1. An integrated 0-19s Public Health Service
for Derby City

2. Derby’s Population 0 – 19 year olds = 64,034
Population getting younger –
particularly more 0-5 year olds
Ethnically diverse city –
182 nationalities, 72 languages

4. Universal Partnership Plus
*Mandated Reviews by Department of Health
Pre birth* /14 d* /8 wks* m* /2.5 y* /5 y /11y / /16y /19y
Universal
Universal Plus
Universal Partnership Plus
Community
SUPPORT FROM SPECIALIST SERVICES
Children’s early help and social care services, Behaviour Pathway, Long Term Conditions, Special Educational Needs and Disabilities; Interface with maternity services
Common language and culture; Colocation; Common IT
Single Assessment Processes
Multidisciplinary teams
Universal Public Health Nursing
Mandated health reviews/assessments to identify need, provide support, guidance and information for families
Health screening (height, weight, vision, hearing) and reviews in school age children to identify further issues
Health promotion messages and interventions at appropriate ages – positive parenting, maternal mental health, breastfeeding, oral health, healthy eating, physical activity, accident prevention, emotional wellbeing, risky behaviours, immunisation support and catch up
Planned support to maximise school readiness
Support for healthy settings – early years, whole-school approaches to health, PSHE, curriculum development, sexual health framework
Building Community Capacity
Appropriate, swift response to any health issues identified by universal services including safeguarding, domestic violence, school readiness.
2. Intensive structured support for young/vulnerable families
2. Intensive structured support for young/vulnerable families
3. Risky Behaviour Support
Support for healthy settings
Brief interventions and extended support or referral for weight management, sexual health, smoking, emotional health, self-harm, drugs & alcohol
Specialist Substance Misuse Support

5. Structure and Priorities
Levels of intervention
universal
universal plus
universal partnership plus
community
Universal health assessments
10 key touch points from 0-19 years
High impact areas
10 areas to reflect a range of health priorities & approaches
Aim to keep things simple and acknowledge that Providers are the experts
Based on the HV model (4 levels of intervention, 5 universal health assessments, 6 high impact areas)
Around 10 Touchpoints from pre-birth to 19 years – important opportunities to identify needs and provide interventions, both individual and population level (school, community, age group)
High impact areas to be further developed into KPIs – we have identified around 10, have we got these right? E.g. transition to parenthood, healthy weight, school readiness, developing whole-school/settings approach to health improvement…

6. What to expect from a PHN for School Aged Children?
A visible School Nurse Service that is easily accessible for schools, parents, children and young people with identified Public Health Trained nurses for each Senior School and their feeder schools.
Easy and clear access to health support and information for schools, parents ,carers and pupils, using new technology and processes.
A timely and supportive Public Health Approach encompassing support for Healthy Schools, identified local issues, curriculum and PSHE development.
A service that has robust assessment tools and clear pathways for referrals within health and other children and young peoples services alongside access to adult services for parents.
Health reviews, drop ins and screening to address underlying health issues at timely points through a child’s life to support prevention and deterioration of both physical and mental health.

7. Preventing childhood obesity in Derby
1 in 5 children in Derby carrying excess weight by age 4-5
By age the figure has risen to over a third
Greater risk of type 2 diabetes, heart disease and stroke, certain cancers, low self-esteem and can reduce life expectancy by up to 9 years
Strong association between childhood obesity and deprivation, and the gap between disadvantaged and affluent areas widens as the child grows older
Obesity is a complex issue determined by how we live our daily lives, the environment in which we live and work, and how we feel about ourselves

8. Derby’s Childhood Obesity Strategy
Tackle the 'obesongenic environment', including availability of 'junk food' & the drivers of sedentary lifestyles 
Tap into the wider workforce to positively impact public health in their community, by supporting them to have a conversation about adopting healthier eating and physical activity 
Go beyond health education and behaviour change approaches to incorporate environmental changes to shift norms and enable the adoption of healthy behaviours within everyday life 
Giving every child the best start in life is crucial from infant feeding and early years settings, through schools and the importance of working with families, to promoting healthy transitions into adulthood

9. Preventing obesity: Early years and School settings
Take a whole school approach. Interventions should be sustained, multicomponent and address the whole school, including after-school clubs and other activities
minimise sedentary activities during play time, and provide regular opportunities for enjoyable active play and structured physical activity sessions
Promote and enable walking and cycling to school
ensure children eat regular, healthy meals in a pleasant, sociable environment free from other distractions. Children should be supervised at mealtimes and, if possible, staff should eat with children
Encourage high uptake of school meals, and promote healthy lunchboxes; introduce ‘stay onsite’ policy
School breakfast clubs offer a chance for pupils to have a healthy breakfast in a social environment, setting them up for the school day ahead
Involve parents and incorporate children’s views

10. Moving forward
Opportunities to engage with you about school based PH services on a regular basis?
Capacity to contribute to obesity strategy group?

11. Contact details Hamira Sultan, Consultant in Public Health
Bev Plested, Operational Lead School Nursing
Jilla Burgess Allen, Public Health Registrar