Agenda item

The Committee considered the report of the Director of Public Health to update Members on the 0-24 Family Health Service workforce and service delivery across County Durham (for copy of report, see file of Minutes).

Amanda Smith, General Manager, Harrogate & District NHS Foundation Trust was in attendance to deliver a presentation that provided details of the 0-25 Family Health Service County Durham; Key Highlights for 0-6 and 6-25 age groups; the Key Highlights of the Workforce and Key Challenges (for copy of presentation, see file of Minutes).

Following the presentation, the General Manager answered the questions from the previous presentation regarding breast feeding support and stated that they recently had five staff qualified as Lactation Consultants and they were currently ten infant feeding groups across County Durham and three early latch clinics. They were in the process of looking at the Lactation Consultants linking into the existing groups or if there was a need to set up a specialist clinic but there was one to one support available. The Lactation Consultants would not necessarily deliver every aspect of a care plan in relation to supporting a mum but would certainly agree the care plan with the mum and then the peer supporters would support that plan.

With regard to the concern around contacting the Health Visitor they were very much having to take a team approach in delivering care to families and indicated that on the enhanced parent support pathway there would be different professionals delivering on different elements it was an additional ten contacts to the eight Healthy Child Programme contacts. She understood the frustration that they were working on and indicated that the shortage of Midwives was across the board and they had some vacancies and agreed about communication with parents as to why it was not the same Health Visitor but they needed to be cautious and protect staff confidentiality.

Councillor Coult asked what they were doing to support young people and families who had become addicted to substance misuse.

The General Manager responded that for any referrals they received for any issues, they would undertake a health needs assessment with that young person. If substance misuse was identified including smoking, they would provide brief intervention and refer to the appropriate specialist service.

Councillor Scurfield asked if there were any issues in terms of oral health as they know that access to NHS dentistry was challenging and had being for a while and asked for an update.

The General Manager responded that they work closely with the County Durham and Darlington Foundation Trust Oral Health Lead, within the 0-5 cohort the Henry Team deliver sessions on oral health that had a good uptake and positive feedback. Within the school age it depends on what need schools but again they work closely with Public Health. They understand the issues within their home visiting and Healthy Child Programme contacts as every single contact directs you to check about oral health. Dentistry was a concern and they were currently undergoing a programme of oral health training but the issue regarding access to dentists was a different challenge.

Mrs Gunn referred to speech and language communication challenges and if this was as a result of staffing shortages. If staffing levels were fine in that area could the issue be around the time taken for referral timelines. She then referred to the ELIM (Early Language Identification Measure) test and asked what age this was measured against and if there were any possible gaps particularly with neuro diversity that may present later on in life, would it capture those children as well. She then referred to sleep and children who are neuro diverse and use melatonin for sleeping who were not able to access from the age of 18 and asked if there was any scope for providing support for that age group for the transition off melatonin into a really good sleeping pattern.

The General Manager responded in relation to staffing and speech and language and indicated that the Healthy Child Programme Contacts and the speech and language area was not impacted by staffing and receive the appropriate contacts at the appropriate time. She continued that the ELIM tool itself was only for use between two years and two years and six months so that tool itself was only for that period and was developed for that age range. Referrals would be made immediately after contact. She was not aware of the waiting times for speech and language but they would always carry out interventions first. For older children with speech and language issues, their last contact would be three and a half years pre-school. Should concerns develop at a later age, the service would work closely to identify such issues and signpost to appropriate treatment/support pathways. With regard to the melatonin issue, the service would work with young people and SEND and care leavers until they were 25. She referred to the Sleep Scotland programme which was available from 18 months until 19 and would check if it went any older. She indicated whoever prescribed the medication would carry out an exit strategy care plan around its use.

The Chair referred to the sleep pathways that was a good resource and asked if they offered any physical resources such as cots and mattresses to help the young mother.

The General Manager responded that through their early helps system, VCS links and Greggs Trust Fund if there was a lack of equipment, bedding or an appropriate mattress they would look at those avenues to source equipment for the child to sleep safely.

The Chair congratulated the team on their Silver Award and more recently the Gold Award and thanked the Officer for her presentation.

Resolved: That thecontents of the report and presentation be noted.