SpecialistCommunityPublicHealthservices:Healthvisitingforallfamilies,forsomefamilies

andforafewfamilies

AlisonMortonHeadofNursing,Children’sDivisionSHFT;iHVFellow

VisitingProfessionalAdvisor(HealthVisiting)PublicHealthEngland

“Itiseasiertobuildstrongchildrenthantorepairbrokenmen”(andwomen)

(FrederickDouglass)

2

Publichealthlifecourseapproach-preventionpays:

“goingupstream”totacklethegreatestthreatstoournationshealth

“Beststartinlife”Universalassessment- Earlyidentification- Intervention

Determinantsofhealth

Thehealthandwellbeinggap:Ifthenationfailstogetseriousaboutprevention,thenrecentprogressinhealthylifeexpectancieswillstall,healthinequalitieswillwiden,andourabilitytofundbeneficialnewtreatmentswillbecrowded-outbytheneedtospendbillionsofpoundsonwhollyavoidableillness.FiveYearForwardView(2014)

WhyHealthVisiting?Universalassessment- Earlyidentification- Intervention

DeterminantsofhealthGivingeverychildthe“BeststartinLife”

HealthVisitingProportionateuniversalism

universal– universalplus– universalpartnershipplusavisiblepublichealthservice

forallfamilies,somefamiliesandafewfamilies

Universalhealthreviews:Dotheymakeadifference?

Advice:Healthyeating– 89%;KeepingActive– 82%;Behaviourmanagement– 82%Goodsleephabits– 80%;DentalHealth– 91%;ChildSafety– 86%;Immunisations– 87%

Earlyidentificationandintervention:Unmethealth/developmentneedidentifiedin39.5%ofchildren

Behaviourchange:• Positiveparentingstrategies• Foodchoices/portionsizes• Vitamins• Removingthebottle&dummy• Dentalhealth– registeringwithdentist• Uptakeofpre-school/earlyyears

education

(SHFT,2016;n=1177parents,3monthcohort,following2yearuniversalhealthreview)

Ready Steady Mums Hampshire “Breastfeeding Welcome” schemeHealthy eating groups in Children CentresIn school initiatives- Daily Mile / healthy eating

Assessment/SupportSlimmingWorld

Information/adviceHealthyeating/physicalactivity

Group or 1:1 support

HENRY and iHV resources

Tacklingobesity:

holisticapproach(HampshireHealthyWeightsPartnership)

Additionalsupport

UniversalcontactsPregnancy

Community“HealthyLifestyle”

Maternal/InfantmentalhealthEstimated annual financial cost= £8.1 billion; associated poor outcomes for children

Early identification – Intervention – Holistic approach to mothers and babies

ReducingA&Eattendances:addressingthereasonswhyparentschoose A&E

WessexParentalsurveyThedecisiontoconsultahealthcareprofessionalisnottakenlightly:

– seekingpeaceofmind;worryingaboutfailingtorecogniseaseriousillness

– beingjudgedtodothewrongthing– accesstohealthservicewithoutdelay

Parentsreceivingconsistent,explicitsafety-nettingadvicearelesslikelytore-attend

WessexHealthierTogether- increasingparentalconfidence-Resourcestomanagemostcommonsymptoms(Red,Amber,Greenadvice)-App,website,parentinggroupresources

HealthvisitingImprovingaccess,experienceandoutcomes

Reducinghealthinequalitiesforover150years