The King’s Fund calls for more health visitors

iHV welcomes today’s briefing from The King’s Fund which considers current state of health and care services for children and lists 10 actions that the government can take to improve children’s health.

The briefing was produced in response to growing concerns for children’s health and wellbeing which has declined in recent years, with children in the UK experiencing some of the worst health outcomes in Europe. Many lifelong health issues are established in childhood and, unless strong and meaningful action is taken to change course, the current generation of children is set to become an unhealthy generation of adults.

The King’s Fund makes it clear that improving children’s health will take comprehensive effort across all of society. The government has committed to raising ‘the healthiest generation of children in our history’, and this King’s Fund briefing focuses on a list of actions that the government should prioritise.

One of the actions for the Department of Health and Social Care is focused on addressing shortages in the child health workforce. Demand on the child health workforce has continued to increase at an unprecedented rate. Combined with shortages across the children’s workforce, ranging from midwifery and health visiting to consultant paediatricians, school nurses and allied health professionals, this means a record number of children are waiting to access health services. Children’s health services have witnessed underinvestment and reprioritisation at system and local levels, with a gap between research and innovation for adult health services and children’s health care. Children’s health services are also frequently out of the scope of government investment.

The King’s Fund is calling for a whole-government approach across all departments to support national prioritisation of children and young people’s health, including greater focus on prevention.

Today’s briefing outlines 10 actions that the government must take to turn the decline in children’s health around and help to create a healthier generation of children – including a recommendation supporting health visiting, urging the government to:

“Place a stronger focus on addressing the shortages in the child health workforce (including in school nurses, health visitors, midwives and consultant paediatricians), and improve staff retention across the medical, nursing and allied health professional specialist children’s workforce when reviewing the NHS Long Term Workforce Plan”.

The King’s Fund said:

“Children’s health has been heading in the wrong direction for too long; the need for change is urgent and requires a multifaceted, multi-system approach. The government has a pivotal role to play in ensuring that every child has a healthier childhood. Adopting the recommendations outlined in this briefing would go a long way to turning the tide and creating a healthier generation of children that is able to reach its full potential.”

Alison Morton, CEO at iHV, commented:

“Today, the highly respected King’s Fund has added their weight of support, calling for more health visitors in their briefing – and we are indebted to them for their advocacy and support for our profession. This comes hot on the heels of a call earlier in the week from the Centre for Mental Health calling for the government to train and employ more health visitors! And a long list of other high-profile organisations and think-tanks with the same message – we need more health visitors to improve child health!

“We hope that the government will heed the collective wisdom and advice of so many, and honour its manifesto commitment to strengthen health visiting and turn this into reality.”

Read the briefing and its 10 recommendations

iHV welcomes new IPPR briefing: Hitting the Poorest Worst?

iHV welcomes the new Institute for Public Policy Research (IPPR) briefing: Hitting the Poorest Worst? which investigates how cuts to public health budgets have resulted in substantial cuts to services, particularly among the most deprived communities in England.

Dr Cheryll Adams CBE, Executive Director iHV commented:

“This timely report from the IPPR provides further evidence that the current arrangements for funding and delivery of preventative public health services for children and families is not serving them well. Relentless, year on year budget cuts are hitting the poorest hardest. We join with colleagues across the sector calling for urgent action to establish sustainable and fairer funding mechanisms to ensure that the rhetoric of giving every child the best start in life is translated into action to make the difference.”

The briefing shows that £1 in every £7 cut from public health services has come from the ten most deprived communities — compared to £1 in every £46 in the ten least deprived places. This has meant that the total cuts in the poorest places have been six times larger than in the least deprived. Those partners with specific interests should refer to Table 1 in the report and see the service-level breakdown of cuts.

Download IPPR Briefing – Hitting the Poorest Worst? How public health cuts have been experienced in England’s most deprived communities

iHV welcomes PHE/COHIPB briefing on breastfeeding and dental decay

iHV welcomes PHE/COHIPB paper on breastfeeding and dental decay, and the statement below from Dr Jenny Godson MBE, Chair of the Child Oral Health Improvement Programme Board.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“Health visitors will be very pleased to have this clarity.”

There have been a number of recent queries received by Public Health England (PHE) and the Child Oral Health Improvement Programme Board (COHIPB) with regard to policy and guidance on breastfeeding and dental decay.

The briefing paper clarifies current evidence and guidance.

Key points from the briefing are:

Dental teams should continue to support and encourage mothers to breast feed
Not being breastfed is associated with an increased risk of infectious morbidity (for example, gastroenteritis, respiratory infections, middle ear infections)
Breastfeeding up to 12 months of age is associated with a decreased risk of tooth decay
Exclusive breastfeeding is recommended for around the first 6 months of life. Complementary foods should be introduced from around 6 months of age alongside continued breastfeeding.
The prevalence of breastfeeding in UK is low with 34% of mothers still breastfeeding their child at 6 months with only 1% exclusively breastfeeding
Further advice for dental teams can be found in Health Matters: Child Dental Health and Delivering Better Oral Health (2014)

With regard to the recent British Society of Paediatric Dentistry (BSPD) position statement on infant feeding, it supports breastfeeding and seeks to provide individual level preventive advice to all. With regard to the small proportion of parents who continue to breastfeed after 1 year, the statement advises that with diversification of the infant diet to include foods and drinks other than breast milk or infant formula, the risk of dental decay changes depending upon the free sugar content of the complementary foods and drinks, and how frequently such foods are consumed and access to fluoride through the commencement of tooth brushing with fluoride toothpaste. The BSPD statement recognises these confounding issues, and advises careful consideration of all factors and individual patient counselling.

There is evidence of benefits to child health including oral health from breastfeeding however levels of exclusive breastfeeding at 6-months remain very low (1%). PHE and BSPD agree that dental teams have a key role to play in supporting and encouraging mothers to breastfeed.

Download PHE briefing on breastfeeding and dental decay

Dentists’ Briefing Resource

Please find enclosed some information about the Be Food Smart App developed by the PHE marketing team – It follows on from the Sugar Smart App that was well received. This was sent out to dentists to encourage their involvement.

Dentists' Briefing resource

Letter sent to dentists to encourage their involvement

Watch PHE’s film about the Be Food Smart app and see how much sugar, sat fat and salt is really inside your family’s food and drink.

New addition to “Why a HV?” series – new birth visit

The iHV is delighted to share a new addition to complete its very popular “Why a HV?” series of briefings around the 5 mandated visits.

“Why a HV?: New Birth Visit” covers knowledge and skills to support the second of the mandated visits. The new birth visit is part of a series of reviews that health visitors undertake in the context of a valued relationship of trust established with parents from before the birth of their child and based on their knowledge of the family and community, as well as their direct assessment of their child’s development at this critical stage.

The review therefore requires knowledgeable and skilful assessment, observation and relational skills to identify and act on any concerns, and to promote positive health and developmental outcomes amongst which are: High Impact Areas 1, 2, 3 and 5.

These excellent briefings, written by Dr Robert Nettleton, can be used by Service Leads who are redesigning their service specification with their local commissioners.

Download briefing - Why a HV?: New birth visit

See the full set of Why a HV? briefings - available under the For Health Visitors/School Nurses/Leads section

New – iHV Local Authority Briefing (9): The Health Visiting contribution to Child Accident Prevention

Local authorities are charged with commissioning children’s public health services as part of a wider remit for children’s services.

This new briefing for commissioners of children’s services provides an overview of the central role that health visitors play in reducing unintentional injuries in the under-fives, along with the associated high personal and financial costs to children, families, communities and society.

Unintentional injuries in and around the home are a major cause of death and disability among the under-fives in England.

Local Authority Child Public Health Briefing (9): The Health Visiting contribution to Child Accident Prevention

Please share this Local Authority Public Health briefing with your local commissioners – along with the other briefings in the series (under the “For commissioners” section on the link below).

Working in partnership with your local authority