Team: Sunrise Hub: The Northeast London Child Sexual Abuse hub (CSA Hub) and LBBD CSA Practice Leads.

Partners: Barts Health NHS Trust, Barnardo’s

Main Submission:

Introduction to the Initiative and Motivations for Action
The North-East London (NEL) Child Sexual Abuse (CSA) Hub, also known as the Sunrise Hub, is a holistic, child-centred, and integrated approach to supporting recovery of children and their families affected by sexual abuse. This initiative was commissioned by Newham CCG and involves multiple partners, including Barnardo’s TIGER services, Barts NHS Health Trust, and a Social Care Liaison officer (SCLO) employed by LB Barking & Dagenham (LBBD).

The Hub has expanded to become a comprehensive wellbeing Hub for all North-East London. The Initiative’s motivation stems from statistics that 1-in-20 children and young people experience child sexual abuse, costing the UK £3.2bn annually. In NEL alone, there were over 700 cases of non-acute CSA reported in 2018/19, with Newham having the second highest rate of reporting in London. The challenge was the lack of tailored emotional support for these children, which led to the development of the TIGER service (Trauma Informed Growth and Empowered Recovery).

Details of Actions, Activities, and Initiatives
The Sunrise Hub has implemented several best practices, combining traditional psycho-educational work with coaching and trauma-informed practice, helping children find strength to lead their recovery. The service operates across NEL and Northwest London Integrated Care Systems (ICSs) and supports victims of both intra-familial and extra-familial abuse. Key actions include:

• Young Person Research-Based Evaluation: In 2022, MOPAC, along with NEL and NWL, funded a research project focusing on how London CSA services can be improved. Peer researchers undertook surveys with over 300 current and historical CSA service users and their parents.
• Flexible Service Delivery: Emotional wellbeing services are delivered in locations chosen by the child.
• Partnership and Collaboration: Weekly intake and partnership meetings between Barnardo’s, the health team, and the SCLO ensure ongoing collaboration. Partnership with Local Authorities
• SCLO: This is a LBBD employed role, supporting 7 NE London boroughs. It offers advice and liaison between social care professionals and the Sunrise Hub. As a result of this role and the CSA improvement work undertaken in LBBD, the borough has submitted the highest number of referrals in NEL to the Sunrise Hub for CSA medical assessments as well as TIGER referrals for children. In addition to this, LBBD have set up a CSA Think Space consultation which is run by the SCLO and CSA Practice Leads who offer a reflective space to consider and drive best practice. Sunrise Hub attended 61 strategy meetings in LBBD between April ‘24 and December ‘24 in contrast to 28 during the same 2023 period. This has resulted in children and their families receiving timely coordinated services.
• Promotion and Referral: Local authorities, particularly GPs and children’s social care directorates, actively promote, signpost, and refer children to the Sunrise Hub.
• Awareness Training: The Sunrise Hub, in collaboration with local authorities, conducts training on trauma-informed conversations with children, parents, and carers, as well as support for lower-risk children
• Statutory Safeguarding Processes: The partnership ensures that statutory safeguarding processes are followed, reducing the need for children to repeatedly recount their experiences.
• Service Expansion and Development: The local authority has developed work within schools to raise awareness about healthy relationships, consent, and the use of pornography.
• Feedback and Improvement: Local authorities alongside the Sunrise Hub gather feedback from children, young people, and families for service improvement.

Evidence of Impact

• Improved Emotional Wellbeing: The TIGER service has helped children and young people improve their emotional wellbeing, rediscover their sense of self, and learn to self-regulate.
• Increased Referrals and Access: The CSA health assessment clinics have seen an increase in referrals since 2020, and Barnardo’s has received 388 referrals from April 2020 to March 2023, with 95% being accepted and offered support.
• Sustainability and Clinical Practice: The creation of a network of paediatric CSA expertise with contracting/funding processes ensure the sustainability of the hub.

Voice of the Child
The Tiger Talks evaluation project recruited peer researchers to undertake surveys and oneto-one interviews with children and young people. Key findings include:

• Safe Space for Exploration, Validation and Support: Children and young people reported that the support services provided them with a safe space to explore their emotions and talk freely.
  • “It has been good having sessions, and I have learnt a lot, and my TIGER practitioner has listened to me and not judged me. My confidence has
    gotten better, and I go out more with friends. I get on better with my mum as I can be more opened when speaking with her. Thank you”
  • “It has been good to speak about what happened to me. I have never felt judged. – It has been easy to open up to you about my feelings/moods
    and my emotional well-being. I have found our discussions good.”
  • “I was able to talk about my feelings and problems. I understand what abuse is and I recognise when someone is taking advantage of me. I felt happy working with my practitioner, and I felt safe”.
  • “The sessions with my TIGER practitioner benefited me and helped me process hard thoughts. Helped with my derealisation. Made me realise I have a voice and am heard. And empowered.”
• Comments were made regarding the professionalism, attentiveness and friendliness of both doctors and play specialists. Parents/carers felt that their child’s choices were respected throughout and would recommend the hub to others
• 2 Parents stated that information and videos before the appointments were helpful to manage expectations
• older kids commented on the fact that they liked the pace of the appointment and the fact that staff took time to explain everything before it was done.

In summary, the North-East London Sunrise Hub exemplifies best practice in supporting children and young people affected by sexual abuse. Its holistic, child-centred approach, combined with strong partnerships and innovative practices, has made a significant difference in the lives of many. This model of multi-disciplinary working lends itself to being better placed to respond to the recommendations set out in the National Review into child sexual abuse within the family environment

Supporting Information:

Partners: South East London ICB, Public Health Team

Main Submission:

Commissioning  

Our commissioning work has long been delivered in partnership with our ICB and Public Health Teams and there is a long-standing commitment to sharing resources where this supports the effective delivery of effective services to children and their families. Two jointly funded integrated Commissioning Director posts, one for adults and one for children, were established in 2021 with responsibility for overseeing commissioning activity across the Local Authority and South East London Integrated Care Board. 

The integration at senior leadership level was further built on through the development of a fully integrated staffing structure over 2022-23, which was implemented from 1 April 2024. These jointly funded teams now oversee the commissioning of services across all aspects of children’s – from CAMHS and placements for children in care to detached youth work and maternity services.  

This has helped strengthen the focus on join-up in our commissioning, including supporting the development of examples below.  

Direct and Commissioned Services  

As part of working together across the LA, ICB and our provider Trust (Oxleas NHS Foundation Trust), we have established a new integrated Clinical Team.  The team is employed by Oxleas and co-located in Children’s Services. The team delivers direct services to children and families with emerging mental health needs (child or adult). It also supports practitioners by offering clinical consultation and supervision. The service accepts referrals for children open to any part of children’s services (including youth justice services, education welfare services as well as social care). Building on this team it has recently expanded to include two specialist mental health workers for Care Leavers (fully funded by the ICB) who are also clinically supervised by Oxleas adult mental health services. 

These arrangements have recently been strengthened by the introduction of family network co-ordinator (funded by Public Health) to improve the emotional well-being of care leavers and reconnect Care Leavers with their networks.  

Our partnership with health also enables us to have strong joined up continuing care and social care decision making and commissioning arrangements in place. A joint panel co-chaired by the ICB and LA oversees the assessments for Continuing Care and provision under the Chronically Sick and Disabled Persons Act.  Although our continuing care budget is overspent, leaders across the partnership understand the volume and complexity of need and work together to alleviate pressure and provide the best support for children and their families.  

The successful commissioning and delivery of services is based on governance and oversight arrangements that are characterised by high trust and integrity. Our DCS has regular 1:1 meetings with the Director of Children and Young People in the Community Health Trust. These meetings are complemented by regular joint leadership meetings between Children’s Services, the Community Trust and ICB.  Most recently these have been extended to Heads of Service. These arrangements strengthen cohesion by fostering sustainable and high-trust relationships.  

Our health partners play a strong role in statutory safeguarding arrangements and co-chair three of our five sub-groups (Quality Assurance and Audit, Learning, Training and Policy as well as the Serious Care Review Group).  

All of our recent inspection activity has highlighted the strength of partnership working in Greenwich.  

HMIP (March 2023): ‘There is an extensive health offer to the children working with the YJS, including a family intervention and clinical health lead (consultant clinical psychologist with CAMHS), YJS nurse, substance misuse service workers, a speech and language therapist, and a liaison and diversion specialist. These personnel are co-located with the YJS team and we saw good evidence of speedy access to services in our case’ inspection. The health team supports accelerated access to specialist mental health services, where this is required. 

Local Areas SEND Inspection (May 2023): ‘Leaders in Greenwich are determined that every child or young person with SEND should have their needs identified accurately and met consistently. The local area partnership in Greenwich is mature and fully integrated. Jointly commissioned services are well established. Leaders across education, health and care know exactly what is working well, and which aspects of work could be even better’. 

ILACS (June 2024):  

• Highly effective partnership working with housing colleagues, schools, youth services and children’s centres, as well as mental and physical health services, helps children and their families receive the right support at the right time. Collaborative multiagency working is making a difference to children and young people’s lives and helps to limit the demand for more intensive statutory provision. 

• There is a strong focus on supporting care leavers to maintain their physical and emotional health. Intelligent and effective joint work with the mental health early intervention team provides timely and effective support to care leavers experiencing mental health difficulties. 

Team: Family Hub Transformation team.

Partners: Merton Connected, Keystone Marketing, KidsFirst (parent/carer forum)

Main Submission:

In late 2021, Merton applied for transformation funding to support borough wide implementation of the DfE Family Hub programme. Since November 2022 Merton has, alongside 12 other successful LA’s worked diligently to initiate and embed widescale change in the way that Early Help services are accessed and experienced by babies, children, young people and their families.

Moving to a place-based delivery model with strong focus on ‘Access, Connections and Relationships’ has been achieved with careful planning, navigation and engagement across a wide stakeholder landscape. The need to talk with, hear and respond to the views of local families has remained front and centre of early development work. Embedding the ‘Family Hub’ brand and a shared understanding of the concept has taken time. The evolution of ‘Our Merton Family Hub’ was driven by a need to develop simple language and messaging about how Family Hub services would be experienced by those who use and deliver them.

The development of ‘Our Merton Family Hub’ (or visual pledge as it is often referred) was an iterative process, drawing initially, from insights and feedback gained through engagement and consultation activity. This included:

1) Discussions with parents who had joined ‘Merton Family Voice’ (a parent/carer forum where feedback on various aspects of transformation has been sought).

2) Conversations with young people and families who attended the Family Hub launch event in August 2023.

3) Feedback shared by VCFSE partners in a series of workshops aimed to build relationships with third sector organisations (many of whom represent the views/experiences of lesser groups within our local communities).

4) Structured activity held during a Partner Engagement Day (19.01.24) where views were sought on the shaping of a visual pledge.

A visual illustrator was drafted in to translate words into pictures. This was considered important to ensure that the messaging about Merton Family Hubs is understood and accessible to a diverse audience, including younger children, families with SEND, people with learning needs and those with English as an additional language. Young people also told us that any information needed to be easy to both read and understand.

Five versions of ‘Our Merton Family Hub’ were drafted before landing a final product. Each draft was consulted on, and feedback drawn from several sources (including the audiences has allowed Merton to be fully assured that the inception of ‘Our Merton Family Hub’ is truly informed by co-production and collaborative working, supporting a sense of borough wide ‘ownership’ regarding the programme and its aspirations.

This mode of engagement and consultative approach has enabled families and delivery partners to contribute to the shaping of Merton’s Early Help/Family Hub offer. We recognise that for many families, the support provided through Our Merton Family Hub has made a huge difference when managing very challenging circumstances and whilst waiting for specialist health interventions. This has been of particular significance to parents of children with SEND, who have told us how Family Hub services have really helped them to better care for their children when they become dysregulated. The interface with ‘Kids

First’ has helpfully shaped the framing of Merton’s approach to better reflect and respond to the lived experience of families with SEND and work towards improving outcomes through an effective support offer.

Using the strapline ‘Our Merton Family Hub’ and displaying this widely across buildings, promotional material, websites, presentations and communications has also promoted a sense of collection and belonging. Families told us that they wanted Family Hubs to be somewhere with more opportunities to ‘drop in to’ and meet other parents when the opportunity arises. This is reflected in various ways within both the visual pledge and through the developing Family Hub service offer. As a direct result of feedback, we have increased drop-in sessions across our Family Information and Support Hubs, Open Garden Sessions, MIASS and delivered more open access ‘on off’ events for Families to attend. This has been well received with over 100 family members attending a recent open garden session at one of our Family Hub network delivery locations.

Children young people and parents each contributed to the shaping of this work. Parents of children with SEND shared helpful feedback on use of colours and imaging to support greater full accessibility. Whilst efforts were made to reduce the amount of text within the visual for ‘Our Merton Family Hub’ some parents shared that the visual had too many images and not enough information. Based on this feedback, a decision was taken to develop a separate booklet for parents which explains Family Hub services and the support available. These have been shared at various engagement events with parents reporting that the information contained within these booklets has been a useful source of reference.

We are planning to revisit the effectiveness of our FH brand (including our visual pledge) as part of ongoing review and evaluation activity. This will involve the development of a practitioner resource tool kit which partners will be invited to use in their engagement with families and young people to gauge feedback on perception and experience of support through Merton Family Hub.

Supporting Information:

Team: Family Help: pre- & post-birth

Partners: ICB, NELFT, Public Health, Midwifery

Main Submission:

Delivering together with health in response to the recommendations from Born into Care and to the increasing numbers of post-birth care proceedings, Redbridge Children’s services established a multi-agency pre-birth service in 2021 focused on vulnerable pregnant women where there was a hight risk of post-birth care proceedings.

Redbridge’s data showed that those most at risk were:

• Care experienced young people/children & young people in care
• Parents who had experienced the removal of previous children
• Young parents
  The introduction of this new pre-birth service led to signification reductions in the number of
  child protection investigations and post-birth care proceedings. In 2023/2024, even though the
  number of referrals leading to the assessment of unborn babies increased by 65%. the pre-birth
  service outcomes showed:
• 22% reduction in child protection investigations
• 19% reduction in pre-birth child protection conferences
• 18% reduction in pre-birth child protection conferences leading to a child protection plan
• 30% reduction in the issuing of post-birth care proceedings

Building on the success of this service

Redbridge is now developing a multi-agency pre-& post-birth service with Health Partners as part of its new Family Help service.

Strategic and operational partnerships with Health colleagues are already in place through the Multi-Agency Safeguarding Hub (MASH) including weekly meetings with the hospital midwifery team to discuss and plan for known high risk pregnancies. A range of other health partners also attend these meetings including perinatal services, health visiting and the specialist midwife for teenage pregnancies.

The new Family Help – pre-& post birth service will build on these established relationships, draw on the learning from the successful Family Nurse Partnership in Redbridge and on the achievements of the existing pre-birth service.

The new Family Help – pre-& post birth service will increase the capacity of our multi-agency team enabling them to expand the number of families they work with in the earliest stage of pregnancy, undertaking intensive, preventative family-centred work, including families where babies have previously been taken into care.

The new service aims to support many more vulnerable mothers and families both pre- and postnatally by providing earlier targeted intervention and support to first time parents, particularly those identified as high risk. A key challenge was designing and implementing the right structure to meet the needs and demands of the families requiring support from the pre- & post-birth service. Managed by Children’s services, the team is made up of a Team Manager, Practice Manager, a Senior Social Worker two Social Workers, four Family Support Workers.

Reduced caseloads provide social workers with the time to build relationships. Support will be tailored to the individual needs of the family.

The team will integrate key health professionals enabling Family Help to provide practical support to a much wider group of vulnerable families, giving them the confidence and help to look after their babies and keep them safe, ensuring families can thrive and that those who need it access perinatal mental health support. The service will expand to include five health professionals, co-located with the social care team.

These posts include:

• A dual qualified Health Visitor and Midwife
• A Health Visitor specialising in drug and alcohol use
• A Health Visitor with a specialist interest in working with those who have experienced
  Adverse Childhood Experiences and previous children being removed
• A Mental Health and Wellbeing Practitioner
• A Nursery Nurse

The breadth of health and social care expertise within the team will enable it to provide intensive support, assessment and intervention to those parents most at risk. As outlined, operational links with midwifery services had been well established, with the service further building upon those relationships. Moving forward the service wants to mirror and embed the practice provided by the Family Nurse Partnership to provide consistent support across both social care and health services.

The service will run in tandem with the pre-birth panel which reviews all high-risk pregnancies in the pre-birth team, with particular attention given to those in care/are care leavers to Redbridge. As previously identified, care experienced young people were identified as being at a higher risk of post-birth separation from their child. The aim is for experienced managerial oversight to ensure early care planning and support is implemented to reduce the number of care proceedings, or to ensure that those at the highest risk are identified early.

Evidence that the best practice initiative is having an impact

We already know the impact of our small pre-birth team and we expect that the expansion of this team into a multi-agency service to support and deliver positive outcomes for a much larger number of families.

To reiterate, in 2023/2024, even with the number of referrals leading to the assessment of unborn babies increased by 65%. the pre-birth service outcomes showed:

• 22% reduction in child protection investigations
• 19% reduction in pre-birth child protection conferences
• 18% reduction in pre-birth child protection conferences leading to a child protection plan
• 30% reduction in the issuing of post-birth care proceedings

Team: Edge of Care Team

Main Submission:

The challenge of recurring removals of infants from their parents is a particular issue for Tower Hamlets where 40% of care order applications involve parents who have previously lost custody of at least one infant.

These parents face complex and interwoven challenges. Their histories are often marked by childhood trauma, neglect, and repeated interactions with the care system, leaving them distrustful of professional services and hesitant to engage. Because their children are removed, these parents often become ineligible or untrusting of long-term support. The cycle of infant removal perpetuates their exclusion from essential services, reinforcing patterns of crisis and instability. The Diamond Project was designed to break this cycle by providing the support necessary for parents to improve their lives and future parenting prospects.

Consideration was given to using the Pause Programme, but this is a costly option and imposes some conditions upon the mothers. Tower Hamlets aimed to create a similar, cost-effective project within an established service, ensuring sustainability and innovation at a smaller scale. The Diamond Project was integrated into the existing multi-disciplinary Edge of Care Team which allowed the project to leverage pre-existing relationships and networks within Children’s Services.

The name of the project was chosen because diamonds are strong and unbreakable, qualities we wanted parents to see within themselves so that they felt empowered to make changes in their lives.

The project aims to help referred parents to achieve the following four objectives:

1. Being a parent -Staying in contact with their children and contributing to their lives.
2. Staying healthy – Improving their health, including mental health, self-regard, and safer sexual practices.
3. Staying safe – Avoiding abusive relationships and building safer ones.
4. Being in control – Building security, accommodation, income, employment, and self-confidence.

The project was developed from the ground up as an innovative initiative funded by Tower Hamlets Council (LBTH) and the London Innovation and Improvement Alliance (LIIA). This was in consultation with the East London Family Court and with support from local stakeholders (RESET/CGL, The East London NHS Foundation Trust, OCEAN Mental Health Service and Perinatal MH Service, EAFC Positive Change, Adult Services Community Learning Disability Service, Adoption London East, and Tower Hamlets Housing. Parents who themselves experienced the repeat removal of their children have been consulted to be active partners in the development of the offer.

The Manager for the Edge of Care Team led the project, which was integrated into her team. This setup facilitated trust and effective working relationships, ensuring that referrals were appropriate and timely. This allowed the practitioner to be part of the multi-disciplinary team, providing support and containment.

In the first year, the project faced challenges with limited capacity of one practitioner, but we resolved this by increasing staff and leveraging partnerships. The Better Together Framework provided a consistent language and approach, fostering collaboration and resource-sharing among diverse stakeholders and allowing the project to build a robust network of partner agencies, facilitating the development of our offer.

To date the project has received 23 referrals for support for parents, and we have worked with 16 of those mothers. Some referrals were not accepted as parent was living outside the borough, or they had older children living in their care, or were already pregnant and did not meet the criteria. Where we could, we sign posted them to other services.

In light of a positive evaluation, the project has been extended for a second year, with two workers. This extension provides enhanced stability, enabling more parents to benefit from the program. Additionally, the group offer has been implemented to support as requested by parents from gathered feedback. The group will provide peer support to parents, specifically focusing on addressing the loss they have experienced. This is planned to be a tri-borough initiative, coordinated with Ocean Mental Health NHS service, supported by a clinical psychologist.

Due to our project’s small scale and capacity, our support has primarily focused on mothers, though we recognise that fathers also face recurrent care proceedings. While some joint support has been extended to fathers, it has mostly involved activities like writing letters to their children or referrals to relevant services. Recently, we decided to trial working with a father who has agreed to receive support. This approach is not yet tested, but we hope that with a larger project in the future, we will be able to expand this support

In Year 1, the project worked with 10 parents who had a total of 39 children removed from their care. None of those has had any further care proceeding at this point two years on.

The pilot service achieved several positive outcomes for the 10 parents in the 12 months of the project. Some examples of our first-year impact taken from the evaluation are:

• All 10 women are now registered with a GP
• 2 women facing homelessness are now moved to permanent housing
• 3 women were supported to rebuild family relationships
• 4 women have received counselling or advice around drug and alcohol use
• 7 women have had some advice and support intervention around partner violence

One woman was assisted in accessing the Adult Community Learning Disability Service (CLDS), where she was diagnosed with previously undetected learning difficulties. She now receives support from this service and has been working effectively with its staff, enabling us to conclude our involvement. One partner of a woman was referred for Autism assessment.

Feedback from parents was positive:

“The worker is lovely. She listens to me, and she visits me at home and gives me time. I wanted to understand why my children were taken away. I looked at my papers with her, she helped me to understand it better.”

“She helped me write letters to my children and attends appointments with me as I have learning difficulties.”

“She helped me to be in contact with my children. I didn’t have the letterbox contact but now with support I have the contact and up to date information.”

“If it wasn’t for the worker, I’d be on the streets now”

“My confidence was very low when my children were taken, I didn’t take very good care of myself. She just picked me up and helped me to get on with things.”

Partners have said:

“I cannot over emphasise the importance of having a social worker who is alongside and working for the mothers. She understands her clients’ needs and is able to advocate for them to access the right support.” – Clinical Lead

“This is a service that has been needed for a long time” – CLDS