The Health Visitor’s role in Leading the Healthy Child Programme – Health Review 2 Southampton Sue Wierzbicki Locality Lead Co-ordinator – South cluster Mobile –

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 access Improved experience Improved outcomes Reduced health inequalities Your Community Universal Universal Plus Universal Partnership Plus 5 Mandated Elements 6 High Impact Areas 4 Level service model Nationally Mandated Health Visiting Offer

The Health Visiting service Family Offer Community Universal UP UPP 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 s

Improving preschool links ●Link HV what would make communication better

Many thanks for your contribution ●Questions.