Agenda item

Healthy Child Programme

A report providing an overview of the delivery of the Healthy Child Programme in Oldham, and the progress over the past twelve months.

Minutes:

The Committee considered a report and presentation providing an overview of the delivery of the Healthy Child Programme (HCP) in Oldham, and the progress over the previous twelve months. The report also outlined the current performance of the related services, and the engagement work that was happening with parents, and young people.

 

The Committee was reminded that the HCP had been launched 11 years ago and was still the national evidence based universal programme for children aged 0-19. The programme provided the bedrock for health improvement, public health and supporting families. The HCP was not the responsibility of any individual service but was instead a partnership approach.  The programme was led by health visiting and school nursing: our 0-19 public health nursing services.

 

The Committee noted that Local Authorities were mandated to provide some key public health services, and Bridgewater Community Healthcare NHS Foundation Trust provided a number of them on the Council’s behalf:-

·         Health Visitor review of pregnant women and children

·         Weighing and measuring children at Reception and Year 6, and

·         Oral health promotion programmes as deemed necessary for the area

 

Members were informed that, compared with England averages, the health and wellbeing of children in Oldham was below average. Health outcomes for children were impacted by poverty in a similar way that health outcomes for adults were. As the recent 10-year update on the Marmot Review argued “Poverty experienced during childhood harms health at the time and throughout the rest of life”. In Oldham, there were areas of high rates of deprivation and the latest figures were that 38% of children in Oldham lived in

poverty.

 

The Committee noted that the service generally performed well in relation to the mandated contacts by health visitors. Other than the New Birth Visit, the service completed more than the England average for contacts. There were some challenges to meeting the New Birth Visit target which the service was working on.

 

There had been an increase in demand in relation to safeguarding since the start of the pandemic and the service had implemented the following changes in practice over the past year in order to support families through the pandemic:-

·         Ensured the focus was on those most vulnerable by carrying out caseload reviews and identification of all vulnerable children (Child Subject of Child Protection Plan / Child in Care / Child in Need / child with SEND / extremely clinically vulnerable children)

·         Provided ongoing support to families identified with lower level needs to prevent escalation including creative opportunities for face to face assessments (pram walks / garden visits / park visits / doorstop child growth monitoring)

·         The service provided daily appointment-based healthy child clinics for parents who were reluctant to allow professionals into their homes as well as for the delivery of packages of care

·         The service developed a video in an attempt to allay parental fears of accessing services. The video described the COVID-19 safe arrangements that were in place in order to keep both families and staff safe whilst also stressing the importance of taking up the Healthy Child Programme.

·         Greater use of virtual support for staff including virtual training, and clinical supervision

 

The service had successfully achieved UNICEF level 3 baby friendly accreditation in January 2020 and was working towards the Gold “Achieving Sustainability” Standard.

 

Members were informed that the “Babbling Babies” offer, which provided strategies for families to support their child’s communication development had engaged with nearly 900 families in Quarter 4.

 

The Committee noted that the current Right Start and School Nursing Service had been provided by Bridgewater since 1st April 2016. The contract would continue to 2022. This provided an opportunity to redesign the service in

line with our aspiration to work in a more integrated way, creating a better experience for children and families and better utilisation of the 16 children’s centres across the Oldham borough.

 

The aim was to move to integrated and collaborative working with our partners, with less emphasis on commercial commissioning, setting aside bureaucracy as well as delivering the place-based ambitions we have locally within Oldham to wrap around communities more. There was a real drive to build an all-age system for Oldham that involved local communities and collaborated with all local partners. Support for children, young people and families was at the heart of the integrated place-based approach in Oldham. The new model would be in place for the initial services by 1st April 2022 with new contracting arrangements.

 

A key element of the Oldham approach would be taking a strengths-based and person-centred approach to understand what mattered to people rather than being led by service priorities, to build a system which worked for residents.

 

Members noted the new model would require a formal public consultation. This would be an opportunity to formally gather feedback from the public on any proposed changes and flex any proposed model in response to the feedback. It was intended to ensure that the new model was co-produced with families and there would be a range of engagement activities.

 

Members requested and received clarification on the following:

·         In relation to figures for children attending at A/E, it was highlighted that a breakdown of information per ward would be useful, as there were wards in the borough where several parks are located which would explain the high number of attendances in that ward for attendances at A/E due to children playing in the local parks.

·         The lack of walk-in centres was highlighted and that some residents would attend at A/E due to the lack of such centres.  Some families would not have transport or sufficient funds for transport to travel to A/E.  The Committee was advised the CCG was looking into this issue.

·         The small size of the workforce of school nurses was highlighted as an issue.  It was recognised that for some pupils, speaking to the school nurse could be an opportunity to speak on a confidential basis without the presence of parents.

·         It was recognised that although there were very many helpful leaflets etc provided to new parents, practical advice at home visits, was of enormous value. 

·         Lack of information around where to go and the over reliance of the use of A/E services was highlighted. The Committee received assurances that when the transfer of services had occurred, in depth consultations would be carried out including the Committee due to their depth of knowledge and understanding of local issues.

 

RESOLVED that:

 

1.    The Health Scrutiny Committee noted the progress on the transformation and supported the ongoing actions to further develop the integrated model for 0-19 services in Oldham.

1.    That a further update report be presented to the Committee after March 2022.

 

Supporting documents: