provision leaves families vulnerable to ‘falling through the gaps’, particularly when accessing support during transitional periods (e.g., moving from perinatal support services to early years support).
- An integrated model of family support that improves join-up between organisations can provide a consistent, public-facing point for access, assessment and navigation of family support services. Improved relationships with CVS and grassroots institutions will enable a much wider range of initial contact points, improving the ability of all families to access services.
- Research indicates that families (particularly new parents and young people) appreciate being able to access family support services flexibly, using both physical and virtual spaces to improve access and experience.
Taking a whole-family approach
The family hub model extends support to families with children and young people from conception to 19 years of age (or up to 25 for young people with special educational needs and disabilities). This means that families can access a range of support services appropriate to all stages of family life from within the same hub network, which reflects what families tell local authorities they want. Ensuring consistent support to families of all make-ups, with children of all ages, promotes the development of trusted relationships between families and professionals within family hub services. This extended and universal support, which will be complemented by the incoming NHS 0–25 children and young people mental health delivery system, will be crucial for meeting the needs of groups that have been excluded or discriminated against due to their protected characteristics and offer specific support for children in care, young carers and parents.
Taking a relational approach
- Relational practice has consistently been found to improve both the experience and outcomes of families engaging in family support services. This is highlighted in the independent review of children’s social care, A case for change. Relational practice means taking a family focus, where strengthening relationships within families is prioritised across a variety of situations (e.g., a breakdown in couple relationships) and may range from conception to teenage years. An EIF review of early childhood services delivered through local hubs found that trusted relationships were crucial in enabling parents to feel confident in attending children’s centres, and in sustaining attendance in more targeted support programmes. The delivery of universal services within children’s centres was seen as a way of removing barriers by avoiding a reliance on other services to build relationships with families, which would then connect them to children’s centre support. This integration reduced the likelihood of families falling between services due to ineffective referral pathways.
- A relational approach also means taking account of specific family dynamics, the local situation and the wider sociocultural context to build on family strengths and support the different layers of a family’s needs in a holistic manner. Ultimately, the aim of a family hub is to strengthen families by providing help with the myriad of challenges they face. This is key to a preventative and early intervention approach that improves outcomes for families, children and young people.
Using the rest of the implementation toolkit and National Centre for Family Hubs support
As part of National Centre for Family Hub’s implementation toolkit, we have coproduced a suite of tools and resources to help you in the development of your family hub.
The toolkit has been divided into four sections:
- background information
- strategic ‘golden threads’
- practice approach
- ingredients for successful implementation
We have written the modules so you can build on each section starting with the broad context and gradually becoming more and more specific in terms of implementation. We recognise that areas will be in different positions and so you might find it useful to go to specific areas depending on your current need. At the beginning of each module, you will see the following image to show you where you are in the toolkit. Some modules are in the process of being written and this will be indicated by a “coming soon” placeholder.
In addition to the toolkit, there are other options of support with family hub design and development:
- National webinars: you can book onto upcoming webinars and access previous event recordings and accompanying resources.
- Regional support: you can contact our regional advisory team, who will be able to either provide you with some support or signpost you to someone else. We facilitate a number of communities of practice, 1:1 support and other spaces to share learning such as “lunch and learns”.
- Family hubs online network: join our Teams space to share knowledge, resources and network with other local authorities. Please email firstname.lastname@example.org to sign up.
- Consultancy and training offer: If you would like more in-depth support – not just with family hub development – but also with wider local authority transformation using Anna Freud Centre expertise, we can create a bespoke support package for you. We recommend this takes place in-person but we can adapt this to be online too. Please email email@example.com for more information.
Please find out more about our support for local authorities.
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