Agenda item

Attending for this item were:

Herefordshire and Worcestershire Health and Care NHS Trust

Sue Harris, Executive Director of Strategy and Partnerships

Sally-Anne Osborne, Associate Director for Children, Young People & Families

Louise Langston, Clinical Services Manager

Worcestershire County Council

John Smith, Cabinet Member with Responsibility for Health and Well-Being

Liz Altay, Public Health Consultant

Members were reminded that the Starting Well Partnership had previously been discussed by the Panel as the 0-19 Prevention and Early Intervention Service.  The tender for the new service had been awarded to the Herefordshire and Worcestershire Health and Care NHS Trust (HWHCT).  The service had launched on 1 April 2020 and from the start, the service had had to work in a different way, in light of the COVID pandemic.

Members received a presentation from the Clinical Service Manager, HWHCT.  The following main points were made:

·       Starting Well Plus was a service offering intensive home visiting to young mothers and families from other vulnerable groups.  A task and finish group had been established to review Starting Well Plus and improve the service going forward.

·       During the pandemic, face to face visits had been scaled back to only the most vulnerable.  Others were offered virtual contact, although some families were reluctant or unable to use this.

·       The pandemic had also had some positive consequences including the development of virtual breast feeding support and community support.

·       Members were told about the half term hampers which had been delivered to vulnerable families as part of the HENRY scheme which promoted healthy eating.

·       The families of children who had not re-engaged with school following the extended break due to COVID had been supported via a series of webinars for parents and young people provided by Parent Support Workers, School Health Nurses and CAMHS team members.

·       In response to the reduction in face to face contacts, the Health Visitor Telephone Advice Service had increased from one line to six.

·       The School Health Nurse Team was currently supporting the Worcestershire Local Outbreak Response Team (LORT).  School Health Nurses were also implementing the School Screener digital assessment system to gather information about pupils’ health in a Health Needs Assessment.

·       A working group of Early Years providers, Early Years Advisers and Health Visiting teams had been set up to pilot the development of an integrated two-year review with the aim of gathering a more complete, holistic picture of a child’s progress.

Members had the opportunity to ask questions and the following main points were raised:

·       In relation to the distribution of Henry half term hampers, a Member informed the Panel that he had funded cookery classes for families in his division, and it was important to ensure that suggested recipes were those that people were able to cook with the ingredients provided.  The half term hampers scheme was currently being evaluated and the effectiveness of the inclusion of recipes would be part of the evaluation.

·       In the light of the government’s recent decision to fund free school meals during the school holidays, a question was asked about what level of coordination there would be between different agencies.  The importance of creating a seamless, joined-up approach was noted.

·       A second Member noted the importance of cookery skills suggested that the lack of skills was not just a problem for vulnerable families.  She went on to highlight the importance of sleep for children’s ability to learn.  It was agreed that sleep was one of the fundamentals for education in any setting and confirmed that parents were given advice and guidance on this.

·       In response to a question about how the effectiveness of initiatives was measured, Members were informed that it could be quite difficult to obtain an evidence-based evaluation for community projects.  The views of families were gathered and the service was looking to develop the use of an outcomes star (an evidence based tool) for future evaluations.  It was important to be sure about what worked well and why it was working.

·       It was confirmed that, although some families may have missed ante-natal or 6-8 week checks due to COVID restrictions, women had continued to be supported by community midwives throughout.  All developmental reviews that were missed had now been completed whether face to face or virtually.

·       It was confirmed that participation in Starting Well Plus was voluntary and acknowledged that those who would benefit most were often a very hard group to engage.  Midwives would signpost families to the service and families themselves were sometimes able to engage other families in a form of peer support.

·       A question was asked about what support was available to children who may have put on weight during the long break from school.  It was confirmed that the Henry programme included practical advice on healthy eating and physical activities.  In addition, local leisure colleagues were able to offer advice on virtual activities and organised walks.  School health nurses also had a role to play.

·       The importance of developing a quality assurance framework in order to ensure that the impact of the service was as intended, was noted.  It was confirmed that quality assurance was in place but development of a framework was more challenging in relation to community projects.

·       It was confirmed that there had been an overwhelming response to virtual support for breast feeding and this was definitely something that would continue in the future.

·       If a family was identified as vulnerable but did not want to engage with service providers, it would be important for professionals to work together.  The family may have engaged with one agency who could suggest other support available.  Some families were more likely to respond to peer support.  If there were concerns, the service would involve colleagues from children’s social services.

·       The Panel was informed that volunteers and peer supporters were recruited in many different ways, most having already been involved as service users.  Training was provided and, although it was not currently accredited, the service followed the national volunteer standards and was considering purchasing quality standard accreditation.

·       The number of Henry hampers provided during October half term would be confirmed with the Panel following the meeting.

·       The Cabinet Member with Responsibility for Health and Well-being reminded Members that any service outsourced by Public Health would be subject to robust measures to monitor the service on a quarterly basis.  It was confirmed that the Health and Care Trust had its own Quality Assurance framework and ways of monitoring impact but, as commissioners, the Public Health team also had a robust and lengthy set of performance indicators.  The Trust and the County Council worked together to evaluate the effectiveness of services and develop them over time.

The Chairman thanked colleagues from the Herefordshire and Worcestershire Health and Care NHS Trust for their contributions.  A discussion on how to move forward would be held later in the meeting.