Agenda item
EARLY YEARS: HEALTH VISITING SERVICE - FINDINGS FROM STAKEHOLDER ENGAGEMENT
Lead Officer: Esther Trenchard-Mabere
The report sets out the engagement process that has been carried out on the emerging integrated locality model for the health visiting service.
Recommendation
To note the report
Minutes:
Esther Trenchard-Mabere, Associate Director of Public Health, LBTH presented the report regarding the transfer of commissioning responsibilities for early years (0-5) public health services, specifically, the health visiting service (HV) and the family nurse partnership (FPN) from NHS England to the local Authority on 1st October 2015.
The Board noted the importance of these services in view of the Marmot Review 2010 that concluded that intervention in early years had a real impact on lifelong health and the subsequent government decision to expand this service nationally.
The transfer, along with the significant expansion of the Health Visiting workforce, presented opportunities to strengthen the Health Visiting service and to develop new specification to improve integration with other services.
The Board also noted the health visiting service was central to ensuring that children and families had access to health promotion, preventive and early intervention services to support healthy physical, emotional, social and cognitive development.
Esther Trenchard-Mabere provided an outline of the health visiting service. Health Visitors, who were qualified specialist public health practitioners (registered nurses) worked as part of a mixed skill team supporting and educating families from pregnancy through to a child’s 5th birthday. The aim of the health visiting service included keeping children healthy and safe, protecting them from serious disease through screening and immunisation and ensuring they were ready to start school.
The Family Nurse Partnership (FNP) offered an intensive programme of support for first time mothers (and fathers) under nineteen from early pregnancy up to the child’s 2nd birthday.
The Board noted that some of the positive outcomes of the health visiting service which included; Improving life expectancy and healthy life expectancy; Reducing infant mortality; Reducing low birth weight of term babies; Improving breastfeeding initiation and prevalence at 6-8 weeks; Improving child development at 2-2.5 years and malnourishment; Reducing the number of children in poverty; Improving school readiness; Disease prevention through screening and immunization programs
The Board noted the National 4, 5, 6 Model which:
a) 4 Levels of Service which set out what all families could expect from their local health visitor service:
1) Community: health visitors provide information on community needs and resources available e.g. Children’s Centres and self-help groups and work to develop these and make sure families know about them.
2) Universal (the 5 key visits): health visitor teams ensured that every new mother and child had access to a health visitor, received development checks and received good information about healthy start issues such as parenting and immunization.
3) Universal Plus: families could access timely, expert advice from a health visitor when they needed it on specific issues such as postnatal depression, weaning or sleepless children.
4) Universal Partnership Plus: health visitors provided ongoing support, playing a key role in bringing together relevant local services, to help families with continuing complex needs, for example where a child had a long-term condition.
b) The 5 universal health reviews
The 5 key visits were those that all families could expect under the universal level of service. They were also mandated (i.e. local authorities have committed to deliver) as part of the first 18 months of the transfer of commissioning; antenatal; New baby; 6 – 8 weeks; 9 – 12 months and 2 – 2 ½ years.
c) The 6 high impact areas
The purpose of the High Impact Area documents was to articulate the contribution of health visitors and describe areas where health visitors had a significant impact on health and wellbeing and improving outcomes for children, families and communities. These were noted as follows: Transition to parenthood; maternal mental health; Breastfeeding; Healthy weight; Managing minor illness & accident prevention and Healthy 2 year olds & school readiness
Members regarded this as a crucial development in Tower Hamlets due to the high levels of deprivation and problems with child malnourishment often identified in school.
The Board also heard from a representative from the Health Visiting Service. Whilst there had been an investment in increasing staff numbers, the aim was to develop their role to share good practice and spread knowledge in schools and assist members of governing bodies with needs assessment, particularly in linking the child and families to other services. It would also be prudent to consider caseload mapping for health visitors to ascertain areas which need more resources when funding became available.
RESOLVED -
That the report be noted.
Supporting documents:
- ITEM 4 - Health Visiting Service, item 10. PDF 136 KB
- ITEM 4 - APPENDIX 1 - stakeholder engagement, item 10. PDF 3 MB