January 2016 Blog!






 Welcome to the Final Blog!

January 2016 and a new year brings us to the final publication of our Health Visitor monthly news.  As written in previous publications we have achieved so much in the east of England. This has been through exceptional team work with our partner provider organisations, universities and NHS England as the former service commissioners of health visiting. More recently we have had a very successful sessionwith colleagues from local authorities, which we hope will be the first of many.

Last Wednesday was the final meeting of the HV Implementation Group which has helped sustain and support us during ‘a call to action’ and beyond.  We asked colleagues at the meeting  and others that weren’t able to attend what the health visitor programme had meant to them and the families they work with and the quotes below are what they said.

On a personal note I am moving on to take up a post as Director of Health Improvement and Children’s Services with East Coast Community Healthcare CIC and I have been given the most wonderful send off by HV colleagues and the HEE – east of England Executive team and many others. The photo is just a few of the lovely gifts I have received.

The other current members of the HV Programme Team Sue Mills and Rachael Moore will also be finding new challenges in the months ahead and I wish them every success.  We have also caught up with former colleagues Jenny Gilmour, Helen Wallace and Rowena Harvey, all of whom continue to fly the flag for health visiting and community services. Finally I need to thank Kathy Branson, Executive Lead for Special Projects who has always championed health visiting and has been my line manager and role model for a number of years.  It was Kathy that started the work on ‘a call to action’ in the east of England so it is her lead that we have all followed.

I am sure our paths will continue to cross in the future.

With very best wishesIMG_0205


Julia Whiting

Health Visitor Programme Lead

We asked our colleagues what ‘A Call to Action’ had meant for them- this is what they said:

“An amazing four year programme to increase our HV numbers in Norfolk. Every single member of every team has supported and developed our new workforce. Well done for a great outcome.” – Maria Richardson, Head of Locality North and Broadland, CCS. 

“The HV Call to Action has raised the profile of health visiting. children and families now receive a true universal service which is delivered by motivated, enthusiastic and highly skilled health visitors. “

“Because of the increase in north east Essex from 33 to 74 wte HVs, we are now able to ensure our universal mothers and babies receive 5 planned visits, pre-birth to 2nd birthday. Previously the universal clients would have only received 2 visits unless additional visits were requested.”- ACE

“HVIP- 2011 – 2015 – The most fantastic opportunity for health visiting , children and communities. Providers have benefited from outstanding leadership and commitment from Julia Whiting and her team, which has been instrumental in enabling the changes.

The services are truly transformed with a clear evidence based offer. Our challenge is to maintain the momentum. “

“The Health Visitor Implementation Plan has provided for a well trained and responsive workforce. “

“The Implementation Programme has developed our service so much. Not least the workforce numbers are much improved. But, as importantly, our delivery has so much more quality now. Delivering on integrated 2 year review, a comprehensive, nurturing antenatal course and quality assessment and care for perinatal mental health is not only rewarding but the impact is obvious. Work like this has uplifted our HVs and re-energised their working lives. Important feelings if you want to make a difference to outcomes to children.”

“Implementation of the Programme has been challenging for us all; and  well worth it,  including all the training  commitments and the tight timescales.

Our HV service has  grown and developed significantly, and we are really proud of our highly skilled HV workforce. FPM, MECSH , Sustain and other related training has been invaluable. We have significantly increased the number of HVs in BB &T, and have developed even stronger working relationships locally; including with our commissioning and university colleagues.  The DoH 456 model affords a clear structure and framework for HV and really helps enable our clients, and the public as a whole, to understand the complexity of the HV role in improving health outcomes for children and families.”- Jo Lacey, (NELFT Essex Education and Training (SCPHN) operational lead throughout the duration of the HVIP).

Clare Slater-Robins, Deputy Lead for Nursing and Clinical Services, Suffolk County Council CYP Health; “The HV programme, for Suffolk, has increased our numbers; prepared them to deliver the HCP; given us opportunities to develop pathways (project 4 and the maternal mental health pathway); and enabled us to learn from other organisations. Thank you.”

“The past four years have seen tremendous change at such a rapid pace. The service we offer to children and families looks very different today and we are now able to offer more families responsive packages of care, we have introduced parenting programmes, new workshops such as introducing solids, post natal support groups and increased the number of families we see antenatally.

Our clinicians have been fantastic, coping with complexities of huge change such increasing the workforce, pressure from commissioning key performance indicators, diarising an increased training schedule, a new service structure whilst most importantly visiting the families with new packages of care.

We have introduced and embedded clinical observations which has enabled us to demonstrate the high quality service that is offered to families. It has also demonstrated the culture change from traditional assessment to in action consultations and identified the gaps in practice whilst sharing excellence.  Through the observations we have increased client feedback informing and shaping our service to be responsive. ” – Fleur Seekins, Clinical Lead – Healthy Child Programme 0 – 19; Fellow iHV.

“Rejuvenation of the Health Visiting Workforce with many Newly Qualified nurses coming into profession from Registration. “

“It has been an amazing opportunity to work with Health Education England and the various providers across the East of England to deliver the objectives of the Health Visitor Implementation plan. This opportunity to grow and modernise the service, to be fit for purpose in the 21st century and to meet the needs of our changing society has been unprecedented. 

The training of vast numbers of Health visitor students has been challenging and took all organisations on a steep learning curve in regards to changes required in recruitment models, changing the use of community practice teachers style from one to one engagement to that of a long arm model, whilst maintaining the quality, safety and governance to ensure robust practice. The process has given health visitors of experience the chance to step up and share their knowledge and have a taster opportunity to decide if practice teaching is for them.

The delivery of bespoke workshops linking theory and practice helped the local students form smaller group relationships and ask the questions they may not have felt able to ask in the university setting but also empowered those staff delivering workshops to reflect and grow

Whilst delivering against our trajectory for student training the entire workforce has also been undergoing significant CPD to move towards a stronger more evidence based practice, a partnership model of delivery, alongside revisiting and reinstating building community capacity and taking on new skills in practice.

Exhausting yes!  But exhilarating and exciting too!

Well done east of England.” – Carrie MacGregor, Assistant Director: Children’s Public Health Services, Provide, Essex    

 100 Day Challenge – Project Focused on the Achievement of Rapid Results Through Integrated Working

“June to October saw the West Essex 0-5 children’s services being involved in the 100 day challenge. This approach has been used in Essex over the last 9 months to promote integrated working and joint decision making.

The initial discussions focused on establishing project areas to work on which would have an impact on the whole health economy and work towards achieving targets set by commissioners and identified as a requirement through local and national strategies.

The group consisted of a Health Visitor Lead and Manager, General Practitioners, Family Solutions, CCG commissioners, local authority partnership leads, consultant paediatrician from Princess Alexander Hospital, community paediatric nurses, children’s centre managers, school nurses from PROVIDE.

The main project goal identified was to ” reduce inappropriate secondary care activity(A&E and outpatient referrals) at Princess Alexander Hospital by 50% for children aged up to 11 years old registered at the two identified Harlow GP practices.”

4 main work steams were set up to enable the group to look at different elements of this challenge and as a result multiple activities were put in place over the 100 day period which were considered to have a positive impact on the goal.

These work streams were focused around:-

  • Development of specialist outreach clinics with paediatricians, specialist nurses and community paediatric nurses.
  • Public and patient engagement sessions and questionnaires to help understand how families use health services, collect their views on telephone advice lines ,internet advice, use of GP/HV/Childrens’ Centres and the emergency department of the local hospital
  • Increased education sessions for families and professionals. extensive distribution of the Common Childhood Illness booklets and review of asthma and allergy pathways.
  • Increasing the use of specialist skills within the workforce and professionals working across their normal professional boundaries in order to fully utilize and disseminate this knowledge.

During the whole process all practitioners involved worked alongside each other, meeting weekly and ensuring all elements and activities identified to complete the project stayed on target.

The project was led by a CCG children’s commissioner and the Head of Universal Children’s Services in SEPT west Essex.

One of the key benefits to the project was promoting a model of leadership through enabling and supporting colleagues to share responsibility and authority by removing professional barriers and constraints. Staff were able to build functional working relationships and develop a team which worked confidently and effectively throughout the challenge period.

At the end of the 100 days a final review of the goal showed that in one of the practices referrals to paediatric secondary care had reduced by 50% and there was also a reduced attendance of 24% at the emergency department for the under 18 age group.

Many lessons were learned along the way- some of the key ones being:

  • We make assumptions that specific data will be available through computerised systems to enable us to accurately measure outcomes-this is not the case
  • Families use NHS 111 more frequently than the group had thought-with very positive comments from families with regard to advice and actions suggested.
  • Truly integrated working brings knowledge and increased skill levels in staff, improves communication, reduces duplication of activity and provides an environment which is able to support staff and bring about better experiences and outcomes for families.”

– Judy Hurry, Head of Universal Children’s Services-SEPT West Essex –

Email judy.hurry@sept.nhs.uk

Introduction of a bespoke red book in Essex… 

Earlier this year the four providers of health visiting services in Essex came together to streamline the red books as four different models had developed over previous years in the four service providers. The national book has been used as a base along with the best and most effective pages from the differing versions to create one bespoke book which will be adopted across Essex. Whilst we appreciate that an online book is proposed for the future there will be challenges in rolling this out and parents meanwhile have easy access to their own record.

The new shared record will enable consistency for the parents across Essex. The one record will also enable a financial savings to be made in regards to printing costs and the central ordering point of the Child Health Information system team will ensure stock control and availability.

By Caroline MacGregorAssistant Director: Children’s Public Health Services, Provide, Essex



Bridging the Gap in Public Health Nursing:


“Danish Association of Health Visitors presents the 4th International Conference in Public Health Nursing September 19th and 20th 2016 at Legoland Hotel & Conference Centre in Denmark.

The scientific Committee of the Conference has prepared a wide and varied Programme, which will include Presentations of different Sides of Public Health Nursing worldwide. The Programme contains many Topics presented by a range of Keynote Speakers. Governmental input and the public health Nurses own Experiences in four parallel Sessions: clinical, scientific, educational and management.”

Please click the following link: GNPHN 2016_6 to download the flyer.

Useful Information – updates and publications

PHE logoUpdated Service specification published 20 January 2016

Healthy child programme 0 to 19: health visitor and school nurse commissioning.

This service specification is for local authorities commissioning health visitors and school nurses, for public health services for children aged 0 to 19. Please click on the following link:  https://www.gov.uk/government/publications/healthy-child-programme-0-to-19-health-visitor-and-school-nurse-commissioning 


Online Learning: 

Vast amounts of learning material for health visitors and other professionals can be sourced on line. The E-Learning for Healthcare is website partnership between CPHVA, SAPHNA, Health Education England, E-learning for Healthcare, and Public Health England.  It provides over 95 free modules for health professionals including:

  • ASQ-3
  • Building community Capacity
  • Female Genital Mutilation
  • Domestic Abuse
  • Safeguarding children
  • Safeguarding adults
  • Mental health awareness
  • Perinatal mental health
  • Healthy Child Programme modules contain 76 sessions, each of 20 to 30 minutes duration, distributed across 12 modules, namely:
  • Healthy child programme basics
  • Communication, record keeping and inter-professional working
  • Family health
  • Safeguarding
  • Positive parenting and parenting issues
  • Development and behaviour
  • Speech, language and communication needs
  • Growth and nutrition
  • Immunisation
  • Health promotion
  • Screening
  • Health visitor model of practice
  • Also useful for health visitorsSpotting the sick child’ is a new interactive tool commissioned by the Department of Health to support health professionals in the assessment of the acutely sick child
  • Spotting the sick child – the disabled child
  • Spotting the sick child



New E-Learning Resource by Jill Beswick

Please click on the below link to view Viv Bennett’s Blog article on the  creation of a new e-learning resource to help health visitors and school nurses improve their understanding of children’s needs. It has six sections covering emotional well-being and mental health issues as well as looking at meeting the needs of children with additional health needs or disabilities.


CaptureNew online diagnostic support tool set to transform children’s health:

Paediatric Care Online, hosted by the Royal College of Paediatrics and Child Health, may reduce child deaths by ensuring children receive the best possible treatment before they become too unwell, say child health experts.

Launching today, an online decision support tool, providing specialist diagnostic advice for paediatricians, GPs and nurses, along with other healthcare professionals, will ensure children get the right treatment at the earliest opportunity – preventing delays in care and potentially reducing avoidable child deaths.

Child health experts say that Paediatric Care Online (PCO UK), hosted by the Royal College of Paediatrics and Child Health (RCPCH) and developed by a partnership group, could contribute towards reducing the UK’s 2,000 avoidable deaths each year by ensuring that the right children get referred to hospitals and other specialist services, whilst others are seen in more appropriate settings.

Through the use of Key Practice Points – decision support tools that cover common signs and symptoms and critical care situations – PCO UK will also help healthcare professionals feel more secure about which patients can safely be managed at home.

Dr Hilary Cass, Clinical Lead for Paediatric Care Online (PCO UK) and member of the Royal College of Paediatrics and Child Health (RCPCH), said:

“PCO UK will improve patient safety and reduce hospital admissions by providing healthcare professionals with immediate, professionally assured, evidenced based guidance together with a host of supporting reference materials and patient/carer information. This will enable professionals to diagnose early, treat, prescribe, or signpost timely referral to the most appropriate service.”

The initial development of PCO UK was funded by the Department of Health (DH) and it has been developed by a partnership group comprising of the RCPCH, the Royal College of General Practitioners (RCGP), the Royal Pharmaceutical Society (RPS), the Royal College of Nursing (RCN), the Institute of Health Visiting (IHV) and the American Academy of Pediatrics (AAP). It includes access to the British National Formulary for Children (BNFC), Public Health England’s Green Book on immunisations against infectious disease and the RCPCH child protection companion.

Commenting on how PCO UK will benefit GPs, Dr Maureen Baker, Chair of the Royal College of GPs , said:

“A quarter of a GP’s patients are under 19 years of age, so access to support tools like the Key Practice Points within PCO UK will provide valuable support when we are diagnosing and referring our young patients.

“This resource is easy to use and gives us quick access to the latest clinical guidelines and resources, which is very welcome at a time when GPs and our teams under intense resource and workforce pressures.”

To demonstrate the value of PCO UK to new potential users, healthcare professionals can receive free, open access, to the Key Practice Point on ‘fever’.

PCO UK will be included in RCPCH membership fees from January 2016, giving RCPCH members instant access to content.

To find out more or to subscribe to Paediatric Care Online, visit www.pcouk.org or click here for PCO Flyer A5 14.01.16.



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