Upload
phungthuy
View
215
Download
1
Embed Size (px)
Citation preview
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
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
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.
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
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
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)
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
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
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
AN EARLY YEARS PATHWAY
Health Visitor Birth Visit & Follow-up 1-6 weeks
Measurements
FRAIT, Domestic Abuse Pathway, Peri Mental Health Pathway
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
Antenatal Contact by Health Visitor 28-40 wks
All
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
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
Family Health Review 13 Months
Immunisations
Measurements
Healthy Child Wales Programme (HCWP)
Health Visitor Family Health Review 6 Months
Measurements
FRAIT, Domestic Abuse pathway, Mental Health Pathway
Health Visitor Family Health Review 3.5 Years
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. Pre School Booster
Immunisations
School Health Nursing Service
4-5 years
Deliver Fluenz vaccination. Height, weight and vision screening.
Provide CMP data on height and weight
Community Midwife Home Visits
Day after discharge from hospital-full breastfeeding/bottlefeeding
assessment
72 hours after discharge -Weigh baby. Full breastfeeding/ bottlefeeding
assessment
Day 5 for PKU assessment. Full breastfeeding assessment.
10-14 day visit - Health Visitor takes over care.
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.
Flying Start Enhanced HV programme
Universal Antenatal Contact @ 24+ weeks with
targeted Hello Baby / Parent Nurture programmes
Birth Visit at 10-14 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
15-18 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.
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
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.