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SpecialistCommunityPublicHealthservices:Healthvisitingforallfamilies,forsomefamilies
andforafewfamilies
AlisonMortonHeadofNursing,Children’sDivisionSHFT;iHVFellow
VisitingProfessionalAdvisor(HealthVisiting)PublicHealthEngland
“Itiseasiertobuildstrongchildrenthantorepairbrokenmen”(andwomen)
(FrederickDouglass)
2
Publichealthlifecourseapproach-preventionpays:
“goingupstream”totacklethegreatestthreatstoournationshealth
“Beststartinlife”Universalassessment- Earlyidentification- Intervention
Determinantsofhealth
Thehealthandwellbeinggap:Ifthenationfailstogetseriousaboutprevention,thenrecentprogressinhealthylifeexpectancieswillstall,healthinequalitieswillwiden,andourabilitytofundbeneficialnewtreatmentswillbecrowded-outbytheneedtospendbillionsofpoundsonwhollyavoidableillness.FiveYearForwardView(2014)
WhyHealthVisiting?Universalassessment- Earlyidentification- Intervention
DeterminantsofhealthGivingeverychildthe“BeststartinLife”
HealthVisitingProportionateuniversalism
universal– universalplus– universalpartnershipplusavisiblepublichealthservice
forallfamilies,somefamiliesandafewfamilies
Universalhealthreviews:Dotheymakeadifference?
Advice:Healthyeating– 89%;KeepingActive– 82%;Behaviourmanagement– 82%Goodsleephabits– 80%;DentalHealth– 91%;ChildSafety– 86%;Immunisations– 87%
Earlyidentificationandintervention:Unmethealth/developmentneedidentifiedin39.5%ofchildren
Behaviourchange:• Positiveparentingstrategies• Foodchoices/portionsizes• Vitamins• Removingthebottle&dummy• Dentalhealth– registeringwithdentist• Uptakeofpre-school/earlyyears
education
(SHFT,2016;n=1177parents,3monthcohort,following2yearuniversalhealthreview)
Ready Steady Mums Hampshire “Breastfeeding Welcome” schemeHealthy eating groups in Children CentresIn school initiatives- Daily Mile / healthy eating
Assessment/SupportSlimmingWorld
Information/adviceHealthyeating/physicalactivity
Group or 1:1 support
HENRY and iHV resources
Tacklingobesity:
holisticapproach(HampshireHealthyWeightsPartnership)
Additionalsupport
UniversalcontactsPregnancy
Community“HealthyLifestyle”
Maternal/InfantmentalhealthEstimated annual financial cost= £8.1 billion; associated poor outcomes for children
Early identification – Intervention – Holistic approach to mothers and babies
ReducingA&Eattendances:addressingthereasonswhyparentschoose A&E
WessexParentalsurveyThedecisiontoconsultahealthcareprofessionalisnottakenlightly:
– seekingpeaceofmind;worryingaboutfailingtorecogniseaseriousillness
– beingjudgedtodothewrongthing– accesstohealthservicewithoutdelay
Parentsreceivingconsistent,explicitsafety-nettingadvicearelesslikelytore-attend
WessexHealthierTogether- increasingparentalconfidence-Resourcestomanagemostcommonsymptoms(Red,Amber,Greenadvice)-App,website,parentinggroupresources
HealthvisitingImprovingaccess,experienceandoutcomes
Reducinghealthinequalitiesforover150years