Public Health for 0-3 year olds
Why is the Trust interested in this work?
The Healthy Child Programme, launched in 2010 is still the national universal programme for children aged 0-19 and is the basis for health improvement, public health and supporting families.
Gov. UK website: Public Health Matters (2020) states:
‘Setting the foundations for health and wellbeing during pregnancy and in the early years is crucial to ensure we give every child the very best start in life as possible.
It is also important that support and access to effective interventions is continued throughout the school-aged years. New parents need to be supported as they make the transition to parenthood and have access to support when they need it most. This will help ensure their child can thrive and achieve – we want all children to be ready to learn at 2, ready for school at 5 and ready for life when they reach adulthood’.
Health Visiting is a cornerstone of the delivery of this Healthy Child Programme for 0-5 year olds.
The Government website (as above) goes on to say:
‘The care delivered by health visitor and school nurse teams and their community nurse colleagues has been and will continue to be an essential part of the response to and recovery from the pandemic, supporting families and communities through indirect impacts and ‘hidden harms’ especially in deprived communities and among the most vulnerable. The updated programme is timely as the public health nursing system endeavours to restart its work with the most vulnerable families.’
The Covid pandemic has indeed interrupted many of the preventative public health services, including for those aged 0-5, and in many areas Health Visitors were reallocated to other duties. Yet even before the pandemic the service was under very significant strain:
- There has been a sharp decline in the number of health visitors since they moved out of the health service and into the Local Authority public health offer in 2015.
- There is a steep decline in the number of Health Visitors in training.
- Government’s allocation of funds to Local Authorities for public health saw a 6.2% cut in the overall public health budget in 2015-6 and cost savings each year from then until 2020 of 3.9%
- There is no ring fencing for Health Visiting costs.
Alongside this there is evidence that the outcomes for children are not improving and in some significant areas, they are getting worse. The Royal College of Paediatrics and Child Health report: State of Child Health in the UK 2020, concludes (for England):
- No improvement in infant mortality
- Decrease in breastfeeding
- Decrease in immunisation rates
- Increase in obesity
- Increase in children on the child protection register
- Increase in looked after children
- Increasing level of children living in poverty (after housing costs)
Work the Trust is funding
Funding has been approved to support the Institute of Health Visiting (IHV) to halt the current decline in services that Health Visitors are able to offer. This has enabled:
- the appointment of a Policy and Quality Lead to support the work of the Executive Director at the IHV, as it looks to work with Government and the Treasury on the provision and funding of Health Visiting.
- funding for a 2 day residential for key IHV staff to allow them to plan future strategy.
- with fellow Trust, Kindred2 , funding of a research work, Rapid Evaluation of the Health Visiting Service led by Professor Gabriella Conti. This should report in summary in the Autumn 2021 and in full by the end of the year 2021.
Future funding by The Sylvia Adams Charitable Trust, in cooperation with Kindred2 , is likely to include a wider look at the public health offer for 0-4 year olds, specifically in England.