Cradle to Career: How place-based collaboration is transforming North Birkenhead

Just outside Liverpool, people and services are coming together to upend an old narrative of decline. By joining up services, and putting community priorities and families’ needs at the heart of decision making, they have created impact that could make it a model for national policy change. Katy Oglethorpe talks to the people driving this transformational approach.

When, in October 1844, the foundation stone was laid for the Birkenhead docks system, it was such an important day for the town that a general holiday was declared. Hundreds of new homes were built for shipbuilders, and the industry powered the local – even the global – economy, the area booming as a major supplier of ships to the US.

Today, trade routes have changed or dried up, and the same dockyard is scattered with abandoned ships, the remnants of a dead industry. Work was never replaced. In Birkenhead as a whole, there are only 0.62 jobs for every person aged between 16 and 65, the third lowest of 162 areas nationally. Other outcomes – all connected – are similarly bleak. Male residents have a healthy life expectancy of around 52 years, 11 years lower than the national average. The children of Bidston and St. James’ ward in North Birkenhead are among the top 2% deprived in the country, with more than one in two experiencing poverty.

And yet, North Birkenhead is also the home of an initiative that offers an antidote to the rhetoric – and often the reality – of decline, with outcomes that are capturing national attention and inspiring others to follow suit. It is a small but powerful example of what can happen when you shift power towards the community, connect services, and take a human approach to some of our society’s most pernicious issues.

The birth of Cradle to Career

Cradle to Career started from a undefined but determined notion that something different needed to be done. Steve Morgan, the Liverpool-born founder of housebuilder Redrow (and one of the UK’s wealthiest people), had backed numerous local organisations through his Foundation. By 2019, he wanted to shift to something long-term and systematic. He gathered the local authority and third-sector organisations to devise a course of action. 

North Birkenhead was picked as a focus area because it was the right size (around 10,000 residents, a large proportion of whom are children) and because of its need. The area topped all the wrong tables in terms of multiple deprivation indices and placing the most demand on Wirral Council’s children and family services. 

The Foundation pledged a £2 million initial investment, alongside support from SHINE, UBS Optimus Foundation and co-commissioning from Wirral Council. The next question was how the money should be invested. From the offset, the shape of the project was designed to be a community-led and collaborative decision. The partners – led by Liverpool charity Right to Succeed – embarked on an ambitious discovery period to establish the priorities, needs, challenges and aspirations for residents, professionals and partners.

The conversation lasted a year, further complicated by the first Covid lockdown six months in. This was a necessary timeframe, says Right to Succeed’s CEO Graeme Duncan, due to the conversation’s complexity and the need to build trust.

The people of North Birkenhead were no stranger to ‘initiatives’ – well-meaning but short-lived pilots and charitable interventions that had “failed to move the dial and then moved on”, as Graeme puts it. “These inputs are well-intentioned, but are often designed at a distance and arrive with several assumptions built in and with little agency for the community to make it work in their context.”

North Birkenhead was not low on homegrown community spirit. The area – at little over two square miles – had over 90 local assets and services working to help the community. A recent local campaign had seen people place stickers in their windows reading “I’m a good neighbour”, inviting others to knock on the door if they needed anything. And yet, life chances for residents continued to worsen.

“For the amount of work that was going in, this should have been a thriving community,” says Graeme. “But because of how our economic and social models work in this country, that’s not the case. Instead, you had entire generations who’ve now only known decline since the boom times of shipbuilding.” 

By the end of the year, the community had come up with three priorities – three focus areas for investment.

These were to:   

1. Significantly improve literacy standards among children
2. Give families easy access to the support they need
3. Create new opportunities for local children and young people.

The next step was working out how to do it.

A brave new council service

While improving child literacy involved programme development between local schools, and the youth offer depended largely on the third sector, it was the Wirral Council who held sway over the second priority – giving families in need access to the support they needed.

This was perhaps the most challenging to achieve. England-wide, the social work sector is barely keeping its head above water – facing its first decline in the number of children’s social workers in a decade, as the need for social workers rises. Nationally, councils are spending more of their budgets on social care than ever before, says the IFS. Of this, council spending on acute services such as provision for looked-after children is growing, while investment in preventative services is falling at an even faster rate.

In North Birkenhead, relations between social services and the community were at an all-time low, says Graeme. Residents reported fearing interactions with services, with several reports of people barricading their doors to keep services out of their homes. They wanted consistent relationships with named professionals who were based in the community, but this was simply not the way that conventional time-pressed services operated.

This conversation was witnessed by Elizabeth Hartley, now the Director of Children’s Services at Wirral Council, who was part of the project’s steering group. She recognised the need for a significant shift in the council’s approach, says Graeme, something radically different. Six months into the discovery period, the council then came up with an “incredible proposal”.

“I still remember the email coming through,” says Graeme. “It felt like a make-or-break moment for the project.”

The email proposed the creation of a new team wholly committed to North Birkenhead’s priorities. The team would consist of the equivalent of 17.2 full-time staff members and would be multidisciplinary, including social workers, family workers, family connectors, school readiness workers, specialists in addiction, employment, benefits, and public health—all working together to become a cohesive service based in the community and with a residents’ working group informing the development of their work.

Delivering faster than Deliveroo

“There are families in this area where I had probably assessed the parents when they were kids. It just goes round and round. And we’re trying to break that cycle.”

Angela Heatley has worked at Wirral Council for 20 years. She joined the Cradle to Career programme as it was getting off the ground, and it was her job to select and manage the multidisciplinary team (MDT) that would be the bedrock of a new approach to working with families.

Angela was already dissatisfied with the standard model of social care – particularly with the referral process, the normal procedure in which a social worker conducts an initial assessment of a family or individual and then refers into other services – addiction support, the family worker team, or mental health, for example. It is a process that should take 40 days, but often exceeds that, by which point the circumstances for the person or family in question will likely have deteriorated. She immediately saw an MDT team as a way of avoiding these delays. Here, the specialists sit together in one team, literally under one roof, so referrals and support can happen quickly, or “faster than Deliveroo”, as one of her colleagues describes it.

“I can’t stand the referral process because a referral to me is time,” says Angela. “In the time under the old system the social worker would still be doing their assessment, we can have work underway. And my team can be in the position to step away sooner, knowing that they have made a difference or there is support in place.”

Because the team is multi-disciplinary, it does not have to be a social worker who makes the first assessment. It might be a family connector who makes the first contact, a drug worker, or even a partner community organisation. And in line with the community’s original wishes, families are often given a single point of contact who will also work to help them access other services. 

“It’s getting the right person at the right time with these families to make these changes,” says Angela. “My general rule is don’t start at the highest level. Let’s start at the lower level, and then if things don’t change or there are real concerns, we can escalate it. Often, it’s just a waste of resources having a social worker on the case.”

The MDT meets once a week to discuss any cases that have come up, share information, and solve problems collectively. Instead of a town hall or council offices, they work from the local community centre, The St James Centre. The centre also houses charities, a baby bank, SEND organisations, and is the community’s Family Hub. 

Choosing St James as a base was “incredibly brave”, says Graeme. “It provides services to some of the most vulnerable families in the community, so putting social workers into the building could have been seen as a deterrent to the very families they wanted to engage. But their staff were clear that they wanted to change the relationship between them and the community.”

Trust took some time to build, says Angela. “The first year or so felt like we were on their territory. There was a strong sense that we were just temporary because they had seen it all before – various agencies coming and going.”

Now they have an open door to the community, she says. “I have a few people who come in regularly for coffee, sharing concerns – or local gossip. They’re not afraid of us anymore. They don’t see us as a threat.”

Still, says Angela, this new way of working hasn’t been for everyone, and the team is carefully selected because they are comfortable stretching the definition of what their role usually does.

“I had one social worker on a short-term contract who just couldn’t get her head around it,” she says. “Why weren’t we removing kids? To her, that was the purpose of a social worker. I tried to say to her: you need to think differently. Who are you to walk in and wreck these families’ lives? Some people go through bad times, and we need to recognise that. Removing kids from parents should be the last thing you’re doing.”

Staff who buy into the approach can see the benefits. Caseloads have dropped significantly—an average of 12 at a time, says Angela, compared to around 25 under the previous regime. Social workers can spend more time doing what they joined the profession to do—either working on the most urgent cases or focusing on preventative work that was squeezed out before. 

The MDT also has a worker linked with each of the area’s eight schools, so each institution has someone to call upon to speak about concerns as they appear rather than automatically going down a formal referral route. They hold joint attendance meetings, along with community connectors and youth club workers, focusing their attention on around 1,000 children with persistently poor attendance. They speak about each child individually, sharing joint intelligence about what might have contributed to their missing school – illness, bereavement, overcrowded housing – and arrange suitable support.

As a result of this collaboration and light intervention, the group’s attendance has climbed an average of 16%, bucking the national trend of falling attendance.

Charity and health partnerships

In addition to the council, 43 partners are engaged locally in delivering the priorities, most of whom have a physical base at St James.

The initiative has brought together third-sector organisations who would otherwise be in stiff competition for limited funding, sometimes duplicating efforts. Joining forces has been a positive experience, says Rachel Daley, founder of Positivitree, a social enterprise that works to improve the mental well-being of families with children with additional health or care needs.

Working on such a hyper-local level took some adapting to, says Rachel. There was an expectation that they could “drop” their existing model into North Birkenhead, whereas in fact their work required building local trust and relationships, much as the council had done. Today, she is convinced of benefits of being firmly rooted in place.

“Being based in a community and being very much led by the community is a much more effective way of getting positive outcomes for families,” she says. “In terms of impact, it’s been incredible.”

Charity partners attend the weekly meetings alongside the MDT. Bev Morgan, CEO of family charity Koala NW, says they have also seen the benefits of working so closely with the council, and have built excellent relationships. Frequently, charities such as hers can act as mediators between people and statutory services.

“We work with many families who are terrified of social care involvement,” she says. “They don’t want it, no matter what level it is. But we promote the MDT and what the council can do. It’s a sort of handholding into the local authority services.” 

For many involved in the project, the next step is deepening relationships with healthcare and the NHS. The MDT has an embedded health worker and a link worker from drug and alcohol services, with a new connection to an educational child psychologist. Next, Angela would like to recruit a mental health worker to the team to avoid the waits for chronically oversubscribed child and adolescent mental health services, which are so add odds with the MDT’s pace of delivery.

While the NHS remains culturally and materially focused on acute care, there is hope it will start investing in preventative models such as this, particularly through the recently established Integrated Care Boards (ICBs). Indeed, Raj Jain, the new chair of the ICB for Cheshire and Merseyside, said he intends to shift 10% of his budget to children and young people’s services – investment and partnership that could help further deepen the impact of projects like Cradle to Career.

A remarkable impact

A project as innovative as Cradle to Career comes with its challenges. Although the project maintains community-powered decision-making as a core principle, sustaining ongoing resident engagement has proven more difficult.

For example the steering group, which oversees the three key priorities, is primarily made up of professionals. An evaluation report by Renaisi found that some community members struggled to find time for full engagement, faced difficulties navigating power dynamics within the group, and experienced varying expectations regarding the pace of the work. All of which, it notes, are “common challenges within collective place-based approaches”. Right to Succeed has since created community-only panels and has increasingly taken ideas out to the community instead through events such as pizza days and street parties. 

And yet, as Cradle to Career completes its fourth year, there are strong indications that the community’s priorities are being realised, with a highly impressive catalogue of outcomes. To list a few, the area has:

• Gone from being the highest-need community in Wirral since records started to the fourth-highest
• Almost twice the rate of child protection stepdowns compared to Wirral as a whole
• Reported a 20% reduction in re-referrals to social care
• Seen a more than 500% increase in Families Matters case closures (the level of support just below being considered on the ‘edge of care’)
• Gone from the worst to the best-performing community in Wirral for uptake of the early years 30 hours per week offer

Given the above, it is unsurprising that in 2022, an OFSTED and CQC joint inspection rated the MDT as a ‘highly effective practice’ and encouraged the council to scale it immediately.

There has also been impressive progress in pursuing the community’s first priority: improving literacy rates among children. A partnership between eight local schools has successfully closed a 15-month reading age gap between North Birkenhead and the national average. The first group of students, who have received four years of support, now performs three to four months ahead of the national average. There has also been a 65% increase in children demonstrating the highest reading abilities.

These outcomes have affected the community’s sense of optimism, says Graeme, who recalls sharing the first literacy progress data with residents.

“Suddenly, everybody sat forward a little bit. The role of data in the community previously had been to tell everyone that things were bad and were getting worse, and they were expecting to hear that again. But hearing about the reading age progress was something tangible moving in the right direction. You started hearing people talk about hope.”

Big investment and new iterations

Cradle to Career is spreading its wings beyond North Birkenhead. A year ago, the Liverpool City Region Combined Authority announced it was investing £5.25 million to extend the programme into five more of the region’s most deprived areas. Mayor Steve Rotherham called the programme a “radical, bespoke approach that works with the communities to identify local issues and empowers them to come up with solutions”. 

For Graeme, the Combined Authority’s approach to the scheme has been impressively non-authoritarian. “The Combined Authority could have acted like a mini-Westminster in the region, and been extremely directive in how the money was spent. Instead, they have allowed the communities to define their change individually and backed them in full with no interference, minimising the assumptions and maximising the agency with which the communities have to operate.”

Each area has had, or will have, its own intensive discovery phase for the community to set their priorities. So far, local people have chosen to focus on supporting vulnerable learners, reducing the number of post-16 school leavers not in education, employment or training, and creating a family support hub to support social, emotional and mental well-being in the community – among other priorities.

Nationally, the traction behind community-powered, cross-service working is growing.

“There is a growing sense that there is a growing desire for community-led, collective working as an antidote to the stream of centrally designed interventions that have failed our communities for many decades,” says Graeme. “This could be the answer for policymakers struggling to see the light at the end of the tunnel.” 

Local government Minister Jim McMahon has backed the revival of Total Place, a whole-area approach to public services which New Local has championed. Under this policy, budgets would be allocated at a place level – a joint endeavour between councils, the NHS, police and others – rather than set in the siloed fashion they are today. As New Local’s report outlines, spending decisions would be made collectively, underpinned by the priorities of those with the most skin in the game – local communities.

The work done by Cradle to Career and Wirral’s MDT stands as an example of what place-based collaboration can achieve. It demonstrates what can be done when services join together, their work determined by real local priorities rather than arbitrary and fragmentary national policy, their behaviour informed by real relationships with the people they were established to serve. A government that has pledged to fix public services now has an opportunity to make permanent policy of its success – and make way for the kind of impact we see when places are able to determine and generate their own unique and distinct kind of change.

All images credited to Right to Succeed.

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