www.hertsdirect.org hertfordshire health & wellbeing conference: starting well dr sj louise...
TRANSCRIPT
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Hertfordshire Health & Wellbeing Conference: Starting Well
Dr SJ Louise Smith
Sue Beck
Public Health, Hertfordshire County Council
Jacqui Bunce
East & North Hertfordshire CCG
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Introduction
• Increasing population 77,000 children <5
• 13% live in poverty
• Future challenges
– Inequalities
– Integration
– Finances
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Children's Health Needs
• Mortality
• Inequalities school readiness & attainment
• No breastfeeding data
– Smoking
– Mental Health
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Starting Well – Context• National Review of
Maternity Services • BME profile changing• Teenage Pregnancy rate
is falling• Population –
demographic changes• Older first time Mums –
associated risks• Link to Domestic Violence• Parity of esteem
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High impact areas
• Smoke free homes
• Breastfeeding
• Diet & healthy start vitamins
• Safe sleeping
• Maternal mental health
• Stop smoking in pregnancy
• Immunisation uptake
• Illnesses
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Starting Well draft priorities
Priority 1
We will implement a cross system strategy to reduce tobacco related deaths in the < 5s
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Reducing smoking in pregnancy
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Priority 2- We will bring services together to integrate assessment & care planning
• Teenage Pregnancy & advice/support
• Maternal Health– Obesity – Diabetes– Perinatal mental health– Smoking prevalence
• Support for expectant mothers who are caring
• Midwifery & ante natal care• Support & education for
expecting parents who have mental health problems or a LD
• Family Nurse Partnerships
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Diet & Vitamins
• Breastfeeding
• Normal growth
• Weaning
• Vitamins
• Obesity
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Priority 3-We will implement an integrated approach to parenting support
• Changes to Maternity Services
• Birth experience• Breast Feeding• Post natal care
– Screening – hearing loss– Post natal depression
• Transition from midwife to Health Visitor support
• Children's Centres & other post natal support
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Cot deaths & Safe sleeping
30 deaths since 2009
•Smoking
•Drugs & Alcohol
•Co-sleeping
•Overheating
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Priority 4- We will implement early interventions and accessible, appropriate services to support maternal mental health
• Around one in ten women experience mental health problems during pregnancy and the first year after childbirth
• Perinatal mental health problems make a significant contribution to both maternal and infant morbidity and mortality
• Suicide is one of the leading causes of maternal death in the UK.
• Women who need inpatient care for a mental health problem within 12 months of childbirth should normally be admitted to a specialist mother and baby unit
• Expert early identification and management of perinatal mental health problems should prevent women reaching the point where they need inpatient care
• There is commissioning challenge to ensure equity of access for specialist perinatal mental health services
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Integrated Children's Commissioning Framework
• Partnership
• High quality services
• Needs & evidence based
• Child & Family Centred
• Prevention & Universal
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Who and What?• Schools & education
• Voluntary Sector
• & Wellbeing
– Sexual health, smoking
• Antenatal & Midwives
• 0 – 5 Healthy Child
– Health visitors & FNP
– Immunisation
– Screening
– Surveillance & data
• NHS services
– GPs, acute & community
• Children's Centres & child care
• Schools, SRE
• E.g. NCT, Banardos
• Public Health, County Council
• CCGs,
• Acute & Community NHS Providers
• NHS England,
• GPs
• Antenatal, neonatal, HV
• Child Health Information service
• Children’s services
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0 – 5 Healthy Child Programme
• Universal
• Child & family
• Routine review
• Development checks
• Assess need and identify early
• Parenting
• Immunisation & screening
• Data
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To recap A future HWB strategy - suggestionsPriority 1We will implement a cross system strategy to reduce tobacco related deaths in the < 5s
Priority 2We will bring service together to integrate assessment and care planning
Priority 3We will implement an integrated approach to parenting support
Priority 4We will implement early interventions and accessible, appropriate services to support maternal mental health
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Discussion
How do we tackle these challenges together?
•Comments or feedback to:
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thank you