RISBANE SOUTH

Thriving Kids

Inquiry submission

Supporting children and families in the early years
Brisbane South PHN place-based response
Thriving and On Track
TOTs Impact
What we know works
Partnership with community and systems partners enables holistic support
ECEC educators can be supported to have a pivotal role in monitoring children’s development
Families can support their child’s development when able to access culturally safe and appropriate allied health services in community hubs
Peer mentors who support systems navigation build the capacity of families to advocate for their children
Flexibility in service delivery ensures sustained engagement
Leveraging TOTs to support children with mild-moderate developmental needs
Sustainability and scale
Areas for further development and iteration
The role for Primary Health Networks (PHNs)

First Floor, Building 20, Garden City Office Park, 2404 Logan Road, Eight Mile Plains QLD 4113 F ins,
PO Box 6435, Upper Mt Gravatt QLD 4122 | ABN 53 151 707 765 g 3
1: redacted 1300 467 265 | bsphn.org.au
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Acknowledgement of Traditional Owners

Baugull nyungai
Gurumba bigi
Maroomba biggee

We acknowledge the Traditional Custodians of the land on which we live and work, and of the many different nations across the wider Brisbane south region. We pay our respects to the Elders, past, present and emerging as the holders of the memories, the traditions, the culture and the spiritual wellbeing of the Aboriginal and Torres Strait Islander peoples across the nation. We acknowledge any Sorry Business that may be affecting the communities as a whole.

In the spirit of reconciliation, partnership and mutual respect, we will continue to work together with Aboriginal and Torres Strait Islander peoples to shape a health system which responds to the needs and aspirations of the community.

contactus@bsphn.org.au | bsphn.org.au

Supporting children and families in the early years
Thriving Kids

The early years of a child’s life, from birth to the commencement of formal schooling, provides a foundation for life-long wellbeing. The benefit of early identification of developmental issues and timely access to intervention services is well documented. As part of the Independent Review of the NDIS, it was identified that a large cohort of children, particularly those with developmental delay or autism with low to moderate support needs, could be better supported outside the NDIS. The Australian Government is establishing Thriving Kids, a national system of support that will focus on identifying developmental concerns earlier and scale and leverage supports that help children thrive.

Thriving and On Track (TOTs), developed in partnership by Brisbane South Primary Health Network (PHN), is an example of an existing solution that can be flexibly scaled across different communities to enable the early identification of developmental concerns and access to early intervention, and deliver on the Thriving Kids aims.

Brisbane South PHN place-based response
Thriving and On Track

Background

Thriving and On Track (TOTs) is a cross-sector, local systems collaboration that was developed in 2018 by key stakeholders including Brisbane South PHN, Children’s Health Qld, the Department of Education and Logan Together, in response to existing service gaps in ensuring children aged one to five years are meeting developmental milestones. The 2024 Australian Early Development Census (AEDC) data shows that approximately 25% of children across Queensland demonstrate a developmental delay in one or more developmental domains, with this figure reaching as high as 47% in some areas of the Brisbane South region.

TOTs responds to early child development challenges on many levels, addressing the issue through a systems and community approach:

Engages health and early education in a long-term, partnership approach which is relational in nature, builds trust and is agile in making changes to suit children and families’ needs
Seeks to build capability as opposed to dependence — with both educators and families engaged early on to develop knowledge regarding child development, identify concerns together and obtain timely support to address developmental delays
Builds the capability of early child education centres to be a workforce that can contribute to addressing child development and support children and families to obtain the right supports

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First Floor, Building 20, Garden City Office Park, 2404 Logan Road, Eight Mile Plains QLD 4113
PO Box 6435, Upper Mt Gravatt QLD 4122 | ABN 53 151 707 765
1: redacted 1300 467 265 | bsphn.org.au
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Identifies and responds to what works for children and families in the specific context including responding to family’s needs associated with navigating the health system
Builds on existing supports in the communities including early childhood centres, kindergartens and community hubs (particularly First Nations and culturally diverse community service settings)
Focusses on what it can influence and support within the system — identifying and supporting children with short-term developmental delay, avoiding unnecessary referral into NDIS and supporting children who require further assessment/diagnosis and supports through the system.

Aims

TOTs aims to increase the number of children in target locations who are developmentally on track at 5 years old or receive the support they need to thrive by:

Assisting children and families with timely identification of developmental delays, engagement with appropriate early intervention services and participation in supportive early childhood environments including early childhood education and playgroups.
Building the capacity of families and early childhood educators to support children’s development.

TOTs elements

TOTs engages with children and families through Early Childhood Education and Care centres (ECECs) and community hubs, settings they are already connected to and feel safe engaging, ensuring greater accessibility and engagement.

The initiative includes several elements, delivered in place, to support families with the above objectives. TOTs elements include:

Training and capacity building support provided to ECEC educators to promote children’s development through sensitive conversations with families and localisation of heath pathways (provided by Brisbane South PHN)
Engagement with Child Health Services to support further assessment in a location that is safe and convenient to families (delivered in partnership with Children’s Health Queensland)
Allied health capacity building with ECEC educators to enable implementation of strategies and adjustment of the curriculum to support identification of developmental concerns in children (delivered in partnership with Children’s Health Queensland)
Culturally safe allied health support for families in community hubs, a location that is safe and familiar (delivered in partnership with private, non-for-profit allied health providers)
Support for families to navigate the different service offerings, manage appointments and advocate for their child (delivered in partnership with community hubs)
Collaboration with Griffith University for ECEC educator capacity building, individual speech pathology intervention for a small number of children and initiative evaluation.

TOTs impact

Impact on children and families

Since the commencement of TOTs, over 3500 children have had their development monitored in their ECEC, with approximately 300 children accessing a secondary developmental screen in their ECEC each year. In FY25, 9% of children accessing this secondary developmental screen identified as First Nations children and 21% identified as children from a culturally and linguistically diverse background. It should be noted this number of children is supported by 0.8FTE Child Health Nurse, with a greater number able to be supported with increased resourcing. Of the families supported to access a Child Health Nurse in their ECEC, 100% of those who responded to a survey indicated they understood the next steps to take to support their child and could indicate a strategy they would implement in the home.

Each year, over 170 families are supported to access allied health intervention in community hubs. In FY25, 8% of new referrals identified as First Nations children and 71% identified as children from culturally and linguistically diverse backgrounds. Of families surveyed, 100% had an increased awareness of their child’s needs and increased knowledge of strategies to support their child’s development, with 94% of families indicating they intended to implement strategies in the home.

Impact for ECEC educators

A recent qualitative case study evaluation of the capacity building for early childhood educators provided through TOTs, completed by Griffith University, indicated the following benefits for educators:

increased knowledge and confidence with respect to child development, including becoming more proactive in identifying developmental concerns
increased confidence in initiating conversations with families
shifts in how they support children with additional needs in their day-to-day practice, including implementing developmentally supportive strategies in the classroom
improved awareness of services available to families and how to navigate referral pathways
stronger relationships with families.

While this sector is often characterised by high staff turnover, the evaluation found educators were sharing their knowledge and learnings when they moved to new ECECs, establishing peer support pathways within their ECEC centre and recommending ECEC centres who were not engaged with TOTs to onboard.

Impact on systems partners

TOTs enables system partners to engage with families who may not access child health, development and wellbeing supports via traditional pathways and access points. Over the period of TOTs delivery, approximately 10% of children supported with a secondary developmental screen in their ECEC had engaged with a Child Health Nurse in the previous 12 months. This indicates the provision of TOTs in settings where families are already engaged allows health services to interact with families they may not have otherwise supported with early identification.

First Floor, Building 20, Garden City Office Park, 2404 Logan Road, Eight Mile Plains QLD 4113 s
PO Box 6435, Upper Mt Gravatt QLD 4122 | ABN 53 151 707 765 é
1: redacted 1300 467 265 | bsphn.org.au
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TOTs has been integral in shifting the local narrative around the role of health and education in the early childhood period, normalising the monitoring of children’s development in ECEC and increasing the awareness of the expertise ECEC educators can be supported to have in this space. Anecdotal evidence from numerous school principals in areas where ECECs are supported by TOTs indicates there has been an increase in the number of children entering formal schooling with identified developmental concerns and accessing supports.

What we know works

Partnership with community and systems partners enables holistic support

A reimagined early child development system

In response to feedback from families in Logan that the early child development system was fragmented, siloed and difficult to navigate, Logan Together and a range of government, service delivery and community partners developed a reimagined early child development system to support children and families across the first 2000 days. The Logan First 2000 Days model comprises 5 evidence-based initiatives and five community enablers to provide holistic, integrated, culturally safe care in the critical first few years. Logan Together is collaborating with Brisbane South PHN to realise the implementation of Logan’s First 2000 Days model, in an innovative and strategic partnership providing aligned advocacy, narrative and resourcing. The central role TOTs plays as an initiative of the First 2000 Days model allows for holistic linkage with maternity and other supports.

The importance of working in place

Logan is a geographically large and culturally diverse region, and the importance of place in service delivery has been demonstrated through families connecting more readily with services and supports offered in locations where they are already engaged and feel safe. The Logan First 2000 Days model offers support to families in the home, Community Hubs and Early Childhood Education Centres (ECECs) ensuring accessibility, holistic care and integrated care planning, and reducing the burden on families to engage with a multitude of organisations in different locations. The model is tailored to meet the needs and aspirations of each local community across Logan, ensuring flexibility in service delivery and the provision of services that are universal or targeted, depending on the family need, but not uniform. This ensures each family is supported through partnership and able to equitably access supports and services individually tailored to their circumstances.

Please see below for a schematic of the Logan First 2000 Days model.

ECEC educators can be supported to have a pivotal role in monitoring children’s development

Engaging with Early Childhood Education and Care educators and enhancing capacity is a cornerstone of TOTs. Early childhood educators are uniquely positioned to observe, monitor, and nurture children’s development within the educational context. By collaborating closely with these professionals, TOTs taps into a wealth of knowledge, expertise and resources for the benefit of the children it serves.

Capacity building for ECEC educators encompasses multiple components. It equips them with the skills and knowledge necessary to detect developmental delays and differences promptly. Additionally, educators are empowered to tailor their teaching methods and interventions to accommodate the individual needs of each child, fostering a culture of inclusion, support and promotion of development.

The significance of this approach is demonstrated by extensive research on the pivotal role of early childhood educators in child development. Studies have consistently demonstrated the positive impact of well-trained and supported educators on children’s cognitive, social, and emotional development (Camilli et al., 2010; Durlak, 2003). By strengthening the capabilities of ECEC educators, TOTs aligns with global best practices, supports its dedication to maximising the potential of every child, and ensuring the sustainability of its interventions (Elek et al., 2017).

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First Floor, Building 20, Garden City Office Park, 2404 Logan Road, Eight Mile Plains QLD 4113 a
PO Box 6435, Upper Mt Gravatt QLD 4122 | ABN 53 151 707 765
1: redacted 1300 467 265 | bsphn.org.au
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Families can support their child’s development when able to access culturally safe and appropriate allied health services in community hubs

Community hubs play a central role in fostering collaboration and community engagement. They act as gateways to services, information and learning, enabling families to increase their connections with their local community (Rushton et al., 2017). They offer a sense of belonging and support, and they are often seen as safe spaces for families. This positive perception of community hubs enhances community engagement and participation, contributing to the overall success of the TOTs Initiative (Rushton et al.,2017).

Universal and more targeted allied health support provided to families in community hubs has built the capacity of the families to support their child’s development and allowed families who are not eligible for other support schemes to receive individual intervention. Allied health providers regularly attend community hub playgroups to provide education and strategies to families in a universal manner, while then providing group or individual intervention to families of children with mild to moderate developmental concerns. The allied health professionals work in a culturally safe manner to ensure families access resources and strategies that are culturally appropriate and build the family’s understanding of their child’s developmental presentation and needs.

The integral role of system navigators or link workers in supporting the overall health and wellbeing of community members has been well defined over recent years. Many families, particularly those from culturally and linguistically diverse backgrounds, require support from connectors to navigate the health service system. When incorporated in TOTs, connectors support families with:

capacity building and upskilling in navigating complex service systems
advocacy in appointments
translation of medical information and processes to engage with services
completion of complex paperwork and accessing online portals
education regarding child health, development and wellbeing
engagement with a range of services including ECEC, ECA, child health and development services, and paediatricians
support with life skills such as using public transport.

Connectors supporting families in TOTs share a level of lived experience with respect to navigating complex systems and supporting children with developmental concerns and can work with families through a peer support model. Many connectors also share language and culture with the families they support, building trust and addressing the cultural stigma associated with developmental delay. Over time, observations from connectors in place in community hubs indicated that while a portion of families would require intensive, medium-term support, there were a significant number of families who sought casual advice and were then able to follow recommended pathways independently.

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First Floor, Building 20, Garden City Office Park, 2404 Logan Road, Eight Mile Plains QLD 4113
PO Box 6435, Upper Mt Gravatt QLD 4122 | ABN 53 151 707 765
1: redacted 1300 467 265 | bsphn.org.au
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Flexibility in service delivery ensures sustained engagement

Each of the TOTs elements are flexibly tailored in their delivery to meet the individual context of the family, community hub or ECEC. This enables the development of trusted relationships and ensures sustained engagement in TOTs. Allied health intervention in community hubs is delivered in a way that meets the cultural and other needs of the local community, with intervention further tailored to the individual needs of each family. The trust this has built within the community has resulted in a level of demand that cannot be managed with the current resourcing. Within the ECECs, supportive meetings allow the identification of areas of development that would best meet the needs of the educators at the centre, with a bespoke response provided. This flexibility in service delivery has resulted in 80% of ECECs supported in FY25 having requested additional rounds of support from TOTs.

Leveraging TOTs to support children with mild — moderate developmental needs

Sustainability and scale

TOTs is well established in Logan and Inala, with great trust having been built with a range of systems and community partners, including schools, ECECs and community hubs. The flexible, place-based delivery of TOTs ensures this model has the foundations for scale to other communities and a broad application to support children with mild to moderate developmental delays or autism and their families. Alignment with the Thriving Kids approach would enable a sustainable funding source for a systems response that is currently delivering great impact.

Areas for further development and iteration

The strong foundation of TOTs will enable swift expansion of the system response to a broader early intervention program for children and their families, with differentiated pathways of care for children with mild to moderate developmental delay or autism. This response would offer supports with a range of intensities to meet the differing needs of children and families, including:

universal education for parents, carers and educators on child development to support proactive identification of developmental delay
hands on capacity building of parents, carers and educators to model developmentally supportive strategies as a form of preventative promotion
peer support to normalise conversations about child development
parent and carer education to support understanding of diagnoses and support available
parent and carer capacity building through hands on supportive modelling of strategies in playgroup
short to medium term group or individual intervention in a range of community settings where families feel safe and are engaged
peer support to navigate the different services offerings and system response to ensure families are receiving the best care to meet their child’s needs and ensure they thrive.

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First Floor, Building 20, Garden City Office Park, 2404 Logan Road, Eight Mile Plains QLD 4113
PO Box 6435, Upper Mt Gravatt QLD 4122 | ABN 53 151 707 765
1: ©“ redacted 1300 467 265 | bsphn.org.au
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The role for Primary Health Networks (PHNs)

PHNs have the capacity to play a critical role in providing coordinated commissioning for a systemic response in the implementation of Thriving Kids in a place-based manner in local communities across Australia.

PHNs provide a unique opportunity to support the successful implementation of early identification and intervention supports for the community due to their:

Deep understanding of the local health context and needs
Relationships with key stakeholders and service delivery partners in the local community, including local Hospital and Health Services, NGOs, collective impact bodies and other community organisations
Standing funding relationship with the Australian Department of Health, Disability and Ageing in relation to regional commissioning of funding for priority populations from a primary health perspective
Robust commissioning processes and procedures
Ability to support localised investment and commissioning approaches from a place perspective
DGR1 status which brings the ability to attract other funding and investment, including philanthropic partners
Ability to locally design and commission solutions with communities to ensure tailored early identification and intervention supports that meet the needs of the local context.

To support health system reform and address health inequities for children and families, Brisbane South PHN has cultivated strong partnerships with a range of key stakeholder groups including health and community service providers, government departments and community organisations. This has fostered strong collaborative relationships across service sectors and allowed the development of flexible and innovative solutions to deliver services in a manner that meets the local community context. Currently, through the Logan First 2000 Days model, Brisbane South PHN provides the program management and coordination of Thriving and On Track and is collaborating with Logan Together for the implementation and integration of the Logan First 2000 Days model.

Brisbane South PHN has a standing funding relationship with the Australian Department of Health, Disability and Ageing in relation to regional commissioning of funding for priority populations from a primary health perspective and is using this lever to support co-investment relationships with state-based government health organisations and encourage identification of joint priorities with philanthropy across Australia.

Contact person:

Mike Bosel
Chief Executive Officer
Brisbane South PHN

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First Floor, Building 20, Garden City Office Park, 2404 Logan Road, Eight Mile Plains QLD 4113
PO Box 6435, Upper Mt Gravatt QLD 4122 | ABN 53 151 707 765
1: redacted 1300 467 265 | bsphn.org.au
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Submission 115 — Brisbane South Primary Health Network — Inquiry into the Thriving Kids initiative

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