The Interim Director of Public Health presented the report which informed the Panel of proposals for the transfer of commissioning responsibility for Early Years Public Health Services from NHS England to the local authority and highlighted the following matters reported in the document:

• The transfer would take place on 1 October 2015.
• Early years services were important in terms of the long-term impact on lifelong health and well-being and therefore were critical for the future health and well-being of the community.
• The role of 0-5 years health visitors would increase.  Tower Hamlets had a good allocation of health visiting already and it was anticipated that the health visiting role (which was about supporting families in a holistic way) would incorporate health services delivered in the home environment.
• In the past, because health visitors resources had been lower than they should be, health visitors had had focused on more urgent elements of their role but with the anticipated increasing provision that the transfer would provide, it would be possible to look to fulfil the health visitor role more fully.
• The approach would be to focus resources on the most vulnerable (teenage mothers etc) and in this way to help turn around infant health issues that exist in the borough through better assistance.
• A notional budget of £6.6 million excluding overheads and management costs had been set.  However the Interim Director aimed to that an appropriate level of funding would be released before signing off the transfer.
• Staffing was presently 45 health visitors and the aim was to reach a level of 95 practitioners.  The Interim Director noted that the market for recruitment of this role was competitive and therefore the package needed to be an attractive.
• There were national standards for delivery of health visitor services incorporating; antenatal visits, and health visits at: one month, 6 to 8 weeks, two months, and up to the two-year-old health check.
• The Interim Director noted that there were high levels of childhood obesity in Tower Hamlets and it was intended that the health visitor assessments would help to identify resources to address this situation.
• It was necessary to ensure that the health visitor service integrated with other nursing services in the borough.  To do this, Public Health would engage with the local authority, GPs and other service providers.  The options were to bring health visiting services in-house.
• Options for procurement of the health visiting services were being explored with the Director of Education, Social Care and Well-being taking into account that terms and conditions for a key issue around the transfer of services, recruitment and retention of staff.

Councillor Hassell requested that information on:

• Outcome indicators for early years
• Healthy child review

be circulated to members of the Panel.

In response to Members; questions the following information was provided:

• Funding would be received directly by the local authority therefore the Council would be able to decide how to procure these services either by direct employment or through contracts.  Health visitor funding would be ring fenced within the public health grant however the duration of this grant was not certain.

• The matter of whether funding for the increased number of health visitors would be secured from Government, was being discussed with Barts Health and terms that overhead costs must be covered resolved to ensure that the mandate could be delivered.
• In relation to recruitment pool that could be accessed and facilitating recruitment, overhead costs had been included in the transfer terms of some boroughs.  However the terms of those mentioned in the report excluded overheads.  Reasons for this omission did not directly relate to issues or activities of these councils.
• Boroughs faced different issues concerning the pool for recruitment and its facilitation.  The local recruitment strategy would be to bring students into the service so that by the time the transfer took place the recruits would have worked in the borough and have an option to remain.  The market for recruitment was competitive therefore job satisfaction would be important.
• There was no requirement, per se, to transfer existing staff for capacity building but there were options to explore visiting-type roles which could become involved in health visiting and this may be a good option to explore to bring in skills.  Paul James of East London NHS Foundation Trust (ELFT) advised that ELFT runs visiting services in Newham and similar recruiting issues were encountered.  However there was a fast track commissioning available to train into these roles.
• Stakeholder engagement would be organised by the Associate Director of Public Health in three months time.
• The transfer of health visiting services to the local authority offered opportunities to better monitor health strategies for children.

RESOLVED

That the report be noted

Action by:

Tahir Alam, Senior, Strategy, Policy and Performance Officer (LGP)