Working together to improve the health outcomes of the 0-5s Partners in care Working together to improve the health outcomes of the 0-5s Fiona Coker, Head of Midwifery, Salisbury Foundation NHS Trust and Val Scrase, Head of Children and Young People’s Community Health Services (Wiltshire)

Maternity – What are maternity services all about these days

Care delivered to develop trust: Diet and lifestyle changes Vaccinations Child protection Domestic abuse Smoking Drug and alcohol use Mental Health Blood screening Parenting capacity Screening for vulnerabilities

Where there is a baby there is a mother !!! Risk assessment is crucial. Social- Who else is in the family/how was they parented. Medical- What other conditions are in the family. Psychological- Depression AND anxiety. Support network- no one can do this alone.

Priorities on the ground floor: Communication – MW – HV liaison Dads Reducing Stillbirths Parenting Education Breastfeeding

Challenges: Midwives are ‘Mother focused’. Premise of optimism. Communication across organisations – systems, process and technology. Capacity and staffing. Time to train. Commissioned cohorts and populations. Cash strapped NHS. Opportunities for joint training and networking.

Health Visitors - work with families and communities to improve access, outcomes, and reduce health inequalities.

4 levels of care: Universal – AN, New Birth, 6-8 weeks, 9-11months, 2-2 ½ year. Universal Plus. Universal Partnership Plus. Community.

6 HIGH IMPACT AREAS: Transition to parenthood. Maternal mental health. Breast feeding – initiation and duration. Healthy weight, healthy nutrition, and physical activity. Managing minor illness and reducing hospital attendance and admission. Health, wellbeing and development of the child at 2-2 ½ and support to be ‘ready for school’.

Key Principles: Early identification of need and risk. Promotion of social and emotional development. Empowerment and support of parents. Wider community involvement. Promotion of health – evidence based practice. Strengths based approaches.

Effective partnership working: Clear information on roles and responsibilities. Regular meetings. Clear pathways and procedures. Sharing of information - Information governance and consent. Networking at all levels and regular opportunities for liaison and communication. Clear lines of accountability and supervision. Multidisciplinary training Shared service planning. Safeguarding

Challenges to partnership working: Communication across organisations – systems, process and technology. Capacity and staffing. Staff turnover. Lack of clear clinical pathways. Commissioned cohorts and populations. Funding and funding changes. Opportunities for joint training. Number of providers.

Positives: Shared purpose. Striving to make a difference. Commitment to Healthy child/Healthy families. Commitment to working with partners.