Public Health School Nursing Review

Marmot Review of Health Inequalities “Giving every child the best start in life is crucial for securing health and reducing health inequalities across the life course. The foundations for virtually every aspect of human development – physical, intellectual and emotional – are laid in early childhood. What happens during these early years, starting in the womb, has life-long effects on many aspects of health and well being – from obesity, heart disease and mental health, to educational achievement and economic status”

It’s not just about Early Years… “The effects of poor health during the teenage years can last a lifetime. Keeping adolescents healthy is a valuable investment in the nation’s future.” Chief Medical Officer 2007

What do CYP say they need? 'Someone you can go to with the kind of problems we have, to treat you properly, listen to you, not just sit back in the chair... confidentiality is important, and the way you're treated.‘ 'It's mainly just getting hold of information, that's the hardest thing - you're not sure where to go, especially if it's something you're embarrassed about - that's what people are afraid of, that you might be laughed at, so people don't try.'

Local vision “We want Nottinghamshire to be a place where children are safe, healthy and happy, where everyone enjoys a good quality of life and where everyone can achieve their potential.” Nottinghamshire Children, Young People and Families Plan 2011 to 2014

WHY HAVE A REVIEW?

Big Changes

Impact on school nursing Responsibility for commissioning public health services for children and young people aged 5-19 In the longer term all public health services for children and young people Immunisation and specialist nursing care for children become the responsibility of NHS Commissioning Board

The Purpose To gain evidence to shape the commissioning of Public Health nursing services from 2013/14 onwards (including school nursing).

Principals of the review Services should be based on need not historic demands Services should be evidence based in terms of provision and impact and where evidence is lacking seek to develop it Views of all stakeholders (including children and young people) should be taken into account

Included The core Public Health offer to school aged children aged 5 to 19 Provision of service to school aged children whether at school or not The whole of Nottinghamshire (including Bassetlaw)

Excluded Specialist nursing care in special schools (though the core public health offer to special schools is included) Vaccinations and immunisations (this will be the responsibility of the NHS commissioning board.)

What are we doing now? Pulling together data by district and school family to identify the level of health needs Getting the views of key stakeholders about school nursing Pulling together views of children and young people on what they want from school nurses from national research and local survey data

DAY IN THE LIFE

IDENTIFYING PUBLIC HEALTH NEEDS

Scale of the challenge in Nottinghamshire 135,500 children aged 5 to 19 (~17% of population) 10% from a Black or Minority Ethnic Group 17% of children live in poverty 346 schools –284 Infant/Junior/Primary –51 Secondary –11 Special schools

Reaching children and young people 4,410(4.8%) of children and young people are persistently absent from school 1,210 (4.5%) young people aged 16 to 18 are NEETS 110 permanent exclusions in 2010/11 4,870 fixed period exclusions in 2010/11

Medical Issues 70 children/young people with Cystic Fibrosis 70 children/young people with Sickle Cell Disease 240 children/young people with Crohn’s Disease 360 children/young people with Diabetes Mellitus 280 children/young people with a neoplasm such as leukaemia 10,690 with asthma Source: Nottinghamshire JSNA

Safeguarding 593 Looked after children 297 children referred to social care in September Children on a child protection plan

Wider determinants of health

Variations in Poverty Source: HMRC 2010

Child poverty Variation in Rushcliffe

Child poverty Variation in Mansfield

How are using the data Looking at data from the children's JSNA Building a profile of public health indicators by school family and district The data will support commissioners and providers in targeting areas of high need.

NATIONAL DRIVERS

National Guidance

Getting it right for children, young people and families Early intervention and signposting Healthy Child programme Promoting services, working with the community to promote and protect health Additional services for vulnerable children, young people and families working with partners