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

2. Service Specification:

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

4. 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.

5. 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.

6. Transformation 2: Streamlining of service provision
To make access and engagement as easy as possible for all stakeholders:
One telephone number for the service 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 s arrangements set up with partners spanning health, education, local authority and police to enable timely sharing of information and professional liaison.

7. 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.

8. 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.

9. 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.

10. Annual planning & delivery cycle:

11. Establishing the systems (Year 1):

12. 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

13. HNA individual school reports:

14. School Public Health Plan:
Theme
Element
Indicator
Feelings and Transition
Transition
Worries/concerns about transition
Evidence
66.7% of year olds have concerns and worries about transition to secondary school
70% of year olds were worried about finding their way around their new school
73.3% of 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:

15. 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

16. 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

17. 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

18. HNA Population Data: Healthy Eating

19. HNA Population Data: Fizzy Drinks

20. HNA Population Data: Diet Concerns

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

22. 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