Health
Visiting
and FNP
services
National Policy
Improving the
HV service
Improving
chances for
children with
vulnerable
mothers
Improving
maternity
care
Protecting
children
through
immunisation
Giving all
children a
healthy
start in life
Supporting
mothers &
children with
mental health
problems
Helping
parents to
keep their
children
healthy
Encouraging
healthy living
from an early
age
Providing
free school
meals
Policy deliverables by 2015
increase qualified Health
Visiting workforce by 4200
transform the
Health Visitor
service
increase the
number of Family
Nurse Partnership
places to16,000
HV / FNP Programme key dates
2011
• Health Visitor Implementation Plan 2011-15: A Call to Action launched
• Strategic Health Authorities worked with Primary Care Trusts to identify
how many Health Visitors would be needed in localities to meet identified
population needs. Business cases and Investment profiles agreed.
2013
• Public Health transferred to the Local Authority in 2013, however the
commissioning of Health Visiting & FNP Services moved to NHS England
for a period of two years to complete the investment and transformation
programme.
2015
• Commissioning responsibility for Health Visiting and Family Nurse
Partnership services will transfer from NHS England to Local Authorities
on 1st October to complete the transfer of public health functions.
Why the focus on Health Visiting?
Public Health - The foundations for virtually every aspect of
human development – physical, intellectual and emotional –
are set in place during pregnancy and in early childhood.
Economic - Successive academic and economic reviews
have demonstrated the economic and social value of
prevention and early intervention programmes in pregnancy
and the early years.
Competency - Health Visitors, specialist community public
health nurses, have a unique role in identifying need and
supporting the development and wellbeing of every child in
England up to the age of 5.
The Health Visiting Service…
 provides expert information, advice, guidance and
interventions to help parents become the best parent they
can be and give their children the best start in life.
 has a central role in improving the health outcomes of
populations, reducing inequalities, protecting children from
harm and identifying additional needs at the earliest
opportunity.
 leads the delivery of the national Healthy Child Programme
0-5 for every child
 is the only service that comprehensively assesses the
health, wellbeing and social needs of every child at crucial
stages of their development between pregnancy and the
age of 3, often in the home environment.
Healthy Child Programme
An universal schedule of
evidence based assessments,
screening, immunisations and
contacts aimed at promoting
and protecting the health and
wellbeing of all children as well
as identifying needs early and
taking appropriate additional
action.
National Core Service Specification
Local
provision
Two providers of CIOS Health Visiting
Cornwall
Partnership
Foundation
Trust
• Health Visiting
• FNP
• Health Visitors in
Royal Cornwall
LAC Specialist
Hospital Trust
Nursing Team
Three key aspects
increase qualified Health
Visiting workforce
Transform the
Health Visitor
service
increase the
number of Family
Nurse Partnership
places
Increasing the workforce
May 2010
81fte qualified HV’s
March 2015
117fte qualified HV’s
Transform the Health Visiting service
Public Health & Prevention
Population
uptake of
core checks
Evidence
based tools
Workforce
development
Pathways of
care
Safeguarding
Supervision
Engagement
of service
users
Population uptake of core checks
Antenatal
Newbirth
6-8 weeks *
3-4 months *
By 1 year
2-2.5 years
53%
70%
Q2 2014
Increasing universal uptake - 1 year review
Q3 2013
Evidence based tools examples
Solihull
Family Partnership Model
Motivational Interviewing
Baby Friendly
Ages & Stages 3 & SE
Evidence Based Assessments of Need
Check
uptake
increase
from 67%
to 74%
ASQ to be
nationally
introduced
60% of
reviews
used ASQ
88% of
staff trained
by Q2
Workforce Development examples
NHS
Employers
Leadership of
change training
Action
Learning Set
for CPT’s
Preceptorship
programme
Communities
of practice
Snapshot of local developments
Equitable practice on
the Isles of Scilly
HV in pre-birth
assessment team
HV in MARU
(multi-agency referral
and assessment unit)
Multi-Agency
Antenatal education
Migrant Workers
Needs analysis
Doubled FNP capacity
Restorative
Supervision
LAC Specialist
Nursing Team
Family Nurse Partnership
Licenced
model
Capacity
increased
from 4 to
8 nurses
Up to 200
places
Supporting vulnerable first
time young parents
Looked After Children’s Team
3.4wte New
nurses from
HV
investment
High quality
consistent
assessment
% reviews in
time has
increased
from 34% to
90%+
Case
management
approach –
nurse follows
child
Specific
support for
adoptive
parents to
support
placement
Developing clear pathways of care
Development of
champion roles
• Domestic Abuse
• Perinatal Mental
Health
Infant Feeding
•Infant Feeding coordinator
•BFI accreditation
across Hospital &
Community
Perinatal mental
health &
attachment
• Currently use
Woolley
questions, GAD7
& PHQ9
• Reviewing use of
Promotional
guides / MORS
Integrating two
year reviews
• Introduction of
ASQ
• Working with
Early years to
streamline
delivery
• Part of Social
Marketing project
Engaging families
Needs
analysis
Social
marketing
Meridian
Survey/Friends
and family
HV Challenges
Increased accessibility & expectation
Achieving Population Uptake
Maintaining focus upon public health and prevention as
well as safeguarding
Maintaining the workforce through change
Actively engaging service users and influencing change
Fit for purpose Information sharing and IT
FNP Challenges
Decreasing teenage pregnancy rate
Staff turnover & sickness
Achieving fidelity of programme in a rural
geography
Ensuring alignment to HV & Early Years
services to provide a continuum of support
Any questions?