Health Visiting and FNP services
Jan 14, 2016
Health Visiting and FNP services
National Policy
Giving all children a
healthy start in life
Improving the HV service
Improving chances for children with vulnerable mothers
Supporting mothers &
children with mental health
problems
Helping parents to keep their children healthy
Providing free school
meals
Encouraging healthy living from an early
age
Protecting children through
immunisation
Improving maternity
care
Policy deliverables by 2015
increase qualified Health Visiting workforce by 4200
transform the Health Visitor
service
increase the number of Family Nurse Partnership places to16,000
HV / FNP Programme key dates
2011
• Health Visitor Implementation Plan 2011-15: A Call to Action launched• Strategic Health Authorities worked with Primary Care Trusts to identify
how many Health Visitors would be needed in localities to meet identified population needs. Business cases and Investment profiles agreed.
2013
• Public Health transferred to the Local Authority in 2013, however the commissioning of Health Visiting & FNP Services moved to NHS England for a period of two years to complete the investment and transformation programme.
2015
• Commissioning responsibility for Health Visiting and Family Nurse Partnership services will transfer from NHS England to Local Authorities on 1st October to complete the transfer of public health functions.
Why the focus on Health Visiting?Public Health - The foundations for virtually every aspect of
human development – physical, intellectual and emotional – are set in place during pregnancy and in early childhood.
Economic - Successive academic and economic reviews have demonstrated the economic and social value of prevention and early intervention programmes in pregnancy and the early years.
Competency - Health Visitors, specialist community public health nurses, have a unique role in identifying need and supporting the development and wellbeing of every child in England up to the age of 5.
The Health Visiting Service… provides expert information, advice, guidance and
interventions to help parents become the best parent they can be and give their children the best start in life.
has a central role in improving the health outcomes of populations, reducing inequalities, protecting children from harm and identifying additional needs at the earliest opportunity.
leads the delivery of the national Healthy Child Programme 0-5 for every child
is the only service that comprehensively assesses the health, wellbeing and social needs of every child at crucial stages of their development between pregnancy and the age of 3, often in the home environment.
Healthy Child Programme
An universal schedule of evidence based assessments, screening, immunisations and contacts aimed at promoting and protecting the health and wellbeing of all children as well as identifying needs early and taking appropriate additional action.
National Core Service Specification
Local provision
Two providers of CIOS Health Visiting
• Health Visiting• FNP
Cornwall Partnership Foundation
Trust
• Health Visitors in LAC Specialist Nursing Team
Royal Cornwall Hospital Trust
Three key aspects
increase qualified Health Visiting
workforce
Transform the Health Visitor
service
increase the number of Family Nurse Partnership
places
Increasing the workforce
May 2010 March 2015
81fte qualified HV’s 117fte qualified HV’s
Transform the Health Visiting service
Population uptake of core checks
Safeguarding
Public Health & Prevention
Population uptake of core checks
Antenatal
Newbirth
6-8 weeks *
3-4 months *
By 1 year
2-2.5 years
Increasing universal uptake - 1 year review
53% 70%Q2
2014
Q3 2013
Evidence based tools examples
Solihull
Family Partnership Model
Motivational Interviewing
Baby Friendly
Ages & Stages 3 & SE
Evidence Based Assessments of Need
Check uptake
increase from 67% to
74%
ASQ to be nationally introduced
60% of reviews
used ASQ
88% of staff
trained by Q2
Workforce Development examples
Leadership of change
training
Preceptorship
programme
Communities of practice
Action Learning Set for CPT’s
NHS Employers
Snapshot of local developments
Equitable practice on the Isles of Scilly
HV in pre-birth assessment
team
HV in MARU (multi-agency referral and
assessment unit)
Multi-Agency Antenatal education
Migrant Workers
Needs analysis
Doubled FNP capacity
Family Nurse Partnership
Supporting vulnerable first time young parents
Up to 200
places
Licenced model
Capacity increased from 4 to 8 nurses
Looked After Children’s Team
3.4wte New
nurses from HV investm
ent
High quality
consistent
assessment
% reviews in time
has increased from 34% to 90%+
Case manage
ment approac
h – nurse
follows child
Specific support
for adoptive parents
to support placeme
nt
Developing clear pathways of care
Development of champion roles
•Domestic Abuse•Perinatal Mental Health
Infant Feeding
•Infant Feeding co-ordinator•BFI accreditation across Hospital & Community
Perinatal mental health & attachment
•Currently use Woolley questions, GAD7 & PHQ9•Reviewing use of Promotional guides / MORS
Integrating two year reviews
•Introduction of ASQ•Working with Early years to streamline delivery•Part of Social Marketing project
Engaging families
Meridian Survey/Friends and
family
Social market
ing
Needs analysi
s
HV Challenges
Increased accessibility & expectation
Achieving Population Uptake
Maintaining focus upon public health and prevention as well as safeguarding
Maintaining the workforce through change
Actively engaging service users and influencing change
Fit for purpose Information sharing and IT
FNP Challenges
Decreasing teenage pregnancy rate
Staff turnover & sickness
Achieving fidelity of programme in a rural geography
Ensuring alignment to HV & Early Years services to provide a continuum of support
Any questions?