Healthy Start Factfile - UK Government Web...

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Healthy Start

Factfile

Healthy Start team – Department of Health

healthystart@dh.gsi.gov.uk

www.healthystart.nhs.uk

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What does it provide?

Vouchers: Vitamins:

Liquid milk For women

Fresh fruit and veg For children

Infant formula milk

AND: Information on breastfeeding and

healthy eating

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The Voucher

• Worth £3.10 each

• Issued 4 weekly to

beneficiaries

• Double vouchers for

under 1’s or babies within

12 months of estimated

due date if born early

• Voucher value is

reviewed annually

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Who for?

Pregnant women and families with children under four getting:

• Income Support, or

• Income Based Jobseekers’ Allowance, or

• Income related Employment and Support Allowance, or

• Child Tax Credit (but not Working Tax Credit –except run-on) with an annual family income of £16,040 or less.

And ALL pregnant under 18 year olds(Once baby is born – entitlement ceases unless they fulfil qualifying criteria)

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Why?

• A statutory scheme

• A nutritional safety net

• Encourages breastfeeding/healthy eating

• A public health tool

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Facts and Figures 1

(England Sept 09)

• Healthy Start supports 558,500 women and children in 439,500 families

• England average take up is 79%

• Healthy Start Issuing Unit (HSIU) issues over 2.6 million vouchers per 4 weeks

• HSIU gets 24,000 applications every 4 weeks

Facts and Figures

West Midlands

• Healthy Start supports over 60,000 women

and children in 47,000 families

• West Midlands average uptake is 80%

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Facts and Figures 2

(England Sept 09)

• 90% of vouchers are used

• 30,000 retail outlets accept vouchers

• Usage breakdown:

• 70% spent in supermarkets

• 16% spent with independent retailers

• 6% spent with milkmen

• 5% spent with chemists

• The rest with box schemes/market traders etc

Healthy Start Retailers

All Healthy Start (HS) retailers must:

• Stock one or more of the HS products

• Sign up to the HS terms and

conditions

Retailer application forms available via

the Healthy Start Reimbursement Unit

(HSRU) 9

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Healthy Start is a

Statutory SchemeHealth Professionals are given

the key tasks of:

• signposting the scheme and

• supporting applications

• PCTs have a duty to make HS vitamin supplements available

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• Start4Life Objectives/Remit– Reduce the proportion of overweight/obese children

– Improve breastfeeding continuation rates at 6 weeks

– Increase average weaning age to 26 weeks

– Start4Life’s remit is Engand for 0-2 year olds

• Healthy Start Objectives/Remit– A statutory scheme, a nutritional safety net, encourages breastfeeding/healthy eating, a

public health tool

– Healthy Start communications revamp (due October 09) will cover broader topics such as post-natal depression, smoking, alcohol and child development.

– Healthy Start is a UK wide scheme for pregnant women and children to 4 years old.

• Links between Start4Life and Healthy Start– Fundamental link is the consistent messaging around nutrition and physical activity

– Start4Life = nationwide (England) campaign aimed at reducing obesity, Healthy Start = ongoing communications to beneficiaries adding value to vouchers and supporting them with broader public health messages

– Sharing message where appropriate e.g ‘No rush to Mush’ and importance of vitamins

Healthy Start / Start4Life

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Hear about Healthy Start

Tax credits helpline

Jobcentre Plus

Leaflets on benefits or tax credits

DirectGov or HS website

Invitation from HSIUMidwife/Health Visitor

Application leaflet in GP surgery

Someone on the scheme

Pregnancy or Birth to Five Book

Poster in children’s centre or clinic

Get application leaflet/FormWebsite

HSIU Helpline

GP Surgery

Health VisitorComplete Form

Get signature from midwife or health visitor

Submit to HSIU

Family becomes eligible

Healthy Start application process

Midwife

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HSIU receives application form

Fully completedWrongly completed

Returned to applicant

(no BDP for wrongly

completed forms)

Clearly do

not qualify

Applicant

Informed by letter

Application for

pregnant

Vouchers Issued

Beneficiaries notify

HSIU with baby details

and start claiming CTC

Application

includes children

Validate against

HMRC and JCP data

Match found

Repeat validation

checks every 2 wks

(HMRC) or 4 wks (JCP)

Vouchers Issued

Match not found

Inform applicant and invite to give

additional information. Repeat 2/4

weekly checks for 3 months

Match found

Voucher Issued

No match found

Vouchers not issued

Letter confirming match not found

Validation

with HMRC

and JCP

Vouchers

continue

Key: HMRC – HM Revenue and Customs; JCP – JobCentre Plus;

BDP – Back Dated Payment; HSIU – Healthy Start Issuing Unit

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Current Priorities

• Vitamins uptake!

• Scheme uptake

• Communications review

• Streamlining links with tax credits system

• Frozen fruit and vegetables?

• Monitoring/evaluation

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Priority Vitamin

Uptake!

• PCTs should make HS vitamin

supplements available

• Health Professionals have the key task of:

- alerting pregnant women to the

vitamin supplement scheme

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Vitamin Uptake

(England)

• Vitamin take up through HS is less than

1% across the board

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HS Vitamin products

• Children’s vitamin drops contain vitamins A, C and D

• Women’s tablets contain vitamins C and D, and folic acid

• The importance of both products has been highlighted by NICE

• PCTs are responsible for supplying them

• Local promotion to clients is important

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Why Vitamins?

• Enough evidence to convince COMA and SACN to recommend supplementation and

• NICE report on Maternal and child nutrition (March 2008) places the onus on PCTs to ensure supplementation happens

Key: COMA – Committee on Medical Aspects of

Food and Nutrition Policy

SACN – Scientific Advisory Committee on

Nutrition

NICE – National Institute for Clinical Excellence

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Why Vitamins?

Folic acid – role well understood in

preventing neural tube defects

• Supplement readily taken, preferably in

early pregnancy; often acts as a ‘build up’

for the next pregnancy

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Why Vitamins?

• Understanding of vitamin D role in mediating many illnesses much better understood

• Especially role in 3 trimester in foetal bone mineralisation

• Knock on effect in later life?

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Why Vitamins?

• Most vitamins are available easily through a balanced diet

• Like folic acid vitamin D is not, obtained mainly from sunlight, main food source is oily fish.

• Geographical latitude (above 52° N) available from sunlight April – September only,

• Skin type, clothing, sunscreen all effect uptake

• Rising levels of insufficiency/ deficiency being recorded with rising levels of admission for Vitamin D deficiency as a primary diagnosis

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Cost

• Children’s drops 6months – 4th birthday: £37.03

• Women’s tablets pregnancy to child’s 1st

birthday: Less than £9.00

• Treatment of deficiency for 1 year: £2600

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Children’s Drops

Code: ABX 072

Cost to PCT: £1.61

Cost when

selling:

£1.77

Available to: Children; 6 months –

1 year

Contains: 233mcg Vitamin A

20mg Vitamin C

7.5mcg Vitamin D

One bottle: 10 mls (8 week

supply)

Daily Dose: 5 drops

Classification: General Sales List

Medicine

Manufacturer:

Shelf life:

SSL International

10 months

Women’s Tablets

Code: ABX 073

Cost to PCT: 70p

Cost when selling: 77p

Available to: Women; pregnant and until

child is 1 yr old

Contains: 70 mg Vitamin C

10 mcg Vitamin D

400 mcg Folic Acid

One bottle: 56 tablets (8 week supply)

Daily Dose: 1 tablet

Classification: Multivitamin Food

Supplement

Manufacturer:

Shelf life:

Bayer

2 years

Vitamin Facts

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PCT contacts

NHS Supplychain

Order vitamins

and make

payment

NHS Supplychain

delivers

vitamins to

designated NHS

location – PCT

to arrange

PCT gives out vitamins or passes

onto children’s

centres/clinics according

to local arrangements

PCT records how

many vitamins

given out to beneficiaries

PCT to send DH quarterly invoices

along with the HSVR form

DH reimburses PCT

Healthy Start Vitamins

(Ordering and reimbursement process)

DH send HSVR form to finance

contact in each PCT

Key: HSVR – Healthy Start Vitamins Return

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Vitamin Uptake Success:

Key factors

• Team working across boundaries

• Training

• Senior level support

• Clear Communications

• Distribution - accessibility

• Make things simple!

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More Info?

Healthy Start Website

www.healthystart.co.uk

Including a CPD module