Health Visiting and FNP services. National Policy Giving all children a healthy start in life...

Health Visiting and FNP services

National Policy

Giving all children a

healthy start in life

Improving the HV service

Improving chances for children with vulnerable mothers

Supporting mothers &

children with mental health

problems

Helping parents to keep their children healthy

Providing free school

meals

Encouraging healthy living from an early

age

Protecting children through

immunisation

Improving maternity

care

Policy deliverables by 2015

increase qualified Health Visiting workforce by 4200

transform the Health Visitor

service

increase the number of Family Nurse Partnership places to16,000

HV / FNP Programme key dates

2011

• Health Visitor Implementation Plan 2011-15: A Call to Action launched• Strategic Health Authorities worked with Primary Care Trusts to identify

how many Health Visitors would be needed in localities to meet identified population needs. Business cases and Investment profiles agreed.

2013

• Public Health transferred to the Local Authority in 2013, however the commissioning of Health Visiting & FNP Services moved to NHS England for a period of two years to complete the investment and transformation programme.

2015

• Commissioning responsibility for Health Visiting and Family Nurse Partnership services will transfer from NHS England to Local Authorities on 1st October to complete the transfer of public health functions.

Why the focus on Health Visiting?Public Health - The foundations for virtually every aspect of

human development – physical, intellectual and emotional – are set in place during pregnancy and in early childhood.

Economic - Successive academic and economic reviews have demonstrated the economic and social value of prevention and early intervention programmes in pregnancy and the early years.

Competency - Health Visitors, specialist community public health nurses, have a unique role in identifying need and supporting the development and wellbeing of every child in England up to the age of 5.

The Health Visiting Service… provides expert information, advice, guidance and

interventions to help parents become the best parent they can be and give their children the best start in life.

has a central role in improving the health outcomes of populations, reducing inequalities, protecting children from harm and identifying additional needs at the earliest opportunity.

leads the delivery of the national Healthy Child Programme 0-5 for every child

is the only service that comprehensively assesses the health, wellbeing and social needs of every child at crucial stages of their development between pregnancy and the age of 3, often in the home environment.

Healthy Child Programme

An universal schedule of evidence based assessments, screening, immunisations and contacts aimed at promoting and protecting the health and wellbeing of all children as well as identifying needs early and taking appropriate additional action.

National Core Service Specification

Local provision

Two providers of CIOS Health Visiting

• Health Visiting• FNP

Cornwall Partnership Foundation

Trust

• Health Visitors in LAC Specialist Nursing Team

Royal Cornwall Hospital Trust

Three key aspects

increase qualified Health Visiting

workforce

Transform the Health Visitor

service

increase the number of Family Nurse Partnership

places

Increasing the workforce

May 2010 March 2015

81fte qualified HV’s 117fte qualified HV’s

Transform the Health Visiting service

Population uptake of core checks

Safeguarding

Public Health & Prevention

Population uptake of core checks

Antenatal

Newbirth

6-8 weeks *

3-4 months *

By 1 year

2-2.5 years

Increasing universal uptake - 1 year review

53% 70%Q2

2014

Q3 2013

Evidence based tools examples

Solihull

Family Partnership Model

Motivational Interviewing

Baby Friendly

Ages & Stages 3 & SE

Evidence Based Assessments of Need

Check uptake

increase from 67% to

74%

ASQ to be nationally introduced

60% of reviews

used ASQ

88% of staff

trained by Q2

Workforce Development examples

Leadership of change

training

Preceptorship

programme

Communities of practice

Action Learning Set for CPT’s

NHS Employers

Snapshot of local developments

Equitable practice on the Isles of Scilly

HV in pre-birth assessment

team

HV in MARU (multi-agency referral and

assessment unit)

Multi-Agency Antenatal education

Migrant Workers

Needs analysis

Doubled FNP capacity

Family Nurse Partnership

Supporting vulnerable first time young parents

Up to 200

places

Licenced model

Capacity increased from 4 to 8 nurses

Looked After Children’s Team

3.4wte New

nurses from HV investm

ent

High quality

consistent

assessment

% reviews in time

has increased from 34% to 90%+

Case manage

ment approac

h – nurse

follows child

Specific support

for adoptive parents

to support placeme

nt

Developing clear pathways of care

Development of champion roles

•Domestic Abuse•Perinatal Mental Health

Infant Feeding

•Infant Feeding co-ordinator•BFI accreditation across Hospital & Community

Perinatal mental health & attachment

•Currently use Woolley questions, GAD7 & PHQ9•Reviewing use of Promotional guides / MORS

Integrating two year reviews

•Introduction of ASQ•Working with Early years to streamline delivery•Part of Social Marketing project

Engaging families

Meridian Survey/Friends and

family

Social market

ing

Needs analysi

s

HV Challenges

Increased accessibility & expectation

Achieving Population Uptake

Maintaining focus upon public health and prevention as well as safeguarding

Maintaining the workforce through change

Actively engaging service users and influencing change

Fit for purpose Information sharing and IT

FNP Challenges

Decreasing teenage pregnancy rate

Staff turnover & sickness

Achieving fidelity of programme in a rural geography

Ensuring alignment to HV & Early Years services to provide a continuum of support

Any questions?