Leading the
future of the
Family Nurse
Partnership:
Transition
Alex Morton
4 November 2014
www.england.nhs.uk
Overview
• NHS England - how we work with FNP
• Transfer of 0-5 years commissioning
responsibilities to Local Authorities from NHS
England
• Opportunities for commissioning in the future
www.england.nhs.uk
Public Health Commissioning
3
www.england.nhs.uk
•
NHS England is responsible for the
direct commissioning of a range of
public health services as set out in the
Section 7a Agreement.
•
We commission through our NHS
England area teams, working with
local communities and providers
•
The services we commission for 0-5
are set out in service specification 27
and the annual value of our contracts
for 0-5 services is in excess of £800M
•
The Family Nurse Partnership service
is an integral part of this
commissioning and services for local
populations
•
By April 2015 we aim to have 16000
Family Nurse Partnership places
Commissioning the healthy child
programme
•
Commissioning the healthy child programme is a fundamental part of our
public health commissioning
•
Our overall aim is to improve outcomes for children and their families
•
Improving the quality of services offered to patients and families in the early
years of a child’s life make a real difference. It has been shown that high
quality intervention, prevention and support is vital to giving children the
best start in life
•
We work through our Area Teams to commission the Healthy Child
Programme 0-5 years. A single, national team within each Area Team
commission for the Family Nurse Partnership Services
•
In developing the local commissioning plans Area Teams work in
partnership considering Joint Strategic Needs Assessments and Joint
Health and Wellbeing Strategies with local communities and Health &
Wellbeing Boards
• FNP gives
www.england.nhs.uk
us all the opportunity to focus where people need us most
NHS England priorities
We use evidence based specifications & outcome frameworks
Health Visitor Service Specification
2014/15 sets the strategic framework
for commissioning services:
work in partnership with parents & agencies
in provision of intensive multi-agency
targeted packages where there are
identified complex health needs or
safeguarding needs.
- ‘ On-going support from the health visiting
team, plus a range of local services working
together and with families, to deal with
more complex issues over a period of time.
These include services provided by ….. the
Family Nurse Partnership ’
-
The 2015/16 HV specification updates:
‘For providers this will support an integrated
approach to meeting the needs of young
children and their families and the delivery
of improved outcomes. HVs will lead delivery
of5 the HCP and work in partnership with . . .
www.england.nhs.uk
Family
Nurse Partnership (FNP) colleagues .’
The Public Health Outcomes Framework
and NHS Outcomes Framework include
outcome indicators that are relevant to
the Healthy Child Programme 0-5 years,
health visiting and FNP and form part of
the overall assurance to NHS England.
- Health Improvement including
breastfeeding initiation, child development at
2-2½ years, obesity prevalence in reception
year children,
- Health Protection including MMR
immunisation (by age 2 years)
- Public health and preventing premature
mortality including infant mortality and mean
decayed missing filled teeth in 5 year old
children
- Improving the wider determinants of
health including Children achieving a good
level of development at Early Years
Foundation Stage
NHS England – supporting young
families
FNP Places
16500
16000
15500
15000
14500
14000
13500
www.england.nhs.uk
FNP
places
Apr-15
Feb-15
Dec-14
Oct-14
Aug-14
Jun-14
Apr-14
13000
• In commissioning services we aim
to improve outcomes
• Much of our focus has been on
increasing the number of Health
Visitors and FNP places, as an
evidence based way of improving
outcomes
• To date, 875 new FNP places have
started in 2014/15 & in line with the
agreed trajectories bring the current
total number of places to 14,025.
• A further 1325 places were on track
to start delivery at the end of
October bringing the total to 15,350
• We aim to achieve 16,000 places
by April 2015, so that 1 in 4 of the
eligible population will have access
Transfer of commissioning responsibilities
We are working with local authorities on safe transfer of commissioning
responsibilities from NHS England to Local Government which will transfer on
1 October 2015.
The following commissioning responsibilities will transfer to local authorities
 The 0-5 Healthy Child Programme (Universal/universal plus) which
includes: Health visiting services (universal and targeted services);
 Family Nurse Partnership services (targeted service for teenage
mothers).
NHS England will retain commissioning responsibilities:
 Child Health Information Systems (CHIS) in order to improve systems
nationally. This will be reassessed in 2020;
 The 6-8 week GP check (also known as the Child Health Surveillance)
www.england.nhs.uk
Transfer of commissioning responsibilities
•
NHS England’s aim is to maintain stability of service delivery whilst continuing the planned
improvements in outcomes and modernisation of the workforce and we want to limit risks to
provider organisations, healthcare professionals, children and their families.
•
Partnership working between DH, NHS England, PHE, LGA and other LG representative
organisations (SOLACE, ADPH, ADCS) central to the successful transfer - nationally and locally
•
Our shared purpose and priority is to ensure safe effective transfer of commissioning
responsibilities which provides commissioners of the future with the greatest opportunity to
continually improve services for children.
•
We collectively have strengthened governance to reflect the work we need to do to ensure
safe transfer. There is a comprehensive programme of work. The transfer is focussing on 0-5
commissioning as a whole. There are 4 key work-streams supported local, regional and
national level
• Finance & Contracting
Workforce
• Communication & Engagement
Information & IT
www.england.nhs.uk
Transfer of commissioning responsibilities
•
We are keen to support the system in an effective transfer, recognising we are building on a
firm foundation
•
LAs can expect:
• Support from Area Teams in understanding the current commissioning responsibilities
we hold
• To be able to access great evidence based information on commissioning 0-5 services
including FNP
• To understand from the Department of Health indicative baseline allocations, with time
to comment ahead of grant allocations
• To be able to access regional oversight groups to feed in comments and views
• To understand the indicative timeline for transfer and checkpoints along the way
• To be able to access supportive information such as Fact Sheets and specific guidance
such as NHS England contracting guidance
•
Our shared purpose and priority is to ensure safe effective transfer of commissioning
responsibilities which provides commissioners of the future with the greatest opportunity to
continually improve services for the most vulnerable.
www.england.nhs.uk
A commissioning point to leave you with
There are some very clear benefits of Local Authorities commissioning
services for 0-5 years: Healthy Child Programme
And the evidence base shows we can make a difference through early
intervention and public health approaches.
There are economic & social arguments for investing in childhood.
•
The Family Nurse Partnership estimated savings five times greater than the cost of
the programme in the form of reduced welfare and criminal justice expenditures;
higher tax revenues and improved physical and mental health Marmot showed that
of c. 700,000 children born in 2010, if policies could be implemented to eradicate
health inequalities, then each child could
expect to live 2 years longer
Child poverty has short, medium and long
term consequences for individuals, families,
neighbourhoods, society and the economy.
These consequences relate to health,
education, employment, behaviour, finance,
relationships and subjective well-being.
Working in partnership will make a difference
www.england.nhs.uk