Coventry Parenting Strategy 2024 - 2027

To consider the parenting support required in Coventry, it is essential to understand the current level of need in the city.

Coventry’s population is approximately 345,300. Coventry is a young city with a median age of residents of 35 years and is falling over time, this is notably lower than the England median of 40 years. An estimated 68,300 children under the age of 16 live in Coventry, which makes up 19.5% of the population14.

The percentage of Coventry neighbourhoods that are amongst the 10% most deprived in England reduced from 18.5% to 14.4% between 2015 and 2019. These pockets of deprivation limit people’s opportunities to succeed in life; and transforming life chances requires addressing the social inequalities that are established right from the earliest years. The latest available data, for 2020/21, suggests that 23% of Coventry children aged 0-15 live in relatively low-income families compared to 19% nationally14.

Digital exclusion adds another dimension to inequalities of access to healthcare and should be a consideration. Digital exclusion impacts healthcare both directly and indirectly. Directly by residents not having the opportunity, skills, and confidence to access healthcare digitally, and indirectly digital exclusion leads to poorer opportunities across the wider determinants of health, such as employment, education and housing 14.

Maternal mental health: In Coventry, there are approximately 4500 births per year15. If one assumes that between 10% – 20% will suffer from some form of mental ill health in the year after pregnancy, we can expect between 450 – 900 women to require some level of care. 581 are likely to suffer from anxiety and 536 are likely to be depressed. There will be an overlap between these as some women will suffer from anxiety and depression. Between 5 and10 women are likely to develop psychosis each year. Data quality is poor in this area so local intelligence of the communities will be critical in understanding the likely prevalence moving forward15.

There are many reasons why women develop mental health problems after giving birth, and this can be influenced by a number and often a combination of factors. Some of the risk factors include:

• Health: Mothers who have experienced baby loss, alcohol and/or drug abuse, domestic violence, history of mental ill health, unwanted/unplanned pregnancy, multiple births, and victims of sexual abuse.
• Population: Asylum seekers and refugees, care experienced by women, ethnic minorities and migrants, LGBTQ+ parents, Mothers from radicalised communities, Neurodiverse people and those living with physical disability.
• Environment: Carers, inadequate social support, single mothers, women in rural areas or precarious living situations, women in poverty or low income, young mothers, mothers with disabled children

Health inequalities continue to have a marked impact on infant mortality. The risk of infant death increases with greater levels of maternal deprivation, reflecting the social gradient that exists across underlying risk factors such as preterm delivery, maternal health during pregnancy16,17.

Infant Mortality: The infant mortality rate in Coventry is 5.7 per 1,000. This is similar to the West Midlands (5.6) however more than for England (3.9). The child mortality rate (1-17 years) in Coventry, whilst low in number, is 15.0 per 1,000, and has remained persistently high compared to both the West Midlands (11.0) and England (10.3) since 2012 14.

Smoking at time of delivery: In 2021/22, 9.3% of new mothers from Coventry were smoking at the time of delivery. This has been on a downward trend from 15.1% in 2010/11. It is the same as the England average (9.1%) but lower than the regional average (9.8%) and the average amongst Coventry’s statistical neighbour areas14.

Breastfeeding: In 2020/21, 73.8% of Coventry newborns received breast milk as their first feed, better than both regional (68.3%) and national averages (71.7%). The prevalence of breastfeeding is also measured using data collected by Health Visitors when a baby is 6 to 8 weeks old, in Coventry it has remained around 50% in recent years, so half of babies remain at least partially breastfed by that age. While there is some uncertainty because of missing data for a small minority of babies, we can say the 2021/22 rate of about 51% is higher than the England average of 49.2% and it has been better for the last few years, although the gap has narrowed due to an increasing trend for England overall14.

Children’s Oral Health: The percentage of 5-year-olds with experience of visually obvious dentinal decay in Coventry is 34.2% which is higher than that compared to the national average of 23.7%18.

Inpatient admission rate for mental health disorders per 100,000 population aged 0-17 years: Coventry 2021/22 data shows 55 admissions, a rate of 72.0 per 100,000 compared to England's rate of 99.8 19.

Childhood Obesity: At reception, Coventry’s obesity rate is similar to the England average; but by Year 6, the city’s obesity rate is higher than the England average. 1 in 5 reception year (aged 4-5) Coventry children were measured as overweight in 2021/22, doubling to 2 in 5 children in year 6 (aged 10-11). There is a clear link between deprivation at age 4-5 and age 10-11 with successively higher rates of obesity in areas of higher levels of multiple deprivation. The general trend over the last seven years is of increasing proportions of 10-11 years being overweight or obese14.

Educational attainment: By the age of five, fewer children achieve a good level of development (61.1%) than nationally (65.2%) Inequalities in reaching a good level of development within Coventry have already established themselves by the age of 5. Amongst disadvantaged children, 46.3% achieve a good level of development, compared to 63.4% for non-disadvantaged, a 17-percentage point gap. JSNA (2023) states inequalities in attainment persist into Key Stage 4, the gender gap at the end of primary is still present in Key Stage 4 attainment. The average attainment 8 score amongst female pupils was 48.9, better than 43.4 amongst male pupils. Overall attainment levels for disadvantaged pupils are significantly lower, with an average attainment 8 score of 37.7 compared to 49.8 amongst non-disadvantaged pupils in Coventry. Attainment 8 scores indicate that the overall attainment levels of white pupils in Coventry are lower than those for other ethnic groups. Further analysis is needed to understand these inequalities14.

Early Years childcare places: In Coventry, uptake of funded early years childcare for all children aged two, three and four has increased. The 2-year-old take-up has increased to 74.8% in 2022 compared to 72% nationally. Similarly, the 3 and 4-year-old take-up increased from 86% to 88% but was still below national at 92% and 93% averages14.

Special Education Needs and Disabilities SEND: The number of pupils with Special Educational Needs (SEN) has been increasing, as it has for England overall. In 2021/22 there were 11,054 pupils with SEN in Coventry, making up 18.2% of all pupils compared to 16.5% for England overall. This is divided into two types, those with a Statement or an Education, Health & Care (EHC) plan; and those with SEN support. Between 2015/16 and 2021/22 the proportion of all pupils with a Statement or EHC plan increased from 2.3% to 3.3% and those with SEN support increased from 13.3% to 14.9%, this trend is similar to that for England overall14.

Teenage parents: Under 18s conception rate per 1,000 is 21.2 locally compared to national rates of 16.714.

Children in care: The number of children in care remains above the national average but similar to statistical neighbours. In Coventry 89.5 children out of every 1,000 are in care. This is higher than England's rate of 70 but is more in line with the statistical neighbour average rate of 89. This has been on a slightly increasing trend in recent years14.

Domestic abuse: There has been an increase in domestic abuse incidents in Coventry. There was a total of 9,280 domestic abuse incidents reported to the Police during 2020. This is a 33% increase on the previous highest number over the period which was 7,000 during 201921.

Employment: Across Coventry, more and more people are feeling the pressure from the increasing cost of living. This will disproportionately affect the most deprived families in Coventry. The number of Coventry residents in employment has been increasing strongly for the last few years. In 2022 there were 80% of people in paid work. The balance between male and female is reasonably equitable with 94,400 males and 86,300 females14.

4.1 Parent and carer consultation findings

We are committed to listening to service users, encouraging them to contribute and develop the Coventry Parenting Strategy with us. In August 2023, a survey was undertaken using Survey Monkey online and paper-based questionnaires were also completed in face-to-face sessions with parents and carers. 220 responses were received. 11% (14) said they were male with the majority of responses coming from females 87% (115) and 2 % (3) said they would prefer not to say, other respondents did not answer this question.

In terms of the age of the child/young person, parents told us 45% had a child in the 12- 18-year age group and 31% said they had a child aged 6–11. However, when asked when help and support were most needed, 56% (76/136) of respondents felt that the help and support was most needed when their child was aged 0-2 years. Thus, supporting the importance of parenting support in the first 1001 days of a child's life. 30% of respondents felt that help and support were most needed when their child was 2 – 5 years old.

Most respondents to the survey said they rely on family members or friends for support. Three-quarters told us they rely on family members, while just over half said they rely on other parents within their friendship circle. The least number of responses were received for support from podcasts, only 5 of those responding said they look to the SEND Local Offer however 32 of the respondents said they have one or more children with a disability. 8 of those who responded said they rely on a Parenting App.

Most parents and carers said they have one child (25%) or two children (38%) accounting for almost two-thirds of those responding. 18 respondents said they are currently pregnant (less than 10% of those completing the survey). Of 214 who answered, 1 in 5 (20%) stated that at least one of their children has a disability or is awaiting diagnosis. The survey findings showed that more needs to be done to strengthen support when there is a child with a disability.

When asked what services or support could have been better or were missing, there was a range of responses. The chart shows the areas of help and support that could be missing or could have been better including child and young person's mental health, mental health for mum and baby, child behaviour and toileting. Other areas also include toileting, partners mental health, preparing for the birth, child development concerns, breastfeeding, finance and advice, advice on how to care for my new baby, child's transition to secondary school, nursery/childminder, primary schools and others. Also other areas including weaning childcare, bullying, relationship advice, a close bond with the baby and bed wetting.

36% (46/128) of respondents stated that help with mum and baby mental health could be improved. 36% (46/128) also highlighted child and young person's mental health and 27% (35/128) of respondents felt that partner/dad’s mental health was an area that was missing or could be improved. 31% (40/128) of respondents felt help around child's behaviour was missing or could be improved and 28% (36/128) of respondents felt that advice around toilet training was missing or could be improved. Preparing for birth was also highlighted by 27% (35/128) of parents and carers.

Is there any area of help and support that you feel is missing or could have been better?

Bedwetting (16 responses) a close bond with my baby (18) relationships advice (19), Bullying (19), childcare (21) child health concerns (21) weaning / solid food (21) other (22) child's transition to primary (23) child's transition to secondary school (28) advice on how to care for my baby (29) finance advice (30) breastfeeding (31) preparing for the birth (35) my partner's mental health (35) toilet training (36) child's behaviour (39) mental health for mum and baby (46) child and young persons mental health (46).

Mode of delivery

Parents and carers were also asked about the mode of delivery when receiving parenting support. Face-to-face was the most popular answer. Online was the least popular (only 12 parents or carers strongly agreed they would like online support via YouTube, 26 respondents said they strongly disagree that they like this method). One-to-one sessions were more popular than group or drop-in sessions.

When asked when would you like to receive parenting support the responses received were:

• Evenings 85 responses (65%)
• Weekends 76 responses (58%)
• Weekdays 74 responses (56%)
• School hours 63 responses (48%).

Barriers to accessing support: When asked about barriers to gaining support there were 82 responses. Information/ accessibility was the key theme receiving the majority of comments. A lack of provision or services only being available to certain groups was second most raised with comments around services geared toward or only available to those not at work or on a low income being the major factor falling within this category. The responses highlighted the need for support to be geared not only toward mothers but to consider fathers and LGBT+ parents.

Parents explained they feel that there is a lack of understanding of how challenging parenting is, especially where there are other considerations and stigma associated with asking for parenting support.

“Too many people believe a parenting class is linked to doing a bad job-but it shouldn't be. It should be normalised-no one would be expected to start a new job with no training and the same should be for parenting. It’s difficult for whoever you are and however educated you are”.

The importance of continuity of care was also highlighted by parents and carers. Parents and carers also mentioned the importance of being heard by professionals and having a voice.

MAMTA consultation: A parent survey was carried out in December 2022 to capture the views of ethnic minority parents in Coventry. This was carried out through Foleshill Women's Training who support specifically with ethnic minority women in the antenatal and postnatal period. The survey was completed by 30 women. 28 (93%) of respondents said that they felt they had received the help and support they needed from the MAMTA service which supports women from ethnic minority backgrounds in the antenatal and postnatal period. Comments included;

“Good holistic approach”.

“Very good service referred me to other antenatal support within their partnership”.

“Well trained and multilingual. Peers supported me well in all aspects”.

“A lot of info shared, very engaging, really enjoyed the session”.

When asked if there was any area of support/advice that was missing or could be better, 24 (80%) felt that there was no area of support that was missing. One respondent said ‘MAMTA is supporting so well, peers are well trained, and they are always there for more support’.

When asked what areas of help they needed when they started working with MAMTA;

• 6 (20%) parents said breastfeeding support and advice.
• 5 (17%) said antenatal sessions/health support and education/antenatal classes were cancelled at the hospital.
• 4 (13%) said pregnancy and aftercare.
• 3 (10%) said that they felt they needed general support as a result of having language difficulties.

Parent and Carer forums in Coventry: To ensure parents' voices are heard and help shape the services they receive, Coventry and Warwickshire have a Maternity Neonatal Voices Partnership which ensures the views and experiences of families contribute to the development of local maternity care by collecting feedback and sharing information. There is also a local coproduction and communications workstream to strengthen this work further in the Local Maternity Neonatal System. Additionally, there is also a parent carer panel that has been established to ensure families can provide feedback as part of the Start for Life programme. These forums are essential for ensuring the voices of families and their experiences help improve future delivery of parenting support.

4.2 Engagement with Young People

Child Friendly Cov -Child Friendly Cov is a campaign to make Coventry a child and young person friendly city, ensuring that Coventry is a place where children and young people are valued, supported and enjoy themselves. Together with children and young people, the following themes have been identified as priorities for how to make Coventry a child friendly city: Be Valued, Be & feel Safe, Be and feel healthy, have opportunities.

In line with the work completed on Child Friendly Cov, a focus group was held with young people in October 2023 and young people were asked about what good parenting support looks like.

The responses were predominantly around healthy communication across and within the family. Consideration of feelings and emotional support, listening and understanding as well as a desire for setting boundaries. The views of this focus group reflected other consultations in that young people felt that there was a place for digital delivery of support, but the desired method would be a face-to-face offer.

Further work should be undertaken to ensure the voices of young people continue to be reflected in the development of the Parenting Strategy action planning.

4.3 Equality Impact Assessment

An Equality Impact Assessment (EIA) is a tool to ensure that we consider the effect of the Council’s decision-making processes on different groups of people protected from discrimination – ‘protected groups’ and help us to consider health inequalities and the Marmot Principles.

The EIA shows how equality information and data related to the refreshed parenting strategy have been used to understand the potential impact it will have on protected groups. It has also been used to inform decisions about the recommendation we have made, and, in this way, the Council can demonstrate that it's paying 'due regard' to the Public Sector Equality Duty.

The latest available data, for 2020/21, suggest that 23% of Coventry children aged 0-15 live in low-income families compared to 19% nationally. An EIA was completed for the Coventry Parenting Strategy 2024-27. Some aspects covered in the EIA include the COVID-19 pandemic which accelerated the uptake of digital services nationally, whereby people who are digitally enabled have better financial opportunities, can access new information and are better connected to others. However, for those who are digitally excluded, the digital divide has grown during the last two years, and without intervention, people are at risk of being left behind with poorer outcomes across employment, health and wellbeing, education and service access20. However, all services do offer appropriate in-person services and where appropriate, these services have continued to increase the in-person offer since the lifting of COVID-19 restrictions. This supports those who may have a degree of digital exclusion and the problems that digital access may present such as:

• Minority Ethnic service users - language
• Poverty - lack of access to devices
• Education – lack of awareness to access relevant sites
• Homelessness – access to online services

4.4 Review of parenting support

In June 2023, a range of partners across statutory and non-statutory agencies were asked to map the offer of support to parents and carers in Coventry. The findings showed there is a variety of evidence-based parenting programmes and informal parenting support currently available in Coventry to empower parents in managing their children’s behaviour and promoting their health, education and wellbeing (this includes Triple P, Solihull Approach Online, Five to Thrive, Dad Pad). Family Nurse Partnership and iBumps supports teenage parents, MAMTA support women from ethnic minority backgrounds in the antenatal and postnatal period.

As part of the Special Educational Needs and Disability (SEND) local offer, there are several targeted parenting programmes such as support offered by Communication and Interaction (including Autism) Support Service and the EYSS (Early years support service) SEND offering parent/carers of children with complex needs city-wide support.

The current position for universal and targeted support in relation to parenting programmes identified in Coventry is highlighted below: