1. Learning Mentor & Parent Support Adviser Network
13th November 2013
Shrewsbury Training and Development Centre

2. Programme Healthy Child Programme
Children with Disabilities/additional needs
Family Information Service
Early Help

3. Healthy Child Programme Pregnancy- 19 years
Anne-marie Speke
Shropshire Council
Healthy Child Programme Coordinator
Intro my role

4. Healthy Child Programme 0-19 years
Healthy Child Programme (HCP) is the government’s early intervention and prevention public health programme from conception to 19 years
The guidance is directed at statutory agencies, commissioning bodies, GPs, midwives, practice nurses, school nurses and health visitors.
Delivery includes all agencies working with children and young people.

5. Health Child Programme
Evidence-informed practice
The use of new developments;
Responding to changed public health priorities Integrated service provision, including GP’s and children’s centres, and through better integration between maternity services;
An increased focus on vulnerable children and families;
Parenting support, including support for fathers.
Evidence-informed practice, reflecting a shared understanding of attachment, positive parenting, maternal mental health, and responses to risk factors;
The use of new developments in vaccination and immunisation programmes, newborn hearing screening, and information systems;
Responding to changed public health priorities (eg, increasing the prevalence of breastfeeding, reducing childhood obesity), including taking a more proactive role in promoting the social and emotional development of children;
Integrated service provision, including GP’s and children’s centres, and through better integration between maternity services;
An increased focus on vulnerable children and families;
Parenting support, including support for fathers.

6. Healthy Child Programme
Schedule of interventions to address the priorities for the health and well-being of children.
Offers every family a programme support
Healthy Child Programme, reflecting that the early years and transition stages are a critical time in a child’s life
Offers every family a programme of screening tests, immunisations, developmental reviews, and information and guidance to support parenting and healthy choices.
Healthy Child Programme for 0-5’s split in stages: pregnancy up to 28 weeks, after 28 weeks, birth to 1 week, 1-6 weeks, 6 weeks to 6 months, 6 months to 1 year,1 to 3 years, 3- 5 years which reflects the critical time of life for younger children
5-11, and

7. Healthy Child Programme 0-5 years
Universal: health and development reviews, screening and physical examinations, promotion of health and well-being, preparation for parenthood and promotion of sensitive parenting and child development, involvement of fathers, mental health needs assessment, signposting.
Progressive: emotional and psychological problems addressed, promotion and extra support with breastfeeding, support with behaviour change e.g. smoking, parenting support programmes, promoting child development, additional support and monitoring for infants with health or developmental problems, CAF/EHAF, topic based groups.
Higher risk: high intensity based intervention, intensive structured home visiting programmes by skilled practitioners, referral for specialist input, action to safeguard the child, contribution to care package led by specialist service

8. Healthy Child Programme 5-19 years
A national public health programme for children and young people from 5-19.
Provides a robust evidence based framework and sets out good practice for prevention and early intervention services
Identifies the school nursing service as crucial to the effective delivery of the Healthy Child Programme
Assists local areas to ensure services:
are based on a robust needs assessment
utilise effective practice and prioritise evidence based
programmes
make best use of their workforce

9. Healthy Child Programme 5-19
Universal- Heath Assessment at School entry, vision and hearing, emotional health, psychological well being and mental health, promoting healthy weight, on going support through primary school, support for parent carers. (11-16 includes sexual health, immunisations transition health review, also includes emphasis on transition into further education)
Progressive- immunisations for at risk CYP, emotional health, psychological well being and mental health tier 2,3,4, overweight and obese children, specific groups of at risk children and families, support for parents and carers

10. Links to Shropshire Children’s Trust priorities
Priority 3
Ensuring the mental wellbeing of children and young people by focusing on prevention and early intervention
Priority 4
Keeping more children healthy and reducing health inequalities.
Priority 3 Provide support for parents and carers to help them promote emotional well-being for their children
Provide better information to enable children and young people to access the help they need.
Develop a more integrated approach to supporting mental wellbeing outside of school and health settings, such as youth clubs and children’s centres.
Priority 4 Focus on preventative support such as around breastfeeding, healthy eating, smoking cessation and alcohol misuse, targeted at our most vulnerable communities through our Children’s Centres.
Increase the number of children and young people who are a healthy weight by contributing to the development of a coordinated obesity strategy and evaluation of the effectiveness of current programmes.
Reduce numbers of young people requiring hospital treatment for alcohol abuse.
Maintain low levels of teenage conceptions

11. HCP links to Public Health Outcomes 2013-2016
Increased healthy life expectancy
Reduced difference in life expectancy and healthy life expectancy between communities.

12. HCP links to Public Health Outcomes Indicators
Health improvement Objective: People are helped to live healthy lifestyles, make healthy choices and reduce health inequalities. Health Protection Objective: The population’s health is protected from major incidents and other threats, while reducing health inequalities Healthcare public health and preventing premature Objective: Reduced numbers of people living with preventable ill health and people dying prematurely, while reducing the gap between communities
Health Improvement indicators
Low birth weight of term babies
Breastfeeding
Smoking status at time of delivery
Under 18 conceptions
Child development at years (Placeholder)
Excess weight in 4-5 and year olds
Hospital admissions caused by unintentional and deliberate injuries in under 18s
Emotional wellbeing of looked-after children (Placeholder)
Smoking prevalence – 15 year olds
Hospital admissions as a result of self-harm
Diet (Placeholder)
Health protection includes: Chlamydia diagnoses (15-24 year olds)
Population vaccination
Health care public health includes coverageInfant mortality, Tooth decay in children aged 5

13. Complexity of new commissioning arrangements
PH came to LA in April 2013 and with it commissioning responsibility for 5-19 including SN
Need clear and strong links with between commissioners and providers create greater links with GP’s

14. School Nurse Review
Commissioning for the Healthy Child Programme years became the responsibility of LA in April 2013 this included the School Nursing Service
An initial report re 5-19 years went to Children’s Trust 3rd September 2013
In Mat 2013 a review of the current school nursing service began.
The first stakeholder event held in May enabled us to put together a local economy shared vision based on DH vision for School Nursing

15. Local Health Economy Shared Vision
Key questions that need to be asking ourselves:
What role do we play in this how can we assist?
What does this mean for you? How might it help?
How do we ensure that it happens?
Activity
To come up with potential 1 short term and 1 long term solution for the priority.

16. Consultation methods Focus groups/ interviews/ presentations
Questionnaires
Stakeholder Events
School Nursing Leads
Public Health Leads
Health Visitors and Children’s Centres
Family Solutions
Early Help
Safeguarding
Domestic Violence
Looked after children
Targeted Youth Support
Youth Offending Service
Leads for children not in mainstream education
Lead for travelling communities
Voluntary Sector
Police
Children and young people
Parents
Staff
Primary Care
CCG
Commissioners
Providers
Schools
Healthwatch
Looked after children lead
NHS England
Public Health England
School Nurses
Individual interviews/ focus groups
Collective feedback from stakeholder events and individual interviews on table

17. National maximum caseload requirements
National estimates suggest that a school nurse (Band 6) has a maximum of 2,500 children on caseload. This shows actual levels but doesn’t take into account workload or travel
Area the school is in
Number of children
Actual WTE Band 6 school nurses
Caseload per WTE
Estimated WTE required school nurses
Difference in WTE
North East
8,460
2.56
3,305
3.4
2,500
-0.8
North West
4,456
1.22
3,652
1.8
-0.6
North
12,916
3.78
3,417
5.2
-1.4
S&A
11,636
3.32
3,508
4.7
-1.3
South East
6,182
2.52
2,453
2.5
0.0
South West
4,868
1.75
2,782
1.9
-0.2
South
11,050
4.26
2,593
4.4
Shropshire
35,602
11.36
3,134
14.2
-2.9

18. WTE Activity Model by Work streamNE NW
North SA SE SW
South
Shropshire
Core HCP activity
0.2
0.1
0.3
1.4 (4.3%)
Delivery of health promotion programmes
0.0
0.3 (0.9%)
Safeguarding
1.8
1.0
2.8
2.4
0.8
6.9 (20.9%)
Teacher training
0.6 (1.7%)
Other activity
3.2
2.0
5.2
3.6
6.9
15.9 (48.2%)
Public health leadership
0.0 (0.0%)
Travel time
0.4
0.7
1.5 (4.7%)
Total workstreams
5.7
3.3
9.0
8.5
4.7
9.9
26.6 (80.7%)
Additional admin
1.4
2.5
1.7
2.1
3.8
6.3 (19.3%)
Total WTE
7.0
4.3
11.4
11.1
13.8
32.9 (100%)
Look at far right column which shows where work stream is coming from need to find creative ways to readdress this balance
Activity What creative solutions one long term one short term can you think of that for your priority?

23. Next Steps
Feedback of School Nursing Service consultation with recommendations
New School Nursing service specification in place
From April 2015 commissioning responsibility for Health Visiting Service will be transferred to Local Authority
Re-establish Healthy Child Programme Steering Groups 0-5 and 5-19 years
Stakeholder event held at end of October to feedback key findings from consultation
Report to Children’s Trust and Health and Well Being Board November
Provider response December 2013
New service specification written April 2014 in place Autumn 2014

24. Short Breaks/ Participation Fund
Harry Cade
Short Breaks/ Participation Fund

25. Family Information Service (0-19)
Free information, advice and support on all aspects of family life, whether you are expecting a baby or are the parent or carer of a toddler or teenager.
Research shows that 75% of parents say there are times in their lives or the lives of their children when they need information to support them in their roles as parents.
The Family Information service has been established to help parents access information about options and possibilities which they may not have known about and to support parents in their role as parents.
We could provide the information there and then, or we could undertake research into a specialist subject or we could signpost you to a specialist service.
The FIS as the first universal point of contact for vulnerable families whose children who do not meet the thresholds for safeguarding but who are experiencing crisis in the home. We are therefore a key service for the Early Help Offer

26. Childcare Act 2006
Local Authority statutory duty to provide information, advice and assistance
Brokerage service
Care, advice and support services for disabled children
Services, facilities or publications which may be of benefit to parents, young people or children
The Childcare Act places a legal duty on the LA to provide information to parents – showing how important information is
Brokerage service – for those parents who can’t find childcare to meet their needs, or for those parents who are struggling to access services, and who need some extra support.
Childcare Act places additional responsibilities on supporting parents of children with a disabilities – who face additional barriers for accessing services.
The services, facilities and publications shows the vast range of information required to provide – it could be anything and everything – as no two family are the same.

27. FIS Vision
For families to have access to quality, up to date and comprehensive information to help make a difference to their lives and the lives of children and young people in Shropshire.
Information could be provided directly to parents, or family members or through Practitioners to pass onto families.

28. FIS Aims
To ensure Shropshire Council is meeting its statutory duty as detailed in section 12 of the Childcare Act 2006, and referred to as the Information Duty.
To ensure children, young people and families are at the heart of the service. We will operate in a family focused and child centred way.
For services to be integrated and co-ordinated around individuals and to work in partnership for the benefit of children, young people and families.
To provide free, impartial access to high quality information that supports families and their children.
1 – already spoken about this
2 – we value children, young people and parents and operate in a very customer centred way
3 – we look at the needs of the families and tailor information to meet those needs.
4 – we have to be impartial and so can not recommend but we can support parents in making informed choices. We work hard to ensure the information is up to date and accurate, but obviously rely on a lot of services keeping us up to date – which is vital in the current climate with services changing so frequently.

29. Aims Cont…
To ensure the service is delivered by a trained and skilled workforce.
To ensure information is available through a variety of channels.
To work with other agencies and departments to deliver a co-ordinated and seamless approach to services for families.
Meet current and future information needs through ongoing consultation.
Embrace and evaluate new technologies to ensure further access to the FIS.
To provide the best value for money service.
1 – we have a team of 6 Information Assistants, and 2 modern apprentices.
2 – we try to look at how parents want to access information, and to try to meet those needs by offering a multi channel approach to information delivery
3 – it’s easy to loose track of the services or to be confused if families are accessing different services, so we try to make it as clear and seamless as possible
4 – some of the best ideas for service developments have come directly from parents and other service users so it’s important for us to ask them for their ideas.
5 and 6 go hand in hand, we are trying to look at new, cost effective ways of delivering the information service

30. This is just an example of the information we can provide and some of the topics of enquiries we can get. We respond to approximately 6500 request for information annually.
We will always get enquiries about registered childcare as we are the only service that can provide that comprehensive information, as we get daily updates from Ofsted
Things to do and places to go is a key information need for parents, and one of the top enquires we receive
Finance, benefits and money matters is on the increase in these current economic times.
Family health, healthy eating
Safety, child protection
A significant number of enquires are around family support – parents, or professional supporting parents, looking for information to help them in their role as parents, relationships, bereavement, behaviour, SEN and disabilities, housing

31. Delivery Routes Telephone helplines Face to face appointments
Outreach events
/website
Social Media
On-line directory of services
Ebooks/Apps
Telephone helpline – Mount McKinney and Customer Service Centre
Face to face – Information assistants working in the MATs and within a geographical area
/website
Outreach events
Social Media – trailblazer for the use of social media
On-line directory of services – which have over 2000 live records
Ebooks/Apps
a deliver model which enables the service to continue to support the most vulnerable families in Shropshire through more targeted intervention and early help, whilst also making best use of online tools to deliver information to the majority of families.

32. Especially want to highlight the Family Information Directory
It has over 2000 entries on there – local, regional and national groups and organisations that support families, children and young people.

33. FIS Enquiry Statistics
The majority of request for information comes directly from parents but over recent years we have seen a significant increase in the number of enquiries that have come from professionals and partner agencies that are supporting parents and young people.
Those practitioners accessing the FIS on behalf of families include: social workers, children’s centre support workers, targeted youth support, teachers and school staff, health visitors, community safety officers, family support workers, GPs, housing officers, CAMHS, refuge workers, Job Centre Plus.

34. There is a higher percentage of families with under 5s accessing the service – but this is mainly with childcare requests.

36. Family Information Service
Information to make a difference

37. Tina Dyke & Suzanne Treherne Early Help