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Public Health, Early Years, Children’s Services Focus: HV / SN & Links September 2013

Public Health, Early Years, Children’s Services Focus: HV / SN & Links September 2013. Dr Julia Egan Professional Advisor for Public Health, Early years and Children's Services. Scope: CEL 13 HV / SN Work plan 2013 – April 2014 Associated areas and links. HV / SN: CEL 13 Purpose

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Public Health, Early Years, Children’s Services Focus: HV / SN & Links September 2013

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  1. Public Health, Early Years, Children’s ServicesFocus: HV / SN & LinksSeptember 2013 Dr Julia Egan Professional Advisor for Public Health, Early years and Children's Services

  2. Scope: • CEL 13 • HV / SN • Work plan 2013 – April 2014 • Associated areas and links

  3. HV / SN: • CEL 13 • Purpose • Terminology, definitions, focus and data • Scoping exercise – Aims • Questions and main findings

  4. Questions: • Universal services: Visits, definitions, health promotion, additional input, priorities, GIRFEC • Vulnerability assessment • PH roles / priorities • Caseload weighting • Models of service delivery • Multiagency roles and priorities inc LAC • Evidence base • Education and training priorities and needs

  5. Key Findings: • Generally all follow Hall, but visiting patterns vary • Some Boards have guidance others don’t • Who , what, where differs • Universal gap antenatally and over 5 years • HP needs underlining and defining • General consensus SN role is around: vulnerable children (referred not proactive), LAC, Complex needs & needs revisiting • Gap: primary school, transition, excluded children, LAC, refuge, families not at school

  6. Many have increased universal input under 5 re early yrs work, evidence (Bolton, Cowley), FNP • Differences in tools, when used e.g.- strengths and difficulties questionnaire • Additional: largely consensus (on anything that constitutes more than core) but no agreed definition • Use GIRFEC model of assessment and allocate HPI - lack of uniformity (particularly in 5-19 and maternity) and how applied • 7 other models of vulnerability assessment • Generally no caseload weighting tools but need one

  7. PH roles need prioritising and redefining • Models of delivery predominantly GP attached however significant number of locality, corporate and multi-agency models • GAPS : Substance misuse, CAMHS, MH and need to progress more interagency linked roles • Training and education : consistent messages throughout: …….training, content, HEIs, CPD, career development.

  8. Recommendations: • National guidance for universal contacts and visiting patterns for 0-19 year olds including: a. Who; where, when, evidence base to support visits, tools and interventions; specific health promotion advice to be given and national data recording. b. Guidance on assessment tools: validated tools for assessing: attachment; infant, child and adult mental health; parenting; child development; risk and LAC. c. Consistent approaches to GIRFEC, vulnerability assessment and additional input

  9. Development of a national model for HV caseload weighting. Consideration will be given to SN and other appropriate professional groups. • Redefine the SN role and the evidence base to support it • Commission NES to review and develop future HV/SN training and career pathways based on evidence and recommendations.

  10. Built in will be: • Redefining and strengthening the PH and multiagency contribution of HV and SN, setting out priority areas for development and intervention

  11. Anticipatory care, prevention, assets, strength based approaches, community development • Domestic abuse, substance misuse, mental health, trauma interventions • Equity, equality, access • Vulnerable groups: LAC, excluded children, children not at school, prisoners and their families, preventing offending, homeless, travellers • Third sector growth & links and integration with e.g. family support models

  12. Plan • Progressive universalism • Evidence base – 0-5; 5-19 • Build approaches and interventions into universal, group and population based community nursing work. E.g. routine enquiry, motivational interviewing, assessment tools • Assess and monitor data and outcomes

  13. National : Children’s Young Peoples Nursing Advisory group • Chair Rosemary Lyness – Executive Director NHS Lanarkshire • Role, remit, membership, • Accountability - SEND • Four priorities: universal services, weighting tool, SN, Education • Delivery by April 2014

  14. Associated links: • Wider community and workforce across agencies • Wider workforce development and 20:20 Vision • Wider training and education implications • Integration

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