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Health and wellbeing

Women’s services: don’t put a pause on prevention

A young woman sits on the edge of a bed. She looks directly at the camera with a pensive look on her face.

Catch22 delivers preventative services that support women who have had or are at risk of having more than one child removed from their care. In this blog, we outline what post-removal support is and what impact our services in Derbyshire, Northamptonshire and Worcestershire have had.

Gaps in post-removal support

“We know that a large proportion of children entering care are from families who have previously had a child removed from their care: almost half (47%) of all newborns who are subject to care proceedings were born to mothers who had previously been subject to care proceedings regarding their older sibling.”

– Pause, Never More than Once report (2023)

Mothers who have children removed from their care often have complex health and social care needs. These needs can lead to child protection involvement and can themselves be further exacerbated by child removal. While removing children from the care of their mothers is often required to protect the safety and well-being of at-risk children, child protection policies can skim over the historical and structural disadvantages many mothers face.

In England, there is a statutory service gap for women who have experienced child removal, meaning that any post-removal support available is dependent on local authority, charity or innovation funding. According to the Local Government Association, there has been a 27% real terms funding cut to councils since 2010-2011. Councils are now facing funding gaps of £2.4 billion in 2023-2024 and £1.6 billion in 2024-2025, making it even harder to find money to fund existing and future services for these women. Currently, of the 151 local authorities in England with children’s services, 77 offer no support service to birth parents.

The number of children in care is over 82,000. This is the highest number since records began in 1994, and has steadily risen since 2009. Now more than ever, it is essential that the government fund the roll-out of well-evidenced interventions that reduce demand for children’s social care placements. Understanding the experiences and needs of these women is essential for improving the development and delivery of public support services, and simultaneously reducing the number of children experiencing traumatic childhoods and who subsequently need to be introduced into the care system.

An effective model

The services are delivered using a partnership approach supported by Bridges Outcomes Partnerships using the Pause practice model with Catch22 as the delivery partner. The Pause practice model is centred around an intensive, supporting and trusting relationship between a woman and their Practitioner. The aim of the model is to support women to break the cycle of repeated removal, with the hope that in the future no family experiences the removal of a child more than once. We work with women who have experienced, or are at risk of, repeated pregnancies that result in children needing to be removed from their care. We aim to give women the opportunity to pause and take control of their lives, breaking a destructive cycle that causes both them and their children deep trauma.

In some regions, the services have transitioned into standalone Catch22 services working with the same demographic and building on the expertise of the Pause model. For example, in Derbyshire, the service transitioned from a Pause approach into the new Moving on Up service earlier this year.

What makes the services different to most is the uniquely proactive and flexible approach taken by our Practitioners to tailor intensive support over 18 months. Practitioners use ‘assertive outreach’ to reach people who don’t typically engage with traditional services and are most in need of our support. This means that up to 16 weeks was spent engaging each woman who then went on to enrol onto the programme in Worcestershire. Crucially, our Practitioners use a relationships-based approach to build trust and centre women in the support so that their individual therapeutic, practical, health and/or systematic needs are addressed.

“When I first joined Pause, I felt like my world and life had ended. I was so afraid of judgement and worried that I would have to explain my situation over and over again. My worker helped me learn important things I had long forgotten such as self-care, self-love, and most importantly self-worth. It was an amazing experience and it gave me a new life.”

– Participant, Pause Derbyshire

Unparalleled evidenced impact

The positive outcomes of the programme are undeniable both in terms of big key indicators and the impact on women. In Worcestershire, 29 of our graduates have sustained a Pause pregnancy for 18 months or more, and two have had children returned to their care. They were all at high risk for recurrent pregnancy and have made huge strides forward in breaking these negative cycles.

During the programme we supported women to improve relationships with services and their children, and to address practical needs including housing, finance and life skills:

  • eight of them met with adopters of their children,
  • 11 had better attendance to family time, and
  • 12 agreed to meet with their children’s social worker.

We also supported them to address housing needs, manage finances, and get skills for life – with 20 of them having a new or affordable home or being helped to avoid eviction, ten of them getting jobs, and nine learning to use public transport. Women were also more able to focus on their health needs with our support: 23 women attended sexual health, ten had smear tests and 18 of them either stopped or reduced drug or alcohol use.

An independent evaluation of Pause demonstrated that a Pause programme evidenced a reduction of around 14 infants born into care each year. What our services demonstrate is that repeat removals are not inevitable and we can break the cycle. It’s a tale that is told time and time again, but investing early prevents trauma and saves money in the long term.

“Sometimes the achievements feel a little bit like magic as we aren’t quite sure what we have done to help women move forward, but the reality is the success is down to our determined approach and gradually demonstrated commitment to the women. Relationships really do matter and through persistent assertive outreach and simple acts of kindness we show the women that they do matter to us and they learn they can matter to themselves too. We keep showing up for them and meet them where they are and the high support high challenge environment allows them space to change.”

– Marie Pye, Practice Lead at Pause Worcestershire