Birmingham and Solihull Integrated Care System: pilot assessment report

The assessment had a focus on the Secretary of State’s priority area for children and young people.

The ICS is still facing significant issues regarding equity of outcomes. The system’s infant mortality rate is a stark example of this. Birmingham and Solihull ICS is one of the worst performing systems in the country for infant mortality. This is a long-standing challenge acknowledged by system leaders. The Children and Young People programme recognised that:

• Nearly half of Birmingham’s children lived in the 10% most deprived areas in the country, with 8,000 living in the 1% most deprived areas.
• Almost 3 in 10 (29.8%) households with children in Birmingham are living in lone parent households, against an England and Wales average of 25%.
• Ladywood had the third highest level of child poverty in the UK with 47% of children living in poverty after housing costs.
• The ICS’s Health Inequalities Strategy 2023 identified children and young people as a key area of focus. The Children and Young People Birmingham 5-year Plan and the Solihull All Age Prevention Strategy 2023-28 set out the strategic actions that system partners should take together to make Birmingham and Solihull a great place to grow up. Health and Wellbeing Boards in Birmingham and Solihull oversaw the Joint Strategic Needs Assessments. These set out the key challenges for each place, using ‘data deep dives’ and locality profiles to identify more specific opportunities for action. Shared priorities included:
  • infant mortality
  • childhood immunisation
  • school readiness
  • carer support
  • better data and analysis to increase understanding.

The ICS is also selected to join the Children and Young People Health Equity Collaborative with Barnardo’s and the Institute of Health Equity. This aimed to improve the health of children and young people in the area and ensure they had a say on how services are run in their communities.

Providers within the system continued to face challenges in providing assessments, care and support for children with special educational needs and disabilities (SEND), including learning disabilities and autism. Waiting lists for neurodevelopmental assessments remain an issue, which is exacerbated by workforce pressures and growing referral rates. This is a key area of focus in the system’s children and young people’s strategy and there is also a SEND strategy and strategic group.

System partners had worked together to ensure safer outcomes for children. In 2023, Ofsted rated Birmingham City Council safeguarding provision as good. Solihull Metropolitan Council safeguarding had been rated as inadequate in October 2022. ICS leaders and the ICB are committed to improving safeguarding and both local authorities had been working on improvement action plans. The Independent Scrutineer and Chair of the MASH Steering Group had carried out a review of the multi-agency safeguarding hub (MASH) in Solihull, identified the improvements and made recommendations for continued improvement. Both local authorities had a MASH update visit in August 2023 and received positive feedback.

The ICS is working towards meeting the Transition and Transfer of Care: Looked After Children and Young People Nice Standards (QS31). It had a dedicated children in care (CiC) team, which is for all children in the care of Birmingham and Solihull local authorities. The service reviewed and supported children placed in the geography of the ICS from other authorities. All children in care and young people from Birmingham and Solihull who are living out of the area within the previous 18 months had a comprehensive review of their needs to make sure they are receiving the support they needed.