Role of Health Visitor
2013
Suki Norris/Kristie Hill/Bernice Cooke
Somerset Partnership
What is the Healthy Child
Programme?
The Healthy Child Programme (HCP) is offered to all children.
The HCP for children aged 0-5 is the early intervention and
prevention public health programme that lies at the heart of
our universal service for children and families.
It is a programme of screening, immunisation, health and
developmental reviews and information and guidance to
support parenting and healthy choices.
These are all services that children and families need to
receive if they are to achieve their optimum health and
wellbeing.
Key elements of the service
• Community – the needs of local communities are
understood;
• Universal – all elements of the HCP are delivered.
Contacts with families are increased from the antenatal period to school age;
• Universal plus – evidence based care packages
offered as part of Universal plus are clearly defined.
Key elements continued...
• Universal partnership plus – There should be
a named health visitor on the management board of
the local Children’s Centre;
• the importance of the Health Visitors role in service
co-ordination is emphasised, attendance at HCP
meetings is recommended;
• Safeguarding children – this takes priority.
There is a requirement for effective partnership
working and robust systems of identification, support
and supervision are in place.
Terminology
Minimum Core Contacts
The universal contacts that will be offered are:
 Antenatal contact (after 28 and before 36
completed weeks of pregnancy)
 Initial new birth contact (Between 10-14
days)
 Six to twelve week health review
 After six months and before one year
health review
 Two – two and half health review.
Emphasis on integrated
services
• to be led by a health visitor and delivered by
a range of practitioners across the health
service and the wider children’s workforce;
• health practitioners supporting early years
staff in their role to promote the health of
children;
• identifying when children and their families
need access to additional services;
• initiating and updating a robust Family
Health Needs Assessment at all contacts.
Increased focus on vulnerable
children and families
“A progressive universal HCP is one that
offers a range of preventive and early
intervention services for different levels of
risk, need and protective factors.”
“If we are to reduce inequalities in children’s
health, wellbeing and achievement, we need
to focus on the most vulnerable children and
families, and allocate resources
accordingly.”
Parenting support
• supporting mothers and fathers to provide
sensitive and attuned parenting, in particular
during the first months and years of life;
• supporting strong couple relationships and
stable positive relationships within families;
• ensuring that contact with the family
routinely involves and supports fathers,
including non-resident fathers;
• supporting the transition to parenthood,
especially for first-time mothers and fathers.
New information about
neurological development and
child development
• the importance of attachment and positive parenting
in the first years of life for future outcomes for
children;
• a greater focus on pregnancy;
• recognising the specific impact that mothers and
fathers have on their children;
• building service that responds to the different risk
factors for children’s future life chances;
• integrating NICE guidelines i.e. maternal mental
health, and antenatal and postnatal care;
• incorporating interventions to build resilience and
improve outcomes.
Use of new technologies and
scientific developments
• new vaccination and immunisation
programmes;
• new tests, such as newborn hearing
screening and expanding newborn
bloodspot screening programmes;
• maximising the potential of the internet,
digital TV, help lines and text messaging
services to provide parents with information
and guidance;
• improved data collection systems and
electronic records.
•
Changed public health
priorities
• breast feeding;
• get the balance right between
encouraging play and physical
activity, and minimising the risk of
injury;
• reducing childhood obesity;
• promoting the social and emotional
development of children;
• school readiness.
Early Identification and Early
Intervention is the main aim of our
service
Caseload Sizes
• Super output areas – 250-300
• Rural areas – 350-400
• Child Protection – 15
A rigorous family health needs
assessment is required to assess
priority
Information Sharing
Two Monthly multi-disciplinary Meetings
• Maisey Meetings (Multi Agency Intervention and Support in
Early Years)
• Early Years Practitioners meet and discuss children with
additional educational needs. Main aim is to support
children through the different developmental stages in order
to make a successful entry into school.
• Healthy Child Meetings – Health Visitors work with
Children's Centres to improve the outcomes for the most
vulnerable families in our communities.
Planning and Co-ordinating care
Both meetings ensure that services and provision are looked
at as a whole and co-ordinated around individual needs.
Each meeting has a database of children (discussed with
parents consent)
Each child and family are discussed individually and a care
package is designed.
Home visits regularly take place with health visitors linking
with family support advisers or health professionals such as
OT’s, Community Physiotherapy, Portage etc. To make sure
that we are working towards the same goals.
Care Packages are designed with the family, who are asked
to contribute and agree the goals identified. We try to keep to
a time frame so that our visits are focused and concise .
Health Promotion
Essential to the success of the Healthy
Child Programme
At each Healthy Child Meeting we set aside
time to discuss the delivery of Health
Promotion Programmes appropriate to our
communities.
We discuss local priorities, Update each other
on changes within our services and highlight
deficiencies that can be resolve.
Somerset Partnership
Priorities
• Improving breast feeding rates – We are currently in the
top third of the country for breast feeding rates but we still
have work to do. We ask women in the ante-natal period
their feeding intentions, although 72% say they wish to
breast feed only 65% actually do – when we take over from
the midwives the figure is down to 61% and by 6 weeks
post natal only 50% are continuing to feed. The
government’s aim is that all babies will be exclusively breast
fed for the first 6 months of life.
• Supporting Young Teenage Parents – We have recently
introduced an increased level of support for teenage
parents. We have tried to bring our service up to date to
attract this target group using a workbook detailing the
progress of the pregnancy.
Thank you for listening –
any questions?