The Child Health Promotion Programme

1
(No Transcript)
2
The Child Health Promotion Programme
Dr Sheila Shribman, National Clinical Director
for Children, Young People and Maternity
Services, Department of Health
3
Annual CPHVA ConferenceChildren's Policy Agenda

• Dr Sheila Shribman
• National Clinical Director for Children, Young
  People and Maternity Services

4
The Child Health Promotion Programme

• Screening
• Protection against disease
• Health and developmental reviews
• Promotion of child and family health and
  well-being, including parenting

5
Why the CHPP is important

• Pregnancy and infancy lay the foundations for
  life
• Programme of evidence based prevention developed
  over many years
• It integrates the biological, psychological and
  social
• Early detection ensures early action to address
  ill health, disability and delay
• Many of the problems in childhood and later life
  are preventable
• Progressive universalism to prevent inequalities
• Adaptable to individual family strengths and
  risks it is both highly personalised and highly
  systematised
• Opportunity to connect with peoples goals and
  aspirations as they begin their life as parents

6
Whats new

• Our knowledge of early development in pregnancy
  and the first 2 years of life in particular the
  neuroscience
• Emphasis on pregnancy
• Progressive universalism focusing on improving
  the outcomes for vulnerable children and families
  within a universal service
• New science and technology (screening,
  immunisation, new media websites, texting)
• A greater emphasis on promoting attachment and
  positive parenting
• Importance of fathers
• Changing public health priorities (obesity,
  emotional and social well-being, accidents,
  breast feeding)
• HV to lead through integrated services (both
  Childrens Centres and General practice)

7
Progressive universalism and the Child Health
Promotion Programme

• A universal preventive service offered to all
  families and children with additional services
  for those with specific needs and risks
• Those with greatest needs receiving more
  intensive support and those with lower levels of
  need a lighter touch
• Universal does not mean uniform
• Progressive does not mean more of the same
• Progressive layering
• Moves beyond universal v targeted debates
• Goal of highly personalised and highly
  systematised services

8
CHPP an overview
Progressive
Universal

• Emotional and psychological problems addressed
• Promotion and extra support with breast feeding
• Support with behaviour change (smoking, diet,
  keeping safe, SIDS, dental health)
• Parenting support programmes, including
  assessment and promotion of parent-baby
  interaction
• Promoting child development, including language
• Additional support and monitoring for infants
  with health or developmental problems
• Common Assessment Framework completed
• Topic based groups and learning opportunities
• Help with accessing other services and sources of
  information and advice

• Health and development reviews
• Screening and physical examinations
• Immunisations
• Promotion of health and well being e.g.
• - 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 childs
  development
• Involvement of fathers

• Higher risk
• High intensity based intervention
• Intensive home visiting by skilled practitioners
• Referral for specialist input
• Action to safeguard the child
• Contribute to care package led by specialist
  service

Being alert to risk factors and signs and
symptoms of child abuse, and follow local
safeguarding procedures where there is cause for
concern
9
How the CHPP supports delivery of national and
local priorities

• It provides universal access and is delivered by
  credible and acceptable practitioners
• It is the overarching delivery mechanism for PSAs
  breast feeding, obesity prevention, 12 week
  maternity assessment plus others
• Focus on inequalities through progressive
  universalism
• Can be used to promote integrated services
• Provides an evidence based schedule that should
  be easier to commission

10
What this means for front line practitioners

• Engaging mothers and fathers
• HV as lead at community level
• Delivered by a range of staff across General
  Practice, maternity services and Childrens
  Centres
• Using methods and programmes that work and new
  skills and knowledge
• Matching resources and skills with needs and
  risks
• Monitoring and evaluating outcomes collecting
  and using data
• New roles such as Family Nurse Partnership
  programme
• New approaches to working with families

11
Health visitors leading the CHPP

• Knowing your community of children and their
  families needs, views and outcomes
• Overseeing delivery of the programme as well as
  working with families coverage, quality
• Building a virtual CHPP team across general
  practice and childrens centres
• Supervising the work of non-registered
  practitioners delivering the programme
• Modelling effective ways of working
• Using and sharing information to monitor quality,
  coverage and outcomes
• HVs need to be given support, training and
  authority to take on this role

12
What will support successful implementation?

• Community and parental demand
• Commissioning of CHPP
• The Personal Child Health Record
• Development of lead role for HV
• Delivery of CHPP through Sure Start Childrens
  Centres
• Engaging General Practice
• Learning from and expansion of Family Nurse
  Partnership Programme
• Workforce planning and development (numbers and
  training)

13
Government support for implementation

• Raising the public profile The Healthy Child
  Programme
• Commissioning
• Governance for promoting health and delivering
  health services in Childrens Centres
• Workforce planning and development
• Improve antenatal education and preparation for
  parenthood
• The Personal Child Health Record and 2- 2 ½ yr
  review
• Development of lead role for HV
• Learning from and expansion of Family Nurse
  Partnership Programme
• Prediction of child health and well-being

14
Summary

• CHPP as the umbrella for all preventive health
  services for children
• Commissioners need to take the CHPP seriously
• Commissioners need knowledge and commitment to
  promote health and well-being of children
• Local clinical leadership (commissioning and
  provision)
• Responsibility of HVs for leading the CHPP on the
  ground
• Needs to be part of integrated services -
  Childrens Centres and General Practice and
  maternity
• Importance of pregnancy and infancy babies
  matter
• The need to be psychologically minded when
  working with mothers and fathers including
  pregnancy
• This is work in progress

15
(No Transcript)
16
(No Transcript)