1. Commissioning of the Healthy Child Programme
for 0-19 year olds in Wirral
Julie Graham
Senior Public Health Manager
Going to give a brief overview of:
what’s included in this tender exercise
Brief overview of HCP
Brief overview of Wirral stats
Outline the vision

2. So what’s included…. Area Team (transferring to Wirral Council 2015)
Healthy Child Programme (0-5 year olds)
-Health Visiting Service
-Family Nurse Partnership
Wirral Council
-Health Promotion
Healthy Child Programme (5-19 year olds)
Area Team
Immunisation and vaccination for 5-19 year olds
Different areas included and column on left shows which organisation is responsible.

3. Universal Partnership Plus
Levels of need:
Community
Universal
Universal Plus
Universal Partnership Plus
The four levels identified within the programme are:
Community: the promotion of a range of health services available in the community, of which HV/FNP/School Health will be involved in developing and providing.
Universal Services: the provision of the range of interventions & activities detailed in the healthy child programme (ie, immunisations, health checks/questionnaires, sexual health, healthy weight etc and early help).
Universal Plus: There may be occasions when a child or young person needs a swift response by specialist services. This may have been identified through a health check or through providing accessible services where young people can and ask for help.
Universal Partnership plus: involves more complex problems over a longer period of time.

4. Typical pyramid of need
CYPD also work on a level of need model
There should be a reduction in numbers requiring more specialist intervention/support

5. Wirral ‘pyramid’ of need
Concerted effort underway to prevent so many children and young people being escalated to higher levels of need and work with children
at higher levels to bring them back down.

6. The importance of universal services
Healthy Child Programme Policy emphasises the importance of Universalism -‘it leads to the early identification of vulnerable children because prediction of poor outcomes is an inexact science and the greatest population gains result from universal services’
At a time when services everywhere are subject to scrutiny and cuts some argue that some universal services could be seen as a ‘nice to do’ rather than an essential service, however as this statement highlights the importance of the approach is prevention.

7. National obesity prevalence by deprivation decile National Child Measurement Programme 2011/12
Another key factor that we have to tackle are health inequalities.
This slide is based on national data for NCMP – clearly illustrates how deprivation affects outcomes for children – prevalence is greatest in more deprived areas.
The significance of deprivation in the area can be seen in the next slide
Child obesity: BMI ≥ 95th centile of the UK90 growth reference
Challenges and opportunities for achieving public health outcomes for children and young people 7

8. Percentage of all children living in poverty in 2011
1.     Child poverty is calculated on the basis of the number of children in families in receipt of either out of work benefits, or tax credits where their reported income is less than 60% median income as a proportion of the total number of children in the area.
This slide illustrates how Wirral compares to England and the North West.
What this slide doesn’t give is the huge variation across wards – for example in Bidston and St James ward just over 50% of children live in poverty compared to Heswall where it is only 4%
This slide is taken from the slightly more complicated spine diagrams that are on each table.
Source: © ChiMat, 2013

9. Source: www.chimat.org.uk; © ChiMat, 2013
Child & Maternal Health Observatory
Just an overview of stats
Red and green dots indicate where we are doing significantly better or worse than the rest of England.
Source: © ChiMat, 2013

10. Source: www.chimat.org.uk; © ChiMat, 2013

11. And so to the vision….
The HCP has its own vision - for a universal service to promote optimal health and wellbeing, appropriate for all children and young people – wherever they are – and additional services for those with specific needs and risk factors.
-health, education and other partners working together across a range of settings can significantly enhance a child’s or young person’s life chances.
These are recommendations for us to interpret and build upon locally to meet local needs.

12. A fully integrated system delivered by a lead provider
This can take the form of:
- a consortia
- a partnership
- any other joint working arrangement
A system that has a skilled, knowledgeable, committed and well motivated workforce
Places the ‘voice of the child’ at the centre of service development and improvement
Outcome focused
Imp that the service responds to what children, yp and their families are telling them

13. Seamless transition points
Development of appropriate pathways to ensure children, young people and their families receive the right level of help and support at the right time
Moves beyond any data sharing issues
A system that has effective and reliable performance management processes
A system that maximises value for money
Pro-active in feeding into JSNA
There are some excellent existing local services upon which to build
Evolutionary approach with flexible service provision which responds to service provision
Prevention of duplication at all costs
JSNA input key to ensure that people working on the ground have a way to feed robust emerging evidence of trends/need into the JSNA

14. Behaviour change is key to improving the health of children, young people and their families - we need to be more innovative about motivating people ……..
Insert youtube clip –piano stairs – fun can change behaviour