Agenda item

The Committee considered the report of the Director of Public Health that updated Members on the 0-25 Family Health Service workforce and service delivery across County Durham (for copy of report, see file of minutes).

The General Manager 0-25 Family Health Service was in attendance to present the report and advised Members that they had just been notified that they had received a silver award for their wellbeing priority and were now aiming for gold.

Councillor Hunt congratulated the service on their silver award. She then asked what the main issue was with the recruitment of health visitors. She then asked for the wait times for an appointment at the centres given that they were no longer a drop-in facility and how were they dealing with the issues surrounding dental care for children.

The General Manager responded that there were not enough health visitors trained nationally, the funding for the health visitor training came from Health Education North East. The service always asked for as many students as they could but there was limited funding. This year the Trust submitted funding for 60 places, but they only manged to recruit 42 places. They were trying to encourage Band 5 nurses to work in the community and become health visitors but, it was a very challenging role. She highlighted, that last week the Institute of Health Visitors were filming some of the health visitors delivering more complex work in the East of Durham to show elements of their profession and the rewards. There was a national shortage of health visitors with many suffering burn out and retiring as soon as possible. With regard to wait times for an appointment the Officer advised that sessions were held most days so the wait time for an appointment should be a week at the most. They did not provide dental services, but they would assist any families that were struggling to register with a dentist.

Councillor Walton commented that the recruitment of health visitors was alarming, but she was encouraged that some work had been carried out. She indicated that staff undertaking a Band 4/5 experience was good and achieving the silver award was brilliant then asked if there was anything that members could do to support and promote the work of the service. She then referred to the virtual delivery of services and asked if this was still an option and if they could still get opticians to go into schools to offer an “outreach service”.

The General Manager responded that they did continue to deliver some elements by virtual appointments, but they needed to carry out face to face visits in particular as part of the child health programme as they needed to see and interact with the child and commented that families wanted face to face visits. With regard to opticians in schools this was a commissioning decision and advised that there was currently a scheme running in special schools.

Councillor Gunn referred to dental services and how this service had deteriorated and commented that dentists used to go into schools, but that seemed to have gone and asked if they could put on any pressure to support dental inspections in schools.

The Consultant in Public Health responded that the oral health strategy was currently out for consultation, and she would share the link to the consultation with members of the committee and commented that dental services were a great challenge and the pandemic had impacted on the service. She would take back members comments to the Director of Public Health and the Health and Wellbeing Board.

Councillor Deinali referred to SEND and that it was encouraging to see focus on early intervention and asked what welfare support was offered to 19–25-year-olds who were in education and what support was offered to their families when the family benefits stopped when a child turned 19 years. She also pointed out that children with SEND could stay in education until the age of 25 years and unless you knew how to navigate the benefits system claiming support was difficult. She asked that they ensure relevant and robust information was provided for children with SEND, otherwise children were going into education without access to that support which impacted on their health and wellbeing. She asked what relevant support was in place.

The Consultant in Public Health responded that she would ask the SEND Lead to provide an example and circulate this to members of the committee.

Councillor Varty commented that it was sad that there were not as many health visitors and there was no continuity with health visitors and records needed to be kept of conversations that had taken place to alleviate the need to have to repeat to each health visitor as this was discouraging engagement with the service.

Mrs Gunn raised concerns about the vulnerable cohort of children not being reached, she acknowledged that there were school nurses in County Durham schools but what about children who resided in County Durham but had to attend schools outside of the county.

The General Manager responded that in relation to reach 100% of families were offered the service but not everyone would receive the same contact.

In relation to those children who attended school outside of the area the General Manager advised that there was reciprocal help from school nurses who work together with no boundaries. Mrs Gunn advised that there was a gap, and it was important to ensure that high risk families did not fall through it.

Councillor Gunn referred to paragraph 58 of the report and noted that five members of the team were trained to work with groups of children around emotional regulation and indicated that there were more challenging children in schools now than before and asked if the service were reaching all schools in the county and if there was the opportunity to increase the number of staff.

The General Manager indicated that there was an expansion of the training of staff planned. They currently reached 35 of the targeted schools but she did not think they could reach the 214 primary schools in County Durham.

Councillor Gunn commented that without something in place when pupil behaviour became so challenging this could lead to an exclusion for the pupil.

The Consultant in Public Health advised that she co-chaired the Children and Young People’s Mental Health Partnership and that there was an annual report and all partners worked to help build resilience. Members were advised that a report was planned for May 2023 around Children and Young People’s Mental Health and Emotional Wellbeing.

Councillor Reed referred to staffing in relation to 5000 health visitor shortage and that although 15 appointments were made only 10 had stayed and asked if there were support mechanisms in place for health visitors and staff who dealt with complex issues especially around safeguarding.

The General Manager responded that there was a single point of contact for any safeguarding concerns where they could talk to a Specialist Safeguarding nurse for advice and supervision. They also had one to one supervision with line managers on a monthly basis and had a supervision model in place and the facility to talk to a manger until 8.00 pm, they also had planned wellbeing activities.

Resolved: That the contents of the report be noted.