The Health Visitor’s role in Leading the Healthy Child Programme Southampton

1. The Health Visitor’s role in Leading the Healthy Child ProgrammeSouthampton Sue Wierzbicki Locality Lead Co-ordinator – South cluster Mobile – 07785113842 Sue.wierzbicki@solent.nhs.uk

2. Who are Health Visitors • Qualified nurses (all disciplines) or midwives • Public Health Nurses trained at BSc/MSc level and Nurse prescribers • Working with Children aged 0-5 years and their families, providing a ‘rapid response’ when required. • The HV’s purpose is to reduce health inequalities and improve health outcomes for children at an individual and population level. • Locality working across the city whilst utilising children centres and other community resources • HV’s work with the most complex and disadvantaged children and families through partnership with LA, voluntary sector, health colleagues

3. Why is there a Healthy Child Programme! A Strong evidence base: • Health for all Children (Hall and Elliman 2006) • National Institute for Clinical Excellence (NICE) • Review of Parenting programmes (University of Warwick) HCP universal reach provides opportunities to identify families in need of additional support to improve outcomes Recognition of the vital contribution that maternityservicesmake to child health and wellbeing Lead by Health Visitor (HV) but delivered by range of professionals to engage those least likely to access traditional services

4. The Health Visiting service Family Offer Safeguarding children The Healthy Child Programme provides the evidence base for the offer and the improved outcomes for children and families

5. Nationally Mandated Health Visiting Offer 4 Level service model 5 Mandated Elements 6 High Impact Areas • Transition to parenthood and the early weeks • Maternal (perinatal) mental health • Breastfeeding • Healthy weight, • 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 – 2 ½ year review • Your Community • Universal • Universal Plus • Universal Partnership Plus Improved access Improved experience Improved outcomes Reduced health inequalities

6. The Healthy Child Programme (2009)

7. Empowering Parents Solihull Approach, Motivational interviewing, solution focused therapy

8. Brain Development

9. Antenatal assessment • Family Health Needs Assessment • Promotional interviewing – antenatal and postnatal • Breast feeding • Safety – Sudden Infant Death Syndrome • Health concerns • Good opportunity to develop relationship before the baby is born and discuss attachment and parenting support. • Health social and environmental risk factors. • Early detection of concerns –mental health, domestic violence, alcohol and drugs and relationship.

10. Primary birth visit (10-14 days) • Promotional interviewing and Family Health Needs Assessment continues focusing on parenting, health promotion and family support • Mother – mental health, experience of labour birth, breast feeding, relationships, smoking, • Baby – neonatal examination (muscle tone, colour, breathing, head shape, fontanelle, mouth, eyes, trunk, limbs, genitals, skin(jaundice, birthmarks, bruises) – Growth, immunisations, GP check, SIDS, newborn screening, Vitamins

11. 6-8 week visit • It is an opportunity to review health and wellbeing of mother child and family. • Focus on mental health – Post natal depression screening. • Ensure that the birth is registered and GP examination completed. • The benefits of immunisations • Developmental milestones – Attachment , Is baby smiling ? • Play and stimulation – “Tummy Time”

12. Health Reviews • HR1 aged 1 year - HR2 aged 2 years • Ages and Stages Questionnaire - an assessment of Gross motor, Fine motor, Social personal and communication development. • Referral for support if required • Health promotion – dental hygiene play, social interactions, toileting, sleep behaviour, diet, immunisations family health.

13. How baby’s Develop

14. Encouraging engagement - parent led contact for universal families Clinic offers parents a drop in service to visit and discuss growth, development and concerns. Topics that we may cover – eczema management, weaning advice, fussy eaters, managing childhood illness, behaviour, toileting, sleep.

15. Working with agencies • Universal Plus – PND , breast feeding support, parenting programmes, help to reduce social isolation. • UHA referrals and FFW • Universal partnership plus – MASH / Early Help Children subject to child protection, child in need, car package led by specialist service (perinatal mental health, Jigsaw – children with complex disabilities) • Enhanced families • Agencies we work with :- social care, Midwifery service, GP’s, Public Health Nursing, Children's centres, voluntary agencies, Early years

16. Group work • Looking at the card you have been given think about what might be happening for this family • Impact on the child and how will it affect their health outcomes. • What would partnership working look like( think about the strengths/ weaknesses/ opportunities/ threats of services) Highlight a course of action that agencies can provide to support this family.