HEALTHY CHILD WALES PROGRAMME 2016

Transcription

1 HEALTHY CHILD WALES PROGRAMME 2016 Jane O Kane Health Visiting Lead ABMU Health Board on behalf of the All Wales Health Visiting & School Health Nursing Leads

2 The Ambition Making an Impact The Strategic fit The Principles The challenges, the opportunities and the risks Assurances The So What Our plan for 2020 and beyond

3 THE AMBITION Development of a one Wales model of universal early intervention: committed to safeguarding the health and welfare of all children A model delivered in collaboration with key partners in the Third Sector & across the Public Sector that will equate with more resilient families; parents able to support their children to achieve better health, social and educational outcomes Comprise evidence based interventions that build upon research relating to the impact in childhood of early experiences and impact upon infant brain development, and immunological and nervous system development.

4 A lack of appropriate experiences can lead to alterations in genetic plans. Moreover although the brain retains the capacity to adapt and change throughout life, this capacity decreases with age Keuroghlian et al 2007

5 MAKING AN IMPACT & REDUCING HEALTH INEQUALITIES: PUBLIC HEALTH NURSING 154 year old profession; introduced in 1862 during the philanthropic movement. 1914: State regulated profession and in NHS ACT 1948 Birth Visit imbedded 1966: Contribution to the decline in infant mortality in the1900 s recognised (PJ Cunningham) 1990s: community orientated approach to support social change Remit to incorporate older population & targeting vulnerable groups 2000: safeguarding children policy reforms and perception of state surveillance 2000: WG recognition of HV interventions - Sure Start and Flying Start 2010: The WG Vision for Health Visiting & key priorities

6

7 THE STRATEGIC FIT Reflect strategic guidance, legislation, & professional recommendations: Social & Economic Impact : Build upon the increasing evidence of investing in early years interventions in order to improve the future for the next generation with long term health gain & associated financial savings; noting social & economic links (ACES, 2016,Marmot,2010, Acheson 1998 and The Black Report,1980) Reflecting and Learning from local reviews: Thematic reviews & translation into practice Measuring outcomes : Alignment with existing frameworks ( Early Years Outcome Framework & Public Health Outcomes Framework PHW, 2016)

8 THE PRINCIPLES Model of progressive universalism Key Health Visiting contacts underpinned by a comprehensive assessment of family resilience to help determine ongoing requirements in partnership with families Health Visiting service provision to be offered at 1 of 3 levels; Universal, Enhanced and Intensive dependant upon resilience assessment outcome Delivery of consistent public health messages delivered by a workforce trained in motivational interviewing

9 THE CHALLENGES, OPPORTUNITIES & THE RISKS Alignment of 7 Health Boards local programmes Financial envelopes and constraints Workforce: variations and capacity with 2 HBs risk managing programme priorities Prioritisation of minimum requirements, poverty profiles and characteristics specific to some communities Policy & strategy reforms & a knit between

10 PROVIDING ASSURANCES Quality Assurance Framework underpinning the programme: Minimum Standards Learning from Francis Inquiry: Supportive Practice Review to encompass audit of values & behaviours One Wales HV Job Description National training programme RBA framework Single Record aligning with WCCIS

11 Flying Start Enhanced HV programme Universal Antenatal 24+ weeks with targeted Hello Baby / Parent Nurture programmes Birth Visit at days + weekly home contacts up to 6 weeks 8-16 week contact (weaning) 6-9 month family health review 9-12 month family health review month family health review 2 year family health review and SOGS 3 year family health review and SOGS 3 ½ - 4 year Family Review Access to Drop-in Parent groups offering Baby Massage, Speech and language support, Parenting programmes. Childcare for 2.5 hrs per day, 5 days/week between 2 and 3 years. Community Midwife Home visits Frequency of visits assessed for on individual basis. For breastfeeding issues - Midwives work closely with Maternity Care Support Workers who carry out additional visits. Universal Clinic Contacts 02 Exam: GP assessment at 6 to 8 weeks: Measurements Family Health Review: at 8 weeks, 12 and 16 weeks Immunisations Measurements Mental Health Pathway Family Health Review 13 Months Immunisations Measurements Pre School Booster Immunisations AN EARLY YEARS PATHWAY Healthy Child Wales Programme (HCWP) Antenatal Contact by Health Visitor wks Community Midwife Home Visits Day after discharge from hospital-full breastfeeding/bottlefeeding assessment 72 hours after discharge -Weigh baby. Full breastfeeding/ bottlefeeding assessment All Day 5 for PKU assessment. Full breastfeeding assessment day visit - Health Visitor takes over care. Health Visitor Birth Visit & Follow-up 1-6 weeks Measurements FRAIT, Domestic Abuse Pathway, Peri Mental Health Pathway Health Visitor Family Health Review 6 Months Measurements FRAIT, Domestic Abuse pathway, Mental Health Pathway Health Visitor Family Health Review 15 Months Measurements FRAIT, Domestic Abuse pathway, Developmental Assessment Health Visitor Family Health Review 27 Months Measurements FRAIT, Domestic Abuse pathway, Developmental Assessment Health Visitor Family Health Review 3.5 Years School Health Nursing Service 4-5 years Deliver Fluenz vaccination. Height, weight and vision screening. Provide CMP data on height and weight Baby Friendly Initiative Breast or Bottle Feeding Assessment. Infant weight measurement at birth visit, 02 exam, at each primary immunisation, 03 exam and 12 months or as requested by parent. Apply guidance for BMI and growth measurement from UK WHO Growth Charts and RCPCH Weight Monitoring Guidance Key Interventions throughout the pathway Assessment of family resilience and need Promotion of secure parent & infant relationships Promotion of breast feeding, safe infant feeding and infant, toddler and family nutrition. Promotion of baby and child safety Assessment and monitoring of growth and development Promotion of maternal emotional health Childhood immunisations Assessment of visual development Promotion of speech, language and communication Promotion of dental health Promotion of Childs behaviour Toilet training Key Public Health messages are offered throughout the programme i.e. Smoking cessation Contraception and sexual health Pet safety Reading and play.

12 AND SO WHAT? OUR CONTRIBUTION ( IN PARTNERSHIP) All parents to have the opportunity, the aspiration & confidence to parent well All children to have optimum health & be prepared for school entry & achieve their potential A healthy Wales

13 2020 AND OUR AMBITION FOR THE FUTURE Clearly articulated outcomes Results Based Accountability framework will be imbedded and demonstrate high standards of practice/interventions Primary Care collaboration to develop specific programmes including Advanced HV Practitioner roles in Child Health Research and developments in the fields of perinatal mental health, oral care and positive parental relationships in collaboration with peer groups, local teams & Third Sector.

14 Thankyou