1. Public Health, Early Years, Children’s Services Focus: HV / SN & Links September 2013 Dr Julia Egan Professional Advisor for Public Health, Early years and Children's Services

2. Scope: CEL 13 HV / SN Work plan 2013 – April 2014 Associated areas and links

3. HV / SN: CEL 13 Purpose Terminology, definitions, focus and data Scoping exercise – Aims Questions and main findings

4. Questions: Universal services: Visits, definitions, health promotion, additional input, priorities, GIRFEC Vulnerability assessment PH roles / priorities Caseload weighting Models of service delivery Multiagency roles and priorities inc LAC Evidence base Education and training priorities and needs

5. Key Findings: Generally all follow Hall, but visiting patterns vary Some Boards have guidance others don’t Who, what, where differs Universal gap antenatally and over 5 years HP needs underlining and defining General consensus SN role is around: vulnerable children (referred not proactive), LAC, Complex needs & needs revisiting Gap: primary school, transition, excluded children, LAC, refuge, families not at school

6. Many have increased universal input under 5 re early yrs work, evidence (Bolton, Cowley), FNP Differences in tools, when used e.g.- strengths and difficulties questionnaire Additional: largely consensus (on anything that constitutes more than core) but no agreed definition Use GIRFEC model of assessment and allocate HPI - lack of uniformity (particularly in 5-19 and maternity) and how applied 7 other models of vulnerability assessment Generally no caseload weighting tools but need one

7. PH roles need prioritising and redefining Models of delivery predominantly GP attached however significant number of locality, corporate and multi-agency models GAPS : Substance misuse, CAMHS, MH and need to progress more interagency linked roles Training and education : consistent messages throughout: …….training, content, HEIs, CPD, career development.

8. Recommendations: National guidance for universal contacts and visiting patterns for 0-19 year olds including: a. Who; where, when, evidence base to support visits, tools and interventions; specific health promotion advice to be given and national data recording. b. Guidance on assessment tools: validated tools for assessing: attachment; infant, child and adult mental health; parenting; child development; risk and LAC. c. Consistent approaches to GIRFEC, vulnerability assessment and additional input

9. Development of a national model for HV caseload weighting. Consideration will be given to SN and other appropriate professional groups. Redefine the SN role and the evidence base to support it Commission NES to review and develop future HV/SN training and career pathways based on evidence and recommendations.

10. Built in will be: Redefining and strengthening the PH and multiagency contribution of HV and SN, setting out priority areas for development and intervention

11. Anticipatory care, prevention, assets, strength based approaches, community development Domestic abuse, substance misuse, mental health, trauma interventions Equity, equality, access Vulnerable groups: LAC, excluded children, children not at school, prisoners and their families, preventing offending, homeless, travellers Third sector growth & links and integration with e.g. family support models

12. Plan Progressive universalism Evidence base – 0-5; 5-19 Build approaches and interventions into universal, group and population based community nursing work. E.g. routine enquiry, motivational interviewing, assessment tools Assess and monitor data and outcomes

13. National : Children’s Young Peoples Nursing Advisory group Chair Rosemary Lyness – Executive Director NHS Lanarkshire Role, remit, membership, Accountability - SEND Four priorities: universal services, weighting tool, SN, Education Delivery by April 2014

14. Associated links: Wider community and workforce across agencies Wider workforce development and 20:20 Vision Wider training and education implications Integration