The Health Visitor’s role in Leading the Healthy Child Programme – Health Review 2 Southampton...

The Health Visitor’s role in Leading the Healthy Child

Programme – Health Review 2

SouthamptonSue Wierzbicki

Locality Lead Co-ordinator – South cluster

Mobile – 07785113842

Sue.wierzbicki@solent.nhs.uk

AIMS

● To understand the Health Visitors role in delivering the Healthy Child Programme.

● To understand the value of Health Review 2 and the benefits of sharing information.

OBJECTIVES

● To understand the Healthy Child Programme.● To have an awareness of the Health Visitors role.● To explore Health Review 2 – what are the similarities and differences

with the early years assessment.● To discuss how we can work together and the benefits of sharing

information.

RATIONALE WHY

● To avoid duplicating work and referrals. ● To improve working in partnership and communication.● To support families and improve readiness for school

Who are Health Visitors

● Qualified nurses (all disciplines) or midwives

● Public Health Nurses trained at BSc/MSc level and Nurse prescribers

● Working with Children aged 0-5 years and their families, providing a ‘rapid

response’ when required.

● The HV’s purpose is to reduce health inequalities and improve health

outcomes for children at an individual and population level.

● Locality working across the city whilst utilising children centres and other

community resources

● HV’s work with the most complex and disadvantaged children and families

through partnership with LA, voluntary sector, health colleagues

Brain Development – Why the early years is important

Why is there a Healthy Child Programme!

A Strong evidence base:

● Health for all Children (Hall and Elliman 2006)

● National Institute for Clinical Excellence (NICE)

● Review of Parenting programmes (University of Warwick)

HCP universal reach provides opportunities to identify families in need of

additional support to improve outcomes

Lead by Health Visitor (HV) but delivered by range of professionals to engage

those least likely to access traditional services

• Transition to parenthood and the early weeks

• Maternal (perinatal) mental health

• Breastfeeding • Healthy weight,• Managing minor

illnesses & reducing accidents

• Health, wellbeing & development at 2 years & support to be ‘ready for school’

• Antenatal health promoting visits

• New baby review

• 6 – 8 week assessment

• 1 year assessment

• 2 – 2 ½ year review

Improved accessImproved experienceImproved outcomes

Reduced health inequalities

• Your Community

• Universal

• Universal Plus

• Universal Partnership Plus

5 Mandated Elements

6High Impact Areas

4Level service model

Nationally Mandated Health Visiting Offer

The Health Visiting service Family Offer

Safeguarding children

Empowering Parents

Solihull Approach, Motivational interviewing, solution focused therapy

Why do the health review

●All children should have the best start in life – Marmot review●Two year review is important as it identifies need to ensure readiness to school●It also can provide good data to measure that early intervention is working

Requirements of the Healthy Child Programme

The purpose of health & development reviews is to:

● Assess family strengths, needs and risks● Give mothers and fathers the opportunity to discuss their concerns

and aspirations● Assess growth and development● Detect abnormalities

Healthy Child Programme (DOH, 2009)

Health Review Two

● HR2 aged 2 – 2.5 years● Ages and Stages Questionnaire - an assessment of Gross motor, Fine

motor, Social personal and communication development.● ASQ social and emotional questionnaire.● Referral for support if required● Health promotion – dental hygiene play, social interactions, toileting, sleep

behaviour, diet, immunisations family health.

What is the ASQ-3?

● An evidence based developmental assessment tool recommended by the Healthy Child Programme (DOH, 2009).

● Provides 21 age specific questionnaires for use across the 0-5 Year age group.

● Consists of 30 questions about a child’s abilities organized into 5 areas of development

● To be used with the child present and in partnership with the parent or carer.

Detection Rates

Without Tools

● 30% of developmental disabilities identified

● 20% of mental health problems identified

With Tools

● 70-80% with developmental disabilities correctly identified

● 80-90% with mental health problems identified

Similarities and differences

● Group work

Scenario

XXX is two and a half years old recieving two year funding. XXX is in nursery 15 hours a week and has been attending for two months. XX regularly comes in with a bottle of milk. Father reports that he has tried for 1 and a half hours to get him to eat breakfast. “ he is tricky with all meals”. In the setting he doesn’t eat snacks, but when he does he pushes it in and gags. He has been observed drinking the water from the tray.

What actions would you take and how can we work together.

What could be going on at home for this child

What information the Health visitor can provide

● FHNA – Family health needs assessment● Information from core contacts● Support with health concerns● Referrals to allied health professionals.

Information sharing

● Pilot Two year summary● Now I am 2● Staff lists● Secure emails

Improving preschool links

● Link HV what would make communication better

Many thanks for your contribution

● Questions.