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The Future is HV 456!
Viv Bennett, Director of Nursing, DH/PHE
March 2015
All HCPs
Primary and
Community care
Public health
Patient
Family
Community
Population
Population
health
outcomes
Good
patient
outcomes
Patients and the
Public
Health Care Professionals
(HCP) Roles
Population health - relationships as opportunities to improve health and wellbeing
Prevent Illness & Complication
Protect Health & Safety
Promote Positive Health & Well-Being
Supporting
Health
Wellbeing
and
Independence
Improving
Wider
Determinants
of Health
Lifecourse
Health
Improvement
– Making
Every
Contact
Count
Health
Protection
Healthcare
Public Health
Activities
for
Population
Health
Roles in Health Promoting Practice
6 Domains of
Measuring Outcomes
Maximizing the Opportunity: Putting the Health Promoting Practice into Action
4200 more Health Visitors!
Policy and Plans
A Journey?
4,200 extra health
visitors from
8,092 (May 2010) to
12,292 (April 2015)
Transformed Health VisitorService (redesign and new capacity) • Improved
access to evidence based services
• Delivery progressive model of health visiting
• Improved experience for children and families
Leading to better outcomes including
• Improved reach and delivery
• Locally sensitive commissioning
• Integrated 0-5 services efficient and effective
• 0-19 joined up CYP PH commissioning
• Sustainable place based family services
• Improved publichealth and wellbeing outcomes for under-fives
• And ultimately reduced health inequalities
Transfer of 0-5 public
health commissioning
to Local Authorities
Professionaland service transformationThrough• Evidence• Professional
Mobilisation• Commissioning
and system levers
• Improved metrics
Health Visitor Programme: how the parts fit
Sustainable future2014 onward
• 6 High Impact Areas (HIAs)
• 2015-16 spec in partnership with NHS England/LAs.
• HV fellowships and HV champions.
• HEE working with LAs to sustain service
• CPD programme (s)• Ongoing workforce
planning HEE involving PHE&LGA
Foundation 2010
• Original commitment
• Policy development
• Understanding political intention
• Designing and developing service vision
• Engagement of profession and stakeholders with programme
Initial implementation
2011-13
• Call to Action launched
• Early Implementer Sites (EIS) Waves 1 and 2
• Professional development
• Stakeholder building
• Professional Mobilisation and leadership
• Initial workforce planning & trajectory development
System-wideimplementation
2013-15
• National core HV service spec
• Performance management
• Early years profiles
• DH and HEE commissioned professional development and support for innovative practice.
• NHS Englandcommissioner led service transformation.
• Workforce and training expansion
Transfer to LAs• 0-5 transfer
agreement• Mandation
finalised• Agreeing funding• Programme board
constituted
Health Visitor Programme: the professional and service transformation journey
A community that
supports children
and familiesServices that
give our baby/child
healthy start.
Best advice on a
being a parent
To know our health
visitor and how to
contact them
A quick response if we
have a problem and to
be given expert advice
and support by the right
person
To have the right people to
help over a longer term when
things are really difficult
To know those people and
that they will work together
and with us. To be able to care for our child who is
ill or has a disability at home within a
normal family life
What parents told us they need……
S
A
F
E
G
U
A
R
D
I
N
G
Four level health visiting service model
Health Visitor/School Nurse
Predicted
Population level e.g.
PREview
Assessed by HV
(or others involved
with family)
Expressed by
Family/young person
Provide service/
Service contribution
With partners inc
CC/youth services
Delegate to
Team member
Signpost eg Children’s
Centre &/or build
community capacity
Refer on to
Specialist
Service
Types of Need
Service Response
Understanding and responding to local need
NOT
Information and Evidence
Visibility
engagement
commitment
How we do it: Personalised Care and Population Health Framework
Caring for populations across the lifecourse
Contents Introduction The Framework Applying the
Framework
Beginning of Life: First 1001 days Activities for Population Health
Lifecourse
BACK NEXT
Interventions Outcome Measures
Interventions: Family/ Individual level
Transition to parenthood and the early weeks.
Maternal mental health (PND).
Breastfeeding (initiation and duration)
Obesity – including nutrition and physical activity.
Health and wellbeing - the 2 year old integrated review and support to be ‘ready for school’.
Managing minor illness and reducing accidents.
All interventions link in with the Healthy Child Programme evidence base
NEW!! Six
high impact
areas
Public Health Outcomes Framework
Data from the Public Health Outcomes Framework that are relevant to the Early Years can be accessed below:
Low birth rate of babies
Breastfeeding prevalence
Smoking status at time of delivery
Under 18 conceptions
Excess weight at age 4-5 years
Vaccination coverage
Infant mortality
Tooth decay in children age 5
Caring for populations across the lifecourse
Contents Introduction
The Framework
Applying the
Framework
Beginning of Life Activities for Population Health
Wider Determinants of Health
Health Improvement
Health Protection
Healthcare Public Health
Health, Wellbeing & Independence
Lifecourse
BACK NEXTHOME
Interventions Outcome Measures
| Outcome Measures
(1)
• Transition to parenthood and the early weeks
• Maternal (perinatal) mental health
• Breastfeeding • Healthy weight,
(healthy diet and being active)
• Managing minor illnesses & reducing accidents
• Health, wellbeing & development at 2 years & support to be ‘ready for school’
• Antenatal health promoting visits
• New baby review
• 6-8 week assessment
• 1 year assessment
• 2 to 2 ½ year review
Improved access
Improved experience
Improved outcomes
Reduced health inequalities
• Your Community
• Universal
• Universal Plus
• Universal Partnership Plus
5 Mandated Elements
6High Impact Areas
4Level service model
“Transformed” Health Visiting Services
Local Authority commissioning HCP 0-19 real opportunities for
• Joining up children’s services locally - public health, Children’s Centres early years
/wider family services,
• Integration with children’s social care safeguarding and education
• Streamlining universal access to Healthy Child Programme with early intervention
and targeted interventions/programmes for families needing more help
• Joining up 0 – 5 Healthy Child Programme with 5 – 19 Healthy Child Programme
(which is already commissioned by LAs)
• Improved communication between (foundation) children’s services and primary care
• Better integration of services at point of delivery with improved access and
experience for families .. ‘one stop shop?’
• Improved communication for families with complex needs and in safeguarding
• Health programmes
• Integrated reviews
• Joint training
• Other local priorities16
Challenge
• Information sharing
• Technology supported
service
Sustainable Services 2015 and beyond
Share what we do
key messages…
Healthier through health visiting
•Empowering families for healthier
future
•Leading families and communities to
better health
•Building the future health of our
community
•Designing and delivering care to
families
•Promoting public health to the
community
•A healthier start for children
•Making a difference in your
community
•Better health outcomes and reducing
inequalities
•Leaders in improving the public’s
health
Leadership for improved services and outcomes
Leadership lessons (1) understand what people want and need (and have fun!)
Leadership lessons (2) stay connected (and have fun!)
Viv Bennett appeals to Outer
Space for health visitors
Leadership lessons (3) think outside the box (literally!)
Leadership lessons (4) keep a sense of humour!
Leadership lessons (5) be doggedly determined
Courage does not mean being without fear.
Courage means acting in spite of fear
From the book ‘A Teaspoon of Courage’ by Bradley Trevor Greive
Leadership lessons (6) taking opportunities requires courage …….
Leadership lessons (7 and 8) Take every opportunity, social movement and social
media – celebrate!
