This is slide one

1
Health Visiting in the FACT from Collaboration
to Integration
2
Health Visiting Strategy and Planning Day

• Welcome and expected outcomes
• Defining Integration and key messages from
  Integrated Services consultation
• FACT plans and Integrated services
• Childrens Centres national guidance and local
  implementation Guy Kirk Childrens Centre
  Programme Manager
• Health visiting service specification Janet
  Leigh, Trainee General Manager
• Short break
• Identification of risks and controls for
  integration working groups
• Lunch and networking
• Locality planning for integration - working
  groups
• Closing discussion

3
Objectives for the Day

• Clarify national and local policy drivers
  influencing FACT/integration agenda
• Facilitate effective communication channels
  between health visiting service and FACT/NCT
• Enable HVs and colleagues to contribute to
  operationalising integrated services
• Harness HV knowledge to identify risks and
  solutions to barriers/challenges

4
Background and Context

• Why Integrated Services?
• ECM, Choosing Health, CNO Review, Childrens NSF
  Duty of Partnership placed by Government on
  Statutory organisations
• The FACT - a 'Care Trust for Children. NCT Board
  adopted FACT 'High Level Partnership Agreement'
  December 2003, a commitment to integrate
  resources (human and financial) with NCC
  Children's Services Directorate
• Delivering a Strategic Direction for
  Northumberland Care Trust (improving health,
  FACT as delivery mechanism, LAAs, partnership
  approaches, Director of County-Wide services
  member of FACT Leadership Team)

5
Integration

• Integration refers to a single system of service
  planning and/or provision put in place and
  managed together by partners (parent bodies) who
  nevertheless remain legally independent
  (Integrated Care Network)
• An integrated system means a united mission,
  culture, management, budgets, accommodation,
  administration and records
• From fragmentation to integration complex care,
  safeguarding work

6
WHO Framework
7
QUESTION YES NO NOT SURE
1 Do you agree with the overall aim of the service? 103 4 4
2 Do you agree with the wide remit of the integrated teams? 96 2 13
3 Do you agree with the approach of providing an integrated service through the creation of integrated teams? 93 4 13
4 Do you agree that teams should be locality based around school partnerships? 70 14 27
5 Do you agree with the list of professionals who will make up integrated teams? 61 15 27
6 Do you agree with the proposed list of multi agency teams that will operate on a County wide basis? 68 8 24
7 Do you think the managerial arrangements are workable? 45 15 46
9 Is the size of a team as indicated between 8 and 12 professionals manageable? 64 6 33
8
Some Conclusions

• Overarching aim to raise the achievement of all
  children in Northumberland accepted, if
  understood it means ensuring children are as
  healthy as they can be, have the emotional
  security and social development necessary to
  achieve.
• The principle of integrated service delivery
  through integrated teams fully supported.
• Arrangements for teams and membership of teams to
  be detailed in the local planning for services.
  Includes the issue of school partnership area or
  locality how can children be prevented from
  falling through service provision gaps if they
  live in one area but attend an out of area
  school partnership?
• Matrix management arrangements need detailed
  planning for integrated teams a cause of
  anxiety.
• Develop clarity of understanding around the role
  and responsibilities of integrated teams, to
  determine which professionals belong in which
  team - most staff will belong to a number of
  teams. To include the safeguarding of staff
  identity, skills and support but will also need
  to ensure that the child is central to service
  planning and delivery.

9
Some Conclusions

• Staff training for all integrated team staff
  before the team becomes operational. Staff
  support must be available and communication open,
  honest, timely and in a variety of formats.
• The inter-relationship between extended schools,
  childrens centres, integrated teams, youth
  service, Connexions need to be clearly identified
  and communicated.
• Asset management needs to clearly identify its
  resources and opportunities for co-location,
  including the option of multiple bases for teams
  in rural areas and multiple bases for staff.
• Business processes need to be agreed and
  implemented with issues such as recording policy
  and process, confidentiality, and data collection
  and storage.
• The role of administration will need to be
  determined, including roles in co-ordinating
  information gathering and support.

10
The Way Forward

• Small team to take forward implementation of
  Integrated Teams, matching them to local context
  roll out April 06 - September 07
• HR working group produce policies and procedures,
  complaints processes, personnel issues, training
  and preparation for integrated team development
• Asset Management planning group to analyse and
  recommend options for integrated co-location
• Business systems group looking at referral
  processes, data collection/storage, information
  sharing and confidentiality
• Management group including representation from
  the voluntary sector to co-ordinate and oversee
  the groups and project development

11
Childrens Centres national guidance and local
implementation

• Guy Kirk
• Childrens Centre Programme Manager 1/2/2006

12
What I will cover today

• Setting the scene - national context,
  legislative framework, key policy initiatives
• Childrens Centres what are they and where do
  they fit in?
• Local plans and progress
• Where does primary care fit in?

13
We are at the beginning of a long term commitment
14
Some Key National Policy and Strategy Documents

• Inter-departmental Childcare Review (2002)
• Every Child Matters Change for Children
• National Service Framework for Children, Young
  people and Maternity Services
• Ten year strategy for Child Care
• Working with voluntary and community
  organisations to deliver change for children
• Youth Matters Green Paper
• Children Act 2004
• Childrens Trusts (and the CYPPlan)

15
Every Child Matters Change for Children Programme
Children and young people have told us that
five outcomes are key to well being in childhood
and later life

• Be healthy
• Stay safe
• Enjoy and achieve
• Make a positive contribution
• Achieve economic wellbeing
• (ECMChange for Children,2004)

16
National Service Framework for Children, Young
People and Maternity Services

• Improving the health and welfare of mothers
  and their children is the surest way to a
  healthier nation the best way to achieve a
  fairer society is to improve health and tackle
  inequalities in childhood
• (Professor Al Aynsley-Green foreword to the NSF
  2004)

17
Legislative underpinning

• The Children Act 2004 provides the legal
  underpinning for Every Child Matters Change for
  Children.
• (ECMChange for Children 2004)

18
Children Act 2004

• Establish a Childrens Commissioner for England
• LAs to make arrangements to promote cooperation
  between agencies to improve childrens well-being
• Safeguarding and promoting welfare of children
  key agencies must work together
• Joined up databases
• Local Safeguarding Children Boards
• Children and Young Peoples Plan
• Director of Childrens Services responsible for
  (at least) education and childrens social
  services functions
• Integrated Inspection Framework

19
ECM radical change with whole system
transformation

• Improvement and integration of universal services
• More specialised help
• Reconfiguring services around the child and
  family
• Sharing responsibility across agencies
• Leadership at all levels of the system
• Listening to children, young people and families

20
ECM a national framework with a local focus

• Step change in quality, accessibility and
  coherence of services
• Transformational agenda
• Involving everyone
• Partnership
• Dialogue
• Local change programmes
• Build on what works and tailor services to need

21
Childrens Centres what are they and where do
they fit in?

• Part of the Sure Start initiative
• Key mechanism for delivering both the ECM
  outcomes and the NSF agenda
• Part of the continuum of extended services to
  babies, children and their families in the
  journey to adulthood and beyond..

22
The Childrens Centre Vision

• Improving outcomes for all young children
• Reducing inequalities in outcomes between the
  most disadvantaged children and the rest
• Childrens Centre services in all the most
  disadvantaged areas moving to reach every child
  and every community by 2010
• Services tailored to need

23
Childrens Centres key to delivering-

• The best start in life for every child
• Better opportunities for parents
• Affordable good quality childcare
• Stronger and safer communities

24
Role of Childrens Centres

• Coordinating the delivery of effective integrated
  early years and childcare services across the
  county
• Bringing all partners together to identify need
  and deliver services in a way that meets local
  need
• A way of thinking and doing
• Better outcomes for families and children

25
The Core Offer

• Good quality early learning - integrated with
  full day care provision
• Good quality teacher input to lead the
  development of learning within each centre
• Parental outreach
• Family support services

26
The Core Offer (cont.)

• Support for parents and children with special
  needs and disabled children including early
  identification of need and provision of services
• Child and family health services including
  antenatal services
• Local advice and information for parents

27
Childrens Centres will also.

• act as a service hub within the community for
  parents and providers of childcare services for
  children of all ages
• offer a base for childminder networks with a link
  to local Neighbourhood Nurseries, out of school
  clubs and extended schools
• and
• have links with local training and education
  providers, Jobcentre Plus and Childrens
  Information Services
• plus
• Provide management and workforce training

28
All partners working together..to achieve..

• Services for all
• Flexible at point of delivery
• Starting early
• Respectful and transparent
• Community driven and professionally led
• Outcome focussed
• Integrated and joined up

29
Local plans and progress

• 2004 2006 NCC to
• Create 239 additional childcare places in 20
  most disadvantaged wards
• Reach 3,573 under 5s

30
Phase 1 Centres
Delivered by

• Blyth Town
• ABC Cramlington
• ABC Blyth
• Ashington
• Berwick
• Wooler
• Bedlington
• Choppington

• - SSD
• - Barnardos
• - Barnardos
• - NCH
• - SSD
• - SSD
• - SSD
• - SSD

31
Childrens Centres national guidance and local
implementation

• Guy Kirk
• Childrens Centre Programme Manager 1/2/2006

32
What I will cover today

• Setting the scene - national context,
  legislative framework, key policy initiatives
• Childrens Centres what are they and where do
  they fit in?
• Local plans and progress
• Where does primary care fit in?

33
We are at the beginning of a long term commitment
34
Some Key National Policy and Strategy Documents

• Inter-departmental Childcare Review (2002)
• Every Child Matters Change for Children
• National Service Framework for Children, Young
  people and Maternity Services
• Ten year strategy for Child Care
• Working with voluntary and community
  organisations to deliver change for children
• Youth Matters Green Paper
• Children Act 2004
• Childrens Trusts (and the CYPPlan)

35
Every Child Matters Change for Children Programme
Children and young people have told us that
five outcomes are key to well being in childhood
and later life

• Be healthy
• Stay safe
• Enjoy and achieve
• Make a positive contribution
• Achieve economic wellbeing
• (ECMChange for Children,2004)

36
National Service Framework for Children, Young
People and Maternity Services

• Improving the health and welfare of mothers
  and their children is the surest way to a
  healthier nation the best way to achieve a
  fairer society is to improve health and tackle
  inequalities in childhood
• (Professor Al Aynsley-Green foreword to the NSF
  2004)

37
Legislative underpinning

• The Children Act 2004 provides the legal
  underpinning for Every Child Matters Change for
  Children.
• (ECMChange for Children 2004)

38
Children Act 2004

• Establish a Childrens Commissioner for England
• LAs to make arrangements to promote cooperation
  between agencies to improve childrens well-being
• Safeguarding and promoting welfare of children
  key agencies must work together
• Joined up databases
• Local Safeguarding Children Boards
• Children and Young Peoples Plan
• Director of Childrens Services responsible for
  (at least) education and childrens social
  services functions
• Integrated Inspection Framework

39
ECM radical change with whole system
transformation

• Improvement and integration of universal services
• More specialised help
• Reconfiguring services around the child and
  family
• Sharing responsibility across agencies
• Leadership at all levels of the system
• Listening to children, young people and families

40
ECM a national framework with a local focus

• Step change in quality, accessibility and
  coherence of services
• Transformational agenda
• Involving everyone
• Partnership
• Dialogue
• Local change programmes
• Build on what works and tailor services to need

41
Childrens Centres what are they and where do
they fit in?

• Part of the Sure Start initiative
• Key mechanism for delivering both the ECM
  outcomes and the NSF agenda
• Part of the continuum of extended services to
  babies, children and their families in the
  journey to adulthood and beyond..

42
The Childrens Centre Vision

• Improving outcomes for all young children
• Reducing inequalities in outcomes between the
  most disadvantaged children and the rest
• Childrens Centre services in all the most
  disadvantaged areas moving to reach every child
  and every community by 2010
• Services tailored to need

43
Childrens Centres key to delivering-

• The best start in life for every child
• Better opportunities for parents
• Affordable good quality childcare
• Stronger and safer communities

44
Role of Childrens Centres

• Coordinating the delivery of effective integrated
  early years and childcare services across the
  county
• Bringing all partners together to identify need
  and deliver services in a way that meets local
  need
• A way of thinking and doing
• Better outcomes for families and children

45
The Core Offer

• Good quality early learning - integrated with
  full day care provision
• Good quality teacher input to lead the
  development of learning within each centre
• Parental outreach
• Family support services

46
The Core Offer (cont.)

• Support for parents and children with special
  needs and disabled children including early
  identification of need and provision of services
• Child and family health services including
  antenatal services
• Local advice and information for parents

47
Childrens Centres will also.

• act as a service hub within the community for
  parents and providers of childcare services for
  children of all ages
• offer a base for childminder networks with a link
  to local Neighbourhood Nurseries, out of school
  clubs and extended schools
• and
• have links with local training and education
  providers, Jobcentre Plus and Childrens
  Information Services
• plus
• Provide management and workforce training

48
All partners working together..to achieve..

• Services for all
• Flexible at point of delivery
• Starting early
• Respectful and transparent
• Community driven and professionally led
• Outcome focussed
• Integrated and joined up

49
Local plans and progress

• 2004 2006 NCC to
• Create 239 additional childcare places in 20
  most disadvantaged wards
• Reach 3,573 under 5s

50
Phase 1 Centres
Delivered by

• Blyth Town
• ABC Cramlington
• ABC Blyth
• Ashington
• Berwick
• Wooler
• Bedlington
• Choppington

• - SSD
• - Barnardos
• - Barnardos
• - NCH
• - SSD
• - SSD
• - SSD
• - SSD

51
Phase 1 Centres
Delivered by

• Western Tynedale
• Newbiggin
• Coquet EEC
• Lynemouth
• Prudhoe

• - CNE
• - NCH
• - Charitable Trust
• - NCH
• - SSD

52
Targets 2006 2008

• Reach additional 7,931 under 5s
• Total reached 04 -08 will be 11,504
• Cover all 30 SOAs
• Deliver a further 10 Childrens Centres

53
Money 06-08

• Revenue - 1,913,732 (includes 285,297 rural
  uplift)
• Capital - 2,296,550 (includes 250,000 rural
  uplift)

54
Planned Phase 2 Centres

• Alnwick
• Amble
• Pegswood
• Morpeth South
• Morpeth Stobhill

• Seaton Delaval
• Cramlington Eastlea
• Cramlington Village
• Hexham Priestpopple
• Bellingham

55
Where does health visiting fit into the
Childrens Centre agenda?

• Health is at the heart of the Childrens Centre
  vision
• NSF reaches back pre birth and forward into
  adulthood
• Cultural change is needed
• Planning services around the needs of the child
  not on the structure of organisations
• Leadership at all levels

56
Where next?this is where you come in

• Opportunity to do things differently
• More effectively tackle public health issues
• Work with Childrens Centres - your local
  knowledge and experience can help shape services
• Champion the cause - aim to make a difference

57
Some examples

• Western Tynedale
• - well man or new dad check at 6 week check
• - training on involving men in the ante natal
  period
• Bedlington
• - GP practices were involved in the training
  and planning that led to the WHO Unicef Baby
  Friendly Award
• - HVs and Midwives working to identify
  potentially vulnerable parents-to-be
• Cramlington/Blyth ABC
• - Mellow parenting 2 HVs co facilitated
  with family support worker and clinical
  psychologist.
• - HVs on management group to directly
  influence service delivery
• Blyth
• - talking teeth joint initiative between S.
  Start and Community HV Team
• - 2 HVs trained in India Head massage
  promoting positive mental health
• Berwick
• - stop and weigh service mobile baby
  clinic for families who are not near a health
  centre

58
Just what you always wanted.
59
Health Visitor Service Specification
60
Background

• Health Visiting profession.
• Context Practice based commissioning,
  Commissioning / Provider split, Families and
  Children's Trust.
• Next steps.

61
Cross Cutting Themes

• Early Intervention.
• Prevention.
• Collaboration.
• Integrated teams.

62
Cross cutting themes

• Strong links with Primary Care.
• Targeted services for vulnerable families.
• Equity.

63
Northumberland District

• Northumberland is ranked in the 45-55 most
  deprived County and unitary Authority.
• 18 of the Northumberland population live in the
  most deprived super output areas( SOAs) in
  England.

64
Extent

• Tynedale 2
• Berwick 3
• Alnwick 5

• Morpeth 9
• Blyth Valley 29
• Wansbeck 38

65
1996 Population Projections
Persons 2005 2010 2015
Age group 0-4 15.9 15.3 15.3
5-9 17.9 16.9 16.2
10-14 19.5 16.9 16.2
66
Principles

• Integrated, accessible and personalised services.
• Prevention and improved safeguarding
• Co location.

67
Principles

• Workforce reform.
• Staff have common knowledge and understanding.
• Multidisciplinary teams and lead professional.

68
Range of Services

• Universal core contacts, Standard 1 NSF Child
  Health promotion programme, Hall 4.
• Targeted and specialised services to promote
  opportunity and prevent problems, offering early
  intervention.

69
Range of Services

• Child and family centred approach.
• Flexible and responsive.
• Listening to children and their families.

70
Organisation of Services

• Leadership through the Child health Directorate,
  Public Health and FACT.
• Priorities and targets developed through the
  Children and Young Peoples plan 2006.

71
Core Services

• HVs lead on the delivery of the Child Health
  Programme to all children under 5 and their
  families.
• Screening and immunisation programmes are
  delivered through partnership working with
  Primary Care and early years services.

72
Core Services

• Where there are concerns about a child's health
  or development, timely and effective intervention
  delivered.

73
Co ordinated Support
74
Promoting Health

• Standard 1 Children's NSF provides us with a
  range of contacts for screening, assessments and
  surveillance.
• Assessing and identifying individual and family
  needs provides an opportunity to identify those
  children who need greater input than universal
  services.

75
Public Health

• Working across agencies in assessing the health
  needs of communities and populations.
• Tailoring health promotion activities through
  home visiting, structured parenting programmes,
  drop in sessions and targeted interventions.

76
Safeguarding Children

• Universal services accessible to all with
  targeted services reduce the likelihood of
  possible harm.
• Where parents have problems in responding to
  their children's needs and their parenting
  capacity is compromised, work is undertaken in
  partnership with social services.

77
Safeguarding Children

• HVs may take the lead in supporting parents and
  carers to enable them to fulfil their role.

78
Sick and Disabled Children

• Working in partnership with The Children's
  Community Nursing Team, School Health advisors
  and social services where a child is sick or
  disabled.

79
Operational Processes

• Records
• IT policies
• Policies and procedures

• Prescribing
• Supervision
• Performance monitoring

80
Enhanced Services

• Outside the service specification there are some
  services HVs are currently delivering or would
  want to deliver with the right level of resource
  for example, baby imms, flu vacs, cardiac rehab,
  exercise programmes, out of hours services to
  mention a few.

81
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