Digital Channels Could Replace Some Child Health Visits in North Yorkshire

Proposed changes to the way public health services for children and young people are delivered across North Yorkshire are to be put out to public consultation.

The proposals are to carry on with the universal service for children under 5, but to focus on more tailored support for children and young people aged 5-19 and target support for families most in need.

Dr Lincoln Sargeant is North Yorkshire’s Director of Public Health

Dr Sargeant says the COVID situation has shown how digital services can be effective in health care and that some of the new technologies and working practises can be applied to the delivery of Child health care services.

The Healthy Child Programme is a child and family health promotion programme for children aged 0-19 years. Some of the services within it are for all children, such as health visiting, and some are targeted to those most in need, such as vulnerable families and children and young people with emotional health and drug and alcohol problems.

The Council currently commissions these services from Harrogate and District NHS Foundation Trust and is proposing a new, long-term agreement, with the Trust, to deliver these services across North Yorkshire.

Dr Sargeant, said:

“We are working with Harrogate and District NHS Foundation Trust to deliver the next stage of the Healthy Child Programme, which provides health visiting, support for children of school age and other prevention services to children and families.

“As we lead on public health service commissioning, we have been funding the programme and have been working with the Trust for a number of years to provide the service.  We are looking to continue that relationship for a longer term of up to 10 years. This will provide the opportunity to transform the way we provide services to children and families, and help closely align the programme with the Early Help Service run by the County Council’s Children and Young People’s Service, as well as other health services and community support.”

The Council and it's partners say they have needed to find new ways of delivering the Healthy Child Service in the face of a national reduction in public health funding.

Dr Sargeant continued,

“In particular, we must take account of the national changes in public health funding which will see a reduction across the board of around 15 per cent.  For us, here in North Yorkshire, that requires a reduction in our public health spending of up to £4m in the next few years. We will protect the Healthy Child Programme as much as possible and reductions to these services will be less than the overall cut to the Public Health Grant. We will have a universal and targeted service for children and it will continue to be our biggest single area of spend in public health.”

The proposals for consultation include:

• Mandatory visits to families with children under five at key child development stages will be co-ordinated by a qualified health visitor.
• At-risk under 5s and their families will continue to be prioritised, as they are now, with face to face visits where needed;
• Learning from how services have operated under Covid-19 restrictions, introducing a blended approach of face to face and online contact for families, based on robust assessment of the child and family’s needs;
• More integrated support from agencies across the health, education, social care and voluntary sector for children to be ready to learn and to address developmental concerns in children and young people;
• More prevention and early intervention activities to reduce childhood obesity focused on infant feeding and family diet and nutrition including breastfeeding and healthy weaning;
• A partnership approach to the prevention and management of risky adolescent behaviour including prioritising and improving emotional health and resilience
• Effective identification and management of the safeguarding of children and vulnerable parents or family members.

Dr Sargeant said:

“We will continue to deliver mandatory health checks for children under five years old and will continue to support new parents with a focus on those children and families most in need.  There will also be a focus on emotional resilience for young people.

“We are committed to continue delivering a safe and effective service that protects children and young people and contributes to them growing up well.”

Stuart Carlton, North Yorkshire’s Director of the Children and Young People’s Service said

“During the Covid-19 pandemic, we have had to make emergency changes to the way we delivered many of our face to face services for children, young people and families, we now have really strong learning about how to provide a safe and effective personal service via digital platforms which can be taken forward for the Healthy Child programme. This is one part of a multi-agency partnership approach to ensure that the right services are provided at the right time and in the most effective way to meet diverse needs across the county.

“The proposals would allow resources to be targeted at those most in need by employing some of these innovations.”

The programme will also work closely with Public Health England, clinical commissioning groups, primary care, NHS hospital trusts, voluntary organisations and community groups to ensure that children and families are supported to access alternative services, for the aspects of the current service that will no longer be delivered with the new service. 

Suzanne Lamb, Head of Safeguarding (Lead Nurse for Public Health and Quality) from Harrogate and District NHS Foundation Trust, said:

“While the Trust recognises that the future model will need to look very different to what is being offered now, we appreciate the opportunity to continue to work closely with North Yorkshire County Council in a longer term arrangement.

“This will ensure that effective services can continue to be delivered to children, young people and families in North Yorkshire, with wider integration of children’s services; more targeted support in relation to need and new ways of working including support via digital channels.

“We appreciate that this process means a lot of change for colleagues in the North Yorkshire service, and we are working hard to support them through it.” 

The public consultation will commence on 26 October 2020.