NHS TAMESIDE AND GLOSSOP

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NHS TAMESIDE AND GLOSSOP Commissioning Strategic
Plan to 2013 Technical Appendix
A healthy start in life for children
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A healthy start in life for children Technical
appendix - contents

• OVERVIEW
• What we want to achieve
• Provider landscape strengths and weaknesses
• Current performance issues and Operational Plan
  Priorities
• PROGRAMME TO 2013
• Programme focus to 2013
• Benefits and metrics
• Initiatives, evidence and how they support what
  we want to achieve
• Pathway recommendations , risks and dependencies
• Enablers
• Stakeholder engagement
• SUPPORTNG DATA
• Aggregate data showing the year to year change we
  need to make
• Year to year change resulting from our
  initiatives
• Delivery planning for our initiatives
• Gantt charts for each imitative

A healthy start in life for children
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Overview what we want to achieve
We want to achieve an increase in percentage of
babies who are breast fed at 6-8 weeks
A healthy start in life for children
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Overview Provider landscape strengths and
weaknesses
Provider landscape Current providers and
activity Local childrens health services are
predominantly delivered by GPs, the PCT Provider
Division, Tameside Hospital Foundation Trust and
Pennine Care Foundation Trust. There are also a
number of small voluntary sector contracts.
Children may also receive care from other
hospitals within the North West. All have a role
to play in meeting these targets. All local
children's health services are working in
increasingly close partnership with children's
services colleagues to deliver seamless care.
Strengths and weaknesses Multi-agency
strategies have been developed for all key areas
but now need to be driven forward. Partnership
working is in place at all levels but continued
progress to integrate children's services is
required. The significant agenda within
childrens services requires ongoing commitment
and leadership to ensure that progress is
sustained throughout changes within
organisations. Pressures exist in all childrens
health services to meet the complex array of
developments within children's services. There
is a need to develop knowledge and awareness of
adult service staff working with parents
regarding impact of parental illness on children
and how to utilise the resources within
children's services to ameliorate this.
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Overview performance issues and Operational
Plan priorities

• Current performance issues to address
• Teenage Pregnancy - Conception rates in Tameside
  and Glossop are the 19th highest in England and
  Wales and 4th highest in the North West.
• Childhood Vaccination and Immunisation - Catch up
  programme to be put in place in low performing
  localities, by school nurses, local publicity
  campaigns for parents in localities with low
  uptake and publication of results by practice is
  routine.
• Chlamydia Screening Programme - A failed target
  in 2007-2008, and a priority for 2008-2009.
• Breastfeeding initiation is increasing but still
  at levels well below the England average
  (53.9/69.2)
• There are considerable inequalities in tooth
  decay by five year old children, and children in
  some areas e.g. Ashton, Hyde, Denton have more
  teeth affected by decay.

• Operational plan priorities 2008 / 09
• A safe and healthy childhood Increases
  safeguarding capacity, develop health trainers to
  focus on key health outcomes, multi-agency
  working with vulnerable families, care closer to
  home, integration within Childrens Trust
  arrangements.
• Children and young people with disabilities,
  complex health needs and long-term health
  conditions integration and consolidation of
  services, review of wheelchair and equipment
  provision, data collection.
• Children and young people with mental health,
  psychological and emotional needs services for
  16 and 17 year olds and those with a learning
  disability, training and development of frontline
  staff, roll out of infant attachment service,
  access for BME and access to psychological
  therapies.

A healthy start in life for children
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Programme to 2013 programme focus
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Programme to 2013 programme focus
Targeted support to families 2009
-2011 Develop and implement comprehensive
parenting pathways with local authority partners
Establish requirements to develop multi-agency
teams that include Community Midwifery to work
with families vulnerable to poor health outcomes
(e.g. BOAT scheme for teenage parents) Scope
ability to establish privileged access workers
within BME communities. Monitor the effectiveness
of the home visiting and befriending scheme
commissioned from Homestart. 2011 -2013 Evaluate
impact of early targeted intervention on the
wider social determinants on health
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Programme to 2013 benefits and metrics

• Benefits
• Healthy start in life is fundamental to
  addressing longer term health inequalities
• Breastfeeding is increasing but still at levels
  well below the England average (53.9/69.2) it
  will impact on key health issues for our children
  including obesity, oral health and mental health
  and onset of chronic disease in later life.
• Investment in breastfeeding is associated with
  net savings after 3 years
• We want children to have foundations of
• Healthy lifestyles, including good nutrition and
  good oral health
• Social and emotional development, including
  secure attachment (healthy infant-parent
  relationship) and sound parenting enabling
  attainment in school

• Additional Metrics
• Increase the numbers of women breastfeeding at
  birth from 54 in 2007 to 60 in 2010
• Reduce the percentage of pregnant women smoking
  from 25 in 2007 to 22in 2010
• Reduce teenage conception rate from 40.6 per 1000
  in 2008 to 25.2 in 2011 (Tameside)
• Reduce the number of Year 6 children with height
  and weight measured who are obese by 0.1 to 15,
  from a 2006/07 baseline by 2010/11
• Reduce the average number of decayed/missing/fille
  d teeth in 5 year olds from 2.24 to 2.05 by 2010.
  
• Metrics to be developed
• Reduction in gastroenteritis and respiratory
  admissions to hospital (birth to 3 years)
• Reduction in hospital admissions of children
  under the age of 16
• Access to health services by BME communities

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Programme to 2013 Initiatives, evidence and how
they support what we want to achieve
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Programme to 2013 Pathway recommendations,
risks and dependencies

• Clinical pathway recommendations
• Align with Healthier Horizons and DH Health
  Inequalities
• The implementation of an externally evaluated,
  structured programme that protects, promotes and
  supports breastfeeding, using the UNICEF Baby
  Friendly Initiative as a minimum standard.
• A structured training programme for all health
  professionals based on NICE guidance on Maternal
  and Child Nutrition, Postnatal care and the
  standards of UNICEFs Baby Friendly Initiative
• Effective, sustainable support programmes, e.g.
  peer support programmes with trained peer
  supporters working as part of multi-disciplinary
  team.
• Targeted support for those individuals and
  communities most at risk of poor health.
• Build on good models of integrated working across
  services, underpinned by strategic workforce
  planning and training
• Healthcare provided is evidence based and
  consensually agreed are best practice, within
  robust care pathways.
• There is greater public accountability for the
  health outcomes of the population

• Key Risks and dependencies
• Effective partnerships need to be sustained with
  all stakeholders including children, young people
  and their families.
• Maximise opportunities within the development of
  Childrens Trust arrangements in Tameside and
  Derbyshire
• Balancing priorities to ensure that prevention
  and service development is not overtaken by
  management of crises
• Change management implications need to be taken
  into account.

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Programme to 2013 enablers, and stakeholder
involvement
Stakeholders The proposals have been developed
in partnership with stakeholders from Tameside
Hospital Foundation Trust, Pennine Care
Foundation Trust, PCT Provider Division, Tameside
Children and Young People Services, Derbyshire
Children and Younger Adults Services and
voluntary sector reps from Barnardos and
Homestart.
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Supporting data aggregate data showing the year
to year change we need to make
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Supporting data year to year impact of our
initiatives
A healthy start in life for children