It’s no secret that Birmingham has constantly fallen short of its responsibilities in relation to Safeguarding Children. After an Ofsted report was published in October 2013, Ofsted chief inspector Sir Michael Wilshaw branded Birmingham “a national disgrace” and said the city “encapsulated” the worst failings in child protection seen in the country.
The new strategy for improving Children’s Services in Birmingham includes committing almost £10 million for children’s social care. 
At the same time, however – as part of Birmingham City Council 2014-15 Budget and Planning Birmingham’s Future Consultation – there is a proposal to decommission the Pregnancy Outreach Worker Service (POWS).
We know that POWS make a big contribution to the safeguarding of children in Birmingham, so we’re very concerned that losing this service will create an even bigger gap for more vulnerable parents and children to fall through.
POWs work with mothers to safeguard children
In our experience, there are two critical times for mothers that have a direct effect on Safeguarding:
- throughout the pregnancy, to prepare the mother to be a ‘fit parent’, and
- after a child has been taken into care.
Preparing the mother is an obvious way to work towards safeguarding, but it also saves money. This time last year, in a blog post called short term cuts make long term holes, I wrote about how our work with just one family – preparing the mother to be a fit parent – saved £20,000. It’s an example of how POWs help to fill the ever-present gap between adult and children’s social care.
Birmingham is recruiting more Health Visitors but, during her pregnancy, a pregnant woman will only see a Health Visitor for a booking visit. Social work and regular Health Visitor appointments begin when the baby is born. After the birth, both Social Worker and Health Visitor are (rightly) there for the child, and will follow the child if he or she is taken into care.
Why is it important for the mother to receive support after a child is taken into care? Because our experience tells us that there is a cycle. After a child is taken into care, the mother:
- often gets pregnant again
- requires emotional support
- can revert to past behaviour – substance misuse, sex work, etc
- has no statutory support
- needs follow up and care for contraception
- often needs ‘bereavement’ type counselling
Stopping the cycle is a crucial part of Safeguarding.
How do POWs save money?
At the moment, POWs support 600 women a year through pregnancy. All of the women we support have social risks and support needs, but about 10% of these are expecting children classified as ‘at risk of significant harm’ or ‘in need of statutory services’ (in other words: ‘known to Social Services’). On average a POW spends 120 hours with a pregnant woman if she is known to Social Services. So, over the course of a year, that is 7,200 hours spent working with women who are known to Social Services, in the pre-natal period.
POWs are not social workers, but they are specially trained and highly experienced workers who work intensively with pregnant women. They can help to stop the care cycle and create more ‘fit parents’. More fit parents means fewer children subject to Safeguarding, which means lower costs for the city and less pressure on Social Services.
With POWS, that £10 million could go a lot further.
This amazing service must continue for the benefit of those mothers and their babies who are most vulnerable. I know from meeting some of the mums, reading the blogs,listening to the midwives etc. the difference that the POWs make. I urge the council to reconsider this proposal.
I for one fully support the work that POWs does. It would be devastating for this service to be decommissioned based on the facts and figures demonstrated. I too urge the council to reconsider this proposal.
Here is your chance to feedback to the Council – Page 21. https://www.birminghambeheard.org.uk/adults-communities/adults-and-communities-budget-consultation/consult_view – POWs has been going for 7 years, it is not a pilot. It had an RCT done in 2009/10 about specific outcomes – results are not out yet, was not related to safeguarding.
We all sympathise with the difficulties that BCC is having in addressing the dire safeguarding issues whilst identifying the savings needed to meet their budgetary obligations but decommissioning POWs is not the answer. POWs have a wealth of experience and knowledge in supporting vulnerable clients throughout pregnancy and during the first months of a child’s life. They act as a first point of contact for vulnerable families, and have the knowledge and skills to support clients in dealing with a multitude of public sector and private agencies. The staff are highly skilled para-professionals and the service is extremely cost effective. The sadness is that it is only commissioned to accept 600 clients per year from the 10 most deprived Birmingham wards. Rather than decommissioning the service we need to discuss to how to extend the service so that it covers the whole of Birmingham and how to ensure that those clients who have left the service are still able to contact their POW for ongoing support and signposting when necessary. This needs to be accompanied by a debate around spreading the cost equitably across all the public sector agencies whose clients/patients benefit from the work done by POWs.