Agenda item

The Committee received a report of the Director of Public Health which provided details on the mobilisation of the new 0-25 Family Health Service for County Durham and delivery the healthy child programme, and the Best Start in Life (BSIL) programme of work (for copy see file of minutes).

Members received a joint presentation of the Public Health Strategic Manager – Starting Well, Harrogate District Foundation Trust (HDFT) General Manager County Durham 0-25 service and the Strategic Commissioning Manager –Public Health (for copy see file of minutes).

Members were informed that the service had expanded the age range from 19 years to 25 years to explicitly recognise the statutory responsibility to vulnerable young people.  When developing the 0-25 service it had been recognised that there needed to be a proportionate universal service together with targeted services to reduce known health inequalities.

The service had moved from a traditional model of service to a more varied workforce model, still encompassing traditional professionals and it was much more people focussed than topic focussed.  One of the key changes to the new contract was the more proactive use of digital technology, as requested by young people.

Members were advised that mobilisation of the new service was restricted by the COVID-19 pandemic and that there had been an extension of the timeline to the 1 April 2021.  A comprehensive training programme had begun in November 2020 and this would increase overtime.

The Strategic Manager – Starting Well, in relation to the Best Start in Life (BSIF) highlighted the plan for health impact assessments, using a robust framework that would bring partners together to provide evidence and reassurance of their effect.  This information would be monitored by the Children’s Integration Board.

Councillor Jewell asked what additional challenges had been placed on the system and asked whether the additional services which had been introduced had generated additional work and was there any extra capacity in terms of staffing.

The Strategic Manager – Starting Well, confirmed that the service planned to reduce some of the pressure in certain areas whilst recognising additional challenges.  The COVID-19 impact had restricted the ability to deliver some of the services due to loss of face to face contact, some of which had already reduced, such as the historical health promotion work which was still being done by working with partners as an integrated service.

The HDFT General manager County Durham 0-25 service advised that one of the key changes was that the integrated team included qualified school nurses, health visitors and practitioners which therefore meant they had the ability to deliver on the face to face intervention, giving more scope for the assessment of vulnerable families.  There was a concern with regards to babies under 12 months, during lockdown as there had been an increase in unintentional injuries and there was increased concern regarding perinatal mental health.  There had been a recruitment process which had not been straightforward during lockdown – there were some colleagues who were reluctant to change roles during a pandemic.

An example of where there was a more challenging demand on workforce was due to schools being closed for the majority of children.  Due to the Think Family approach health visitors went into family homes and looked at every child in the home environment and now they included school age children and therefore a visit for a regular check was turning into a whole family assessment.

The Chair was concerned with regards to children’s dental health as no routine checks were being carried out during the restrictions and she asked whether there were any plans to catch up on the huge backlog of patients.  The Strategic Manager – Starting Well confirmed that there were a lot of areas that would require a catch up, oral health was one of these key areas.  It was recognised there was a lot of inequality around oral health in County Durham, the service would be working closely with early years providers and health visitors to ensure that dental check-ups were caught up and encourage work with dental practices to ensure they were considering the safeguarding agenda when routine dental work resumed.

Resolved:

That the report and presentation be noted.