Agenda item

Briefing Note of the Director of Public Health

The Scrutiny Board considered a briefing note of the Executive Director for People regarding the Health Visiting Service, which was commissioned by the Public Health Department.  The report covered a description of the service, performance and the role of the service in leading CAF’s (Common Assessment Framework).  Coventry City Council became responsible for commissioning Health Visiting Services together with the Family Nurse Partnership Programme in October 2015. These contracts had previously been held with NHS England.

The health and well-being of children in Coventry was generally worse than the England average across a number of key outcome measures.  A number of high profile national reports (Marmot, Tickell, Field and Allen) had all highlighted the same issue: if you want to improve the life chances and health outcomes for children, you need to intervene as early as possible in a child’s life, with the biggest return on investment achieved through interventions before the age of two years.  Social ROI (return on investment) studies showed returns of between £1.37 and £9.20 for every £1 invested in the early years.  Public Health England were currently evaluating the return on investment for universal services, which would be published by March 2017.

Health Visitors were responsible for leading on the Healthy Child Programme, which was a series of mandatory reviews, screening tests and vaccinations for children aged 0- 5 years.  In addition to this, Health Visitors offer maternal mental health assessments, parenting support and advice on family health and minor illnesses.  They also carry out physical and developmental reviews which include advice on feeding, weaning and dental health.  Health Visitors provide a universal service to all families with newborn infants in Coventry. Through weekly child case meetings with Social Care, Midwives and Children Centre workers, Health Visitors share concerns and early warning signs picked up through their visits.  As a team, and alongside social care colleagues, a multidisciplinary decision is made about the appropriate response to each case (e.g. CAF level), reducing inappropriate escalation to social care and providing a joined-up response to the needs of the family.

In 2015/16 Health Visitors held an average caseload of 347 cases per Health Visitor.  The data from the first quarter of the financial year 2016/17 shows that there was generally good performance against the national Key Performance Indicators for this service.  Health Visitors have an important role in leading and supporting CAF cases.  Out turn data for the four quarters of the contract indicated that whilst Health Visitors were engaged and making a core contribution to CAF cases, the number of CAF cases newly initiated by Health Visitors was 73 in total during the course of 2015/16 year.  Although this appears low, this was a significant increase to the number held a few years ago.  Additionally, the health visiting service currently had a role in 425 recorded CAF cases.

The Scrutiny Board questioned the Cabinet Member and officers on the following:

·  The target number or average number of CAF’s Health Visitors could hold in the future

·  Training on e-cafs

·  Whether a Targeted Service could be provided rather than Universal

RESOLVED that

1)  the Scrutiny Board note the information provided in this report and seek follow up as we continue to develop a model that aligns with the Family Hub model and increases the Health Visitors’ role in leading on CAF cases

2)  The Scrutiny Board recommend to the Cabinet Members that the Director of Public Health and the Director of Children’s Services discuss how to calculate an average number of CAF’s it is appropriate for Health Visitors to hold