The Transfer of the 0 -5
Healthy Child Programme
Why early years services for all?
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Focusing solely on the most disadvantaged will not reduce health inequalities
sufficiently. To reduce the steepness of the social gradient in health, actions must
be universal, but with a scale and intensity that is proportionate to the level of
disadvantage. We call this proportionate universalism.
The National Support Team for Health Inequalities demonstrated it is not enough
to have discreet targeted projects we need to have system and scale if we are to
improve health.
Transition to Parenthood and the first 1001 days from Conception to age 2 is a
crucial period that will have an impact and influence on the rest of the life course.
Preventing and intervening early to address attachment issues will have an impact
on resilience and physical, mental and socioeconomic outcomes in life for mother
and child.
Perinatal mental illness including postnatal depression is very common (around 1
in 10 mothers will experience depression)
There is robust evidence on the impact of maternal mental health during
pregnancy and the first 2 years of life, on infant mental health and future
adolescent and adult mental health
Why concentrate on early years?
• The foundations for virtually every aspect of human development –
physical, intellectual and emotional – are laid in early childhood
• Breastfed babies have better neurological development and are at lower
risk of tooth decay, cardiovascular disease and have fewer attachment
issues.
• Children who are overweight are at higher risk of poor health outcomes
such as type 2 diabetes and poor mental health.
• Illness such as gastroenteritis and upper respiratory tract infections along
with injuries caused by accidents in the home are the leading causes of
attendances at A&E and hospitalisation amongst the under 5s
• Development checks for speech, hearing, physical ability ,dryness, eating
all support readiness for school.
• Health visitors have extensive knowledge of child health, child
development and parenting and are well placed to assess, predict and
identify risk early
The Department of Health has confirmed its plans to mandate
the following universal elements of the Healthy Child
Programme :
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Antenatal health promoting review
New baby review
6-8 week health visitor assessment
One year assessment
2 to 2.5 year review
Not just about 5 mandated checks - 0-5s Healthy Child Programme
Performance - local government is not expected to deliver greater than
the NHS at the point of transfer.
The mandate is time limited for 18 months with a review after 12
months. This will help to ensure there is stability within the service.
Opportunities:
• Joining up commissioning in local authorities for children’s public health,
early help and wider family services
• Involving HWB to promote aligned/joint commissioning between LA, CCGs
(which commission NHS children services) for services around the child
and family
• 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)
• Better integration of services at point of delivery with improved access
and experience Improved outcomes for children families and communities
and reduced inequalities
• To recognise the value of a universal service which is the entry gate to the
early identification and management of all need in families with preschool
children.
Safe Transfer
• Work with partners to sustain services and ensure safe
transfer of contracts.
• It is the commissioning that is transferring not the workforce.
• Based on resident population not GP registered.
• Funding will sit in the ring-fenced public health grant.
• LA allocations based on 2015/16 baseline 0-5s expenditure.
Aim to maintain stability of service delivery whilst
continuing the planned improvements in outcomes and
modernisation of the workforce to limit risk to both provider
organisations, healthcare professionals, children and their
families.
Thank You
Eileen O’Meara
Director of Public Health & Public Protection
Halton