The Chair asked for an update on the Healthy Child Programme from Claire Alp, Senior Public Health Specialist. The panel were informed that the Healthy Child Programme had undertaken a procurement exercise to commission a new contract. It was also explained that Covid-19 had impacted its delivery and mobilisation.The presentation provided Members with an update on how the services were impacted by Covid-19 and the plans going forward.
The two services - Health Visiting and the School
Nursing service under the Healthy Child Programme had previously
been commissioned separately. Carrying out the various checks such
as Antenatal check, new birth visit, 6-8 week check, 12-month check
and the 2-2 ½ year review, it then enabled various health
reviews and assessments to be made as well as informed support and
service to be offered to family and children.
In the previous contract only the New Birth Visit, 12-month check and the 2- 2 ½ year review were offered universally, therefore key elements in the re-procurement last year were coverage of the Antenatal check and 6-8 week check.
The officer explained to the Members that once children reach school age they transition into the School Nursing Service.
The part of the school nursing services that Local Authorities are mandated to provide is the National Child Measurement Programme (NCMP). There were also five health reviews as part of the school nursing service which were not mandatory however the service was looking to implement these as part of the new contract.
A service review carried out by the healthy child programme highlighted work around healthcare plans and training as well as and safeguarding as key demands on staff time. The officers highlighted they will look at how to take this forward.
The Annual Value of the previous 5-year contract was £2.595m; officers informed the Members that approval for additional funding was obtained ahead of going out to procure. The procurement exercise which started in May 2019 following the negotiated procurement route which enabled discussion and agreement around the uses of the additional funding in terms of providing delivery outcomes by the service moving forward.
In November 2019 Cabinet had approved the award of the 5 year contract with a potential two-year extension to NELFT - the incumbent provider,. Cabinet had also approved the additional investment in the 0-5 year element.
The new contract had commenced as of the
1st of April 2020 and the mobilisation phase plans
leading up to this included staff recruitment, preparation for
additional service delivery and finalising outcomes
measures and performance reporting
How the service has been impacted by Covid.
40% of Health Visiting and School Nursing Service staff were redeployed into Covid roles. National Guidance informed the prioritisation at this time of safeguarding, new birth visits, follow-ups of high-risk mothers/babies/ families and the offer of telephone or text advice.
Further national guidance published in June outlined priorities for restoration some of which are on hold e.g. the National Child Measurement Programme will not be recommencing until further notice across the country. Lockdown easing had seen staff return from redeployment in July.
Despite the significant impacts, NELFT was still
able to deliver the services through various methods such as
centralising services including admin and clinical duty and moving
towards a remote or virtual delivery model.
Q1- Cllr Patel: On the topic of virtual antenatal checks, do we have a pathway to identify complex cases and how is this done?
Answer: The service works closely with midwives who are based in our clinics delivering their antenatal checks; therefore, any mothers they have concerns about are discussed. Virtual antenatal clinics have been established for working mothers.
Q2 – Cllr Wise: On the topic of school nurses working with schools in order to shape the service offer in light of the way schools are operating under Covid-19 guidance –what have they actually changed and what are they looking to shape there?
Answer: The service has a range of offers, with some schools having virtual calls with teachers so that they can have a consultation with the school nurse and a CAMHS practitioner if they have any concerns. Drop-in sessions and a text-in service are also offered and there are planns to re-send a survey about how children and parents would want to receive a service.
Q3 – Cllr Durant: You mentioned a 40% relocation of staff due to Covid -19, in practice what sort of dip did this make on existing services? Presumably there is also a big backlog; can this be remedied quickly or not?
Answer: The service has have caught up on the backlog through August. In terms of school nurses, the impact was not very big. As schools closed those school nurses that remained behind focused particularly on vulnerable families and on safeguarding – in terms of health visiting this is a greater impact. However, we were able to ensure we met the needs of vulnerable families by carrying out essential work such as antenatal and health visits. As we are now in the restoration phase and health visitors have returned, we are doing more universal clinics etc.
Q4 – Cllr Durant:
What is the officer advice to schools, as there are
mental issues that can arise from isolation?
Answer: Officers conducted a piece of work on this issue and found that children aged 11-16 who had other social factors at home may have undiagnosed or suspected ASD or ADHD. We therefore made contact with this group across NELFT; parents had a list of things to look out for, and signposted children to where they can get help online.
The Sub-Committee noted the update.