1. Promoting the Health of Children in Halton The Role of Halton Healthy Child Programme Karen Worthington Head and Professional Lead Health Visiting Christine Scott Team Leader School Aged Children

2. What is the Healthy Child Programme ( HCP) ? The HCP is an evidence based, early intervention and prevention public health programme that lies at the heart of our universal service for children and families. At a crucial stage of life the HCPs universal reach provides an invaluable opportunity to identify families that are in need of additional support and children who are at risk of poorer outcomes A programme of screening tests, immunisations, physical checks, development checks and information and guidance to support parenting and healthy choices

3. Anticipated outcomes.. Strong parent – infant / child attachment and positive parenting, resulting in better social and emotional wellbeing among children Care that keeps children healthy and safe Healthy eating and increased activity leading to a reduction in obesity Prevention of some serious infectious diseases Increased breast feeding Readiness for school and improved learning Early recognition of growth disorders Early detection of, and action to address, developmental delay, abnormalities and ill health and concerns about safety Identification of factors that could influence health and wellbeing in families ( eg domestic abuse, alcohol misuse)

4. The Healthy Child Programme acts as a 0- 19 seamless framework

5. HCP - an overview of the universal 0 – 5 years schedule Antenatal assessment by 12 weeks of pregnancy Antenatal screening for foetal conditions Newborn physical examination Blood spot screening at 5 days Newborn hearing screening New Birth visit at 10-14 days Health Review at 6 - 8 weeks, 3 – 4 months, 10 – 12 months and 2 – 2 ½ years Immunisations at 2 months, 3 months, 4 months, 12 – 13 months and 3 years 4 months

6. 0 – 5 years continued… Promotion of health and well being; smoking, diet and physical activity, breast feeding and healthy weaning, keeping safe, prevention of sudden infant death, maintaining infant health, dental health Promotion of sensitive parenting and child development Involvement of fathers Preparation for parenthood Mental health assessment Signposting and referral

7. HCP and School aged children Health Assessment at School Entry (4 - 5years) Vision and Hearing screening National Child Measurement Programme – height and weight in reception year and year 6 Identification of children with additional needs

8. HCP and School Aged Children Health review at school transition in year 7 Health assessment for all children in care Immunisation Programmes Human Papillomavirus vaccine (HPV)- Halton has one of the highest uptake rates in the region If girls have this injection it will reduce their risk of getting cervical cancer when they are older by over 70%. Tetanus,diptheria and polio booster Seasonal Influenza for children with complex medical conditions

9. Health Promotion healthy eating and the importance of exercise (particularly in light of the rise in levels of obesity in the country) smoking avoidance (still the main cause of avoidable death in the UK) sexual health and teenage pregnancy drug and alcohol abuse mental health and emotional well being.

10. HCP School Aged Children Health promotion activity - Crucial Crew

12. Health Challenges in Halton…… Unfortunately the health and wellbeing of children in Halton is generally worse than the England average Infant deaths; The infant death rate in Halton is higher than the England average. Mothers smoking at time of their babies birth in Halton is 21.1% compared with an England average of 13.2% We know if we can reduce smoking in pregnancy, reduce the prevalence of obesity and improve infant nutrition we can reduce the number of infant deaths

13. Breast feeding; 51.1% of mothers in this area start breast feeding at birth however this is much lower than the England average of 74% and the European average of 89.1% The number of mothers still breast feeding their baby at 6-8 weeks of age in Halton is 22% compared with the England average of 47.2% Immunisations Immunisation rates in Halton are similar to the England average, however 8.3% of 2 year olds have not received immunisation against Mumps Measles and Rubella (MMR) There were 31 confirmed cases of measles in children in the northwest during the last 12 months.

14. Tooth decay The number of decayed, missing or filled teeth in 12 year olds in Halton is higher than the national average Accident and Emergency Hospital attendances; The number of attendances by pre school children with unintentional injuries is significantly higher than the national average. The highest numbers relate to falls, burns and scalds. Readiness for School The percentage of children achieving a good level of development at age 5 years, as measured by the Early Years Foundation Stage Profile 2012, is significantly worse than the England average at only 55.2% of children.

15. Challenges….. Young people aged under 18 admitted to hospital with Alcohol specific condition are higher than the England average Higher Teenage conception rate compared to the England average Children in Halton have average levels of obesity. 9.6% of children aged 4-5 years and 19.5% of children aged 10-11 years are classified as obese. 66.4% of children participate in at least three hours of sport a week which is better than the England average. Young people aged under 18 admitted to hospital as a result of self- harm (rate per 100,000 population aged 0-17 years) are higher than the England average The area has a higher teenage conception rate compared to the England average Source: ChiMat Halton Child Health Profile March 2013

16. The Importance of prevention and early Intervention Lifestyles and habits established during childhood and young adulthood influence a person’s health throughout their life. Failure to meet the health needs of children and young people stores up problems for the future As adults, parents and professionals we have a responsibility to ensure children have the best start to life Partnership working is key to the successful delivery of the HCP by working together we can increase the uptake of universal services Identifying difficulties early and intervening effectively produces the best outcomes for children

17. A parents perspective ……

18. What do you think your contribution to the Healthy Child Programme could be ? Do you need any support in order to achieve this ?