An integrated 0-19s Public Health Service for Derby City

Derby’s Population 0 – 19 year olds = 64,034 Population getting younger – particularly more 0-5 year olds Ethnically diverse city – 182 nationalities, 72 languages

Universal Partnership Plus *Mandated Reviews by Department of Health Pre birth* 10/14 d* 6/8 wks* 12 m* 2/2.5 y* 4/5 y 10/11y 13/14 15/16y 18/19y Universal Universal Plus Universal Partnership Plus Community SUPPORT FROM SPECIALIST SERVICES Children’s early help and social care services, Behaviour Pathway, Long Term Conditions, Special Educational Needs and Disabilities; Interface with maternity services Common language and culture; Colocation; Common IT Single Assessment Processes Multidisciplinary teams 1. 0-19 Universal Public Health Nursing Mandated health reviews/assessments to identify need, provide support, guidance and information for families Health screening (height, weight, vision, hearing) and reviews in school age children to identify further issues Health promotion messages and interventions at appropriate ages – positive parenting, maternal mental health, breastfeeding, oral health, healthy eating, physical activity, accident prevention, emotional wellbeing, risky behaviours, immunisation support and catch up Planned support to maximise school readiness Support for healthy settings – early years, whole-school approaches to health, PSHE, curriculum development, sexual health framework Building Community Capacity Appropriate, swift response to any health issues identified by universal services including safeguarding, domestic violence, school readiness. 2. Intensive structured support for young/vulnerable families 2. Intensive structured support for young/vulnerable families 3. Risky Behaviour Support Support for healthy settings Brief interventions and extended support or referral for weight management, sexual health, smoking, emotional health, self-harm, drugs & alcohol Specialist Substance Misuse Support

Structure and Priorities Levels of intervention universal universal plus universal partnership plus community Universal health assessments 10 key touch points from 0-19 years High impact areas 10 areas to reflect a range of health priorities & approaches Aim to keep things simple and acknowledge that Providers are the experts Based on the HV 4-5-6 model (4 levels of intervention, 5 universal health assessments, 6 high impact areas) Around 10 Touchpoints from pre-birth to 19 years – important opportunities to identify needs and provide interventions, both individual and population level (school, community, age group) High impact areas to be further developed into KPIs – we have identified around 10, have we got these right? E.g. transition to parenthood, healthy weight, school readiness, developing whole-school/settings approach to health improvement…

What to expect from a PHN for School Aged Children? A visible School Nurse Service that is easily accessible for schools, parents, children and young people with identified Public Health Trained nurses for each Senior School and their feeder schools. Easy and clear access to health support and information for schools, parents ,carers and pupils, using new technology and processes. A timely and supportive Public Health Approach encompassing support for Healthy Schools, identified local issues, curriculum and PSHE development. A service that has robust assessment tools and clear pathways for referrals within health and other children and young peoples services alongside access to adult services for parents. Health reviews, drop ins and screening to address underlying health issues at timely points through a child’s life to support prevention and deterioration of both physical and mental health.

Preventing childhood obesity in Derby 1 in 5 children in Derby carrying excess weight by age 4-5 By age 10-11 the figure has risen to over a third Greater risk of type 2 diabetes, heart disease and stroke, certain cancers, low self-esteem and can reduce life expectancy by up to 9 years Strong association between childhood obesity and deprivation, and the gap between disadvantaged and affluent areas widens as the child grows older Obesity is a complex issue determined by how we live our daily lives, the environment in which we live and work, and how we feel about ourselves

Derby’s Childhood Obesity Strategy Tackle the 'obesongenic environment', including availability of 'junk food' & the drivers of sedentary lifestyles  Tap into the wider workforce to positively impact public health in their community, by supporting them to have a conversation about adopting healthier eating and physical activity  Go beyond health education and behaviour change approaches to incorporate environmental changes to shift norms and enable the adoption of healthy behaviours within everyday life  Giving every child the best start in life is crucial from infant feeding and early years settings, through schools and the importance of working with families, to promoting healthy transitions into adulthood

Preventing obesity: Early years and School settings Take a whole school approach. Interventions should be sustained, multicomponent and address the whole school, including after-school clubs and other activities minimise sedentary activities during play time, and provide regular opportunities for enjoyable active play and structured physical activity sessions Promote and enable walking and cycling to school ensure children eat regular, healthy meals in a pleasant, sociable environment free from other distractions. Children should be supervised at mealtimes and, if possible, staff should eat with children Encourage high uptake of school meals, and promote healthy lunchboxes; introduce ‘stay onsite’ policy School breakfast clubs offer a chance for pupils to have a healthy breakfast in a social environment, setting them up for the school day ahead Involve parents and incorporate children’s views

Moving forward Opportunities to engage with you about school based PH services on a regular basis? Capacity to contribute to obesity strategy group?

Contact details Hamira Sultan, Consultant in Public Health Hamira.Sultan@derby.gov.uk 01332 643 091 Bev Plested, Operational Lead School Nursing beverly.plested@derbyshcft.nhs.uk 01332 888080 Jilla Burgess Allen, Public Health Registrar Jilla.Burgess-Allen@derby.gov.uk 01332 643 098