HCHS Children

1
HCHS Childrens Universal Services delivering
health care through Childrens Centres Extended
Schools

• National Policy Context
• HCHS strategic direction
• CHPP Healthy Child Programme
• Current delivery practice examples
  demonstrating increased access to universal
  services, service integration across CC ESC,
  increasing capacity supporting vulnerable
  children.
• Areas for improvement

2

• National Policy Context
• Section 4 Childcare Act 2006
• Delivering health services through Sure Start
  Childrens Centres (DH) 2007
• The delivery of key components of the National
  Service Framework for Children Young People and
  Maternity Services such as CHPP (Healthy Child
  Programme)
• Healthy Lives Brighter Futures
• CYPP 2009/11 HCTP
• Transforming Community Services

3
HCHS strategic direction for Childrens Universal
Services

• ALTO to PCT
• Provider service
• Community Foundation Trust
• Service realignment to CC ESC
• Service Specifications for HV SN
• Awaiting the Healthy Child commissioning
  intentions
• Increasing partnership working
• Integrated Practice (DCTP, MAST, CAF TAC)
• Public health targets
• SLT clearly linked to CC

4
CHPP (Healthy Child Programme)

• An effective high quality preventive programme
  0-5 (school aged programme awaited)
• CHPP team led by health visitors, delivered by a
  range of practitioners across health the wider
  childrens workforce
• Progressive universalism (universal additional
  services for those with specific needs risks)
• Screening, early detection action
• Immunisations
• Developmental reviews
• Parent child attachment
• Positive parenting
• Healthy eating
• Breastfeeding
• Engagement with fathers
• Maternal mental health
• Readiness for school

5
Service delivery overview Health Visiting (CC)

• Where space provided dependent on current
  service configuration well baby drop in
  clinics for parents.
• Facilitate access to CC
• Developmental assessments
• Breastfeeding expertise support networks
• Antenatal work project focussing on depression
• Post natal depression (joint funded increases
  capacity)
• Parenting support (wonderful ones twos led by
  CNN)
• Infant massage (targeted)
• Post natal groups
• Young parents
• Weaning healthy eating
• HV access at targeted stay play
• Recruitment

6
Vignette

• Vulnerable parents identified learning
  difficulties, physical disabilities and mental
  health issues.
• First baby
• Limited family support.
• Extensive support interventions required to
  ensure parenting standards are available to meet
  the changing needs of the baby. CSF health
  involved in antenatal period assessment work
  carried out regarding capacity to parent.
• Concerns safe effective parenting, hygiene,
  feeding, interactions responses to babys
  needs, accident prevention.
• Family Together package provided for CSF input
  into family large of the day, increased
  following failure to thrive and feeding problems.
• Families Together completed their work
  replaced by a professional assistant for ongoing
  support, health input ongoing Homestart.
• Accessing CC groups rather than outreach worker
  as keen to normalise routines. Socialising baby
  parents, accessing Jo Jingles, building on
  parenting skills.

7
Service delivery overview School Nursing (ESC)

• CAF Coordinators/ESCOs/support workers SN
  working in partnership to deliver CAF process,
  interventions and support, accessing funding and
  arranging activities for children to support
  emotional and mental health.
• SN steering groups to input into service
  development.
• Crucial Crew multi agency.
• Fruit Bar whole school education to prepare
  taste fruits, understanding nutritional values
  and how it fits into the balanced diet.
• Sexual health services chlamydia screening
• Anger management .
• Parenting programmes organised by ESCO, SN form
  part of the referral pathway for identified
  parents.
• Art project.
• Regular meeting with pupil support workers to
  ensure properly scoped, managed by the right
  person at the right time.
• Royston considering as a joint Health ESC project
  MEND - whole family approach to managing a
  healthy weight.

8
Vignette

• Partnership approach to anger management issues
  co-ordinated approach, previously disjointed and
  duplicated.
• Service pathway developed in partnership -
  School Nurses Emotional Health Wellbeing
  Advisor (health) and ESC.
• Pathway - Identified child with anger management
  referred to School Nurse for a 4 week programme,
  identifies sources of anger strategies to
  manage this response. The programme is linked
  into the classroom management strategies ,
  allowing the child to leave classroom if needed.
  This is sometimes supported by drama therapy.
• If the child is at risk of school exclusion for
  any length of time then referred the BST.
• If initial strategies not worked SDQ assessment
  referral to CAMHS
• Regular meeting with pupil support workers to
  ensure properly scoped, managed by the right
  person at the right time.

9
Areas for improvement

• Clarity of vision moving forward
• Multiple partners - communication
• Joint service planning
• Roles responsibilities
• Information sharing
• Outcome measurement
• Commissioning
• Identifying need
• Areas functioning on critical impact