Service transformation - Year 1 Warwickshire School Health & Wellbeing Service Service transformation - Year 1 Rachel Bundock – C&YP Director Maggie Clarke – Assistant Director, HCP

Service Specification:

National specification (5-19 SN) Source: PHE, January 2016

Transformation: key structural changes Reviewing and revising structures, systems and processes to ensure foundations were built for a sustainable future Developing a service to ensure delivery of a modern, safe, effective, efficient and equitable service to all CYP, families and stakeholders across Warwickshire.

Transformation 1: Staffing structure and skill mix In order to deliver a public health offer to a wide range of stakeholders focusing on prevention, targeted support and early intervention based on evidenced need: Compass school health teams are led locally by qualified specialist community public health (SCPHN) nurses Each school (primary, secondary and special) has a named school nurse (SCPHN) and supporting skill mix team Each team operates within a locality and works flexibly across the County Each local team has a skill mix that reflects local population needs.

Transformation 2: Streamlining of service provision To make access and engagement as easy as possible for all stakeholders: One telephone number for the service 03300 245 204 is in place including access to a duty worker for emergency queries and referrals 3 locality teams are in place – North (Nuneaton), East (Rugby) and South (Stratford); each team is led by a Team Leader and specialist community public health nurses Secure emails arrangements set up with partners spanning health, education, local authority and police to enable timely sharing of information and professional liaison.

Transformation 3: Building community capacity Enabling the service to become embedded within local communities Each staff member has a specialism e.g. young carers, to improve understanding of the culture and nature of the community group and care pathways specific to the specialism Use the data derived from the universal contacts to identify priority areas and groups including communities and agencies with a shared interest e.g. underweight children and provision of Foodbanks In addition to schools, use of local communities and established networks to promote the core service and deliver public health interventions e.g. Children Centres.

The core offer – physical, mental health & wellbeing and positive lifestyle choices Key activities: Health Needs Assessment – 4 staged contacts NCMP – 2 staged contacts LAC health reviews Individual healthcare plans Medical conditions awareness training Safeguarding Health promotion Information, advice and support Brief pschyosocial interventions Deliver services in schools and community settings HNA underpins service delivery and how we utilise resources Provides evidence of actual need Enables ‘joined up’ thinking – right person, right time, right skills.

Methods for delivery: Classroom based activities Health fairs/events Assemblies Parents evenings Phone support Supporting the PSHE curriculum Targeted group interventions Digital engagement 1:1 brief intervention for CYP with additional needs.

Annual planning & delivery cycle:

Establishing the systems (Year 1):

Health Needs Assessment activity (Year 1) 2015/2016 return rate (part-year): Reception/School entry – 25% (1638) Year 6 – 80% (4653) Processed 27,000 individual alerts ranging from information and advice to follow up assessment Collated data at individual, school, locality and population levels Breakdown of individual needs/alerts: 5 Pathways of care Total Risk & Protective 1244 Emotional Health & Wellbeing 1475 Holistic Health Interview 1973 Follow Up 15402 Information & Advice 6861 Vision Screening 128 Hearing Screening 70

HNA individual school reports:

School Public Health Plan: Theme Element Indicator Feelings and Transition   Transition Worries/concerns about transition Evidence 66.7% of 10-11 year olds have concerns and worries about transition to secondary school 70% of 10-11 year olds were worried about finding their way around their new school 73.3% of 10-11 year olds very concerned about leaving their old friends behind What needs to be addressed Intervention 1: Build emotional resilience, Supporting, reassurance to young people moving to high school. Provider: Setting: Timescale: Intervention 2: Advice to support parents How to address the needs Intervention 1: Review schools PSHE policy & curriculum to include strategies to cope with change, Themed Drop in sessions, Group sessions, Role play, Question & Answer session, Peer support; Secondary school develop child friendly transition leaflet about their school; Provider: Timescale: Intervention 2: Direct to useful websites, New parents evenings Provider: Timescale:

Warwickshire Population Priorities: Themed areas # Priorities % of schools Healthy eating 94 61 Transition 90 59 Smoking 58 38 Substance Use 39 25 Drugs 37 24 Bullying 34 22 Alcohol 18 12 Puberty 7 5 Parenting 6 4 Weight management 3 Solvents Oral hygiene 2 Physical activity 1 Family disability After school activities

Locality priorities: South hub: North hub: Central hub: # Priorities % of schools Transition 45 82 41 69 Healthy Eating 36 92 Healthy eating 34 62 Smoking 38 64 13 33 Bullying 32 58 Drugs 28 47 Substance Misuse 8 21 31 56 24 Puberty 7 18 Alcohol 17 29 Parenting 6 15 4 Solvent 3 5 weight management 2 10 1 Oral Hygiene Family disability Physical Activity After school activities

HNA Population Data: Mental Health & Emotional Wellbeing Strengths & Difficulties Questionnaire: Emotional Symptoms – happiness, worries, nervousness, fearful • Conduct Symptoms – obedience, temper, behaviour • Hyperactivity – distraction, concentration, overactive • Peer Problems – friendship, relationships • Prosocial – considerate, helpful, kind

HNA Population Data: Healthy Eating

HNA Population Data: Fizzy Drinks

HNA Population Data: Diet Concerns

NCMP Population data: S/E – 6354 children measured = 14% overweight = 454 children Year 6 – 5564 children measured = 25% = 1391 children

Service Priorities for Year 2: (2016/2017) Priority 1 – Strengthen communications with key stakeholders Priority 2 – Extend access and engagement including with vulnerable and hard to reach groups Priority 3 – Measure impact and effectiveness of service interventions Priority 4 – Continue to review and revise our role within the safeguarding arena Priority 5 – Increased integration and joined up partnership working