Ubuntu in Uncertain Times: Bringing Health, Care and Commissioning Together for Children and Communities

October is Black History Month – a time to honour the legacy, leadership and lived experiences of Black communities across the UK, and globally. But this year, our reflections are tempered by a rise in racism and discrimination, and by the unrest we have seen unfolding in our communities, our country, and across the world. As leaders in children’s services, we cannot afford to be passive observers. These challenges are not abstract – they shape the lives of the children, families and communities we serve. They demand that we lead with empathy, act with integrity, and speak with courage.

This is my first blog as Chair of the newly formed ADCS Health, Care and Commissioning (HCC) Policy Network, and I want to begin by thanking colleagues for the trust placed in me. In my Expression of Interest, I spoke about the values that guide my leadership: integrity, collaboration, curiosity, and courage. I also spoke about Ubuntu – the African philosophy that means “I am because we are.”

Ubuntu reminds us that our humanity is bound up in one another. It’s a call to build systems that honour dignity, and to recognise that the wellbeing of children and families is inseparable from the wellbeing of our communities. It’s also a powerful lens through which to view the work of our network – where health, care and commissioning must come together not just in structure, but in spirit.

We often hear the phrase ‘the care market is broken,’ but what does that actually mean? Having spoken directly to a number of our children in care and care leavers and through the various forms of feedback, and re-reading the Big Ask from 2021, the reality of the above statement becomes even clearer: who better to hear it from but those that experience it first-hand. Our children’s top priorities remain wanting to:

• Feel safe, stable and loved
• Maintain relationships with their family and friends
• Have a say in where they live and be treated with respect
• Be supported to pursue their interests and aspirations.

Nationally, IFAs now account for almost half of foster care placements and research shows there’s a year on year 2% reduction in in-house foster carers. Similarly residential care costs have skyrocketed, with the vast majority (some 84%) being run privately with significant profit margins. So, seeing these statistics and hearing from children, I find myself reflecting on the best way to articulate it… the children’s care market has become a distorted system: it no longer serves the best interests of children. It is fragmented, profit-driven, and increasingly unaffordable, while children face instability, distance from home, and inconsistent care. We need a new model – one that prioritises relationships, transparency, and public value over profit.

We must, therefore, continue to strive to tackle this issue and make ‘care’ the number one priority. Our work is imperative in increasing our in-house foster carer population and developing our in-house provision, continuing to prioritise connected persons placements wherever right and possible, and helping to find the best match. We are developing our wider services through relationships with our children and carers by celebrating them and working with them, championing improved outcomes, supporting and celebrating innovative initiatives, and simply being a trusted adult in a child’s world.

Let’s build on our ambition as we start to prioritise tackling this all-important issue and making ‘Care’ serve the best interests of our children.

We are operating in a time of significant system change – and with it, considerable uncertainty. From NHS and ICB reforms, to Local Government Reorganisation (LGR) and Devolution, many ADCS members are navigating shifting landscapes, unclear accountabilities, and growing anxieties about what these changes mean for children’s services.

As a network, we must continue to be a space for sense-making and solidarity. We must advocate for clarity, coherence and child-centred design in every reform conversation. This was a theme in the first HCC Policy Network meeting I recently chaired, which had a focus on changes in the ICB and wider health landscape. Looking ahead, as our priorities continue to develop, we will also strengthen our links with other ADCS networks and ensure our voice is heard in national policy spaces.

In a time of uncertainty and unrest, our work is more vital than ever. Let’s continue to lead with empathy, act with integrity, and speak with courage. Let’s hold fast to the spirit of Ubuntu – I am because we are – and build a network that reflects the best of our collective leadership.

I look forward to working with you all – and to learning from the rich expertise across our network.