Today, the government has published the Command paper which sets out the government’s response to the Health and Social Care Select Committee report on ‘First 1000 days of life’, published by the House of Commons in February 2019.

The iHV supported the recommendations set out in the Health and Social Care Select Committee’s report ‘First 1000 days of life’, which makes a clear case for early intervention and a strengthened national strategy for the first years of life. The government’s response today and renewed commitment to ensure every child has the best start in life is welcomed – although today’s response is, in many ways, a holding response as we await the results of the Spending Review, the publication of the Prevention Green Paper and Inter-Ministerial group on early years (Leadsom Taskforce) which will hopefully fill the many gaps in detail.

Today’s response recycles a number of existing policy commitments to improve maternity services, support Troubled Families and address the inequalities in early language. In particular, we welcome the renewed commitment to the ambitions of the Maternity Transformation Programme “for maternity services across England to become safer, more personalised, kinder, professional and more family friendly; where every woman has access to information to enable her to make decisions about her care; and where she and her baby can access support that is centred on their individual needs and circumstances.” It also calls for all staff to be supported to deliver care which is women-centred, working in high performing teams, in organisations which are well led and in cultures which promote innovation, continuous learning, and breakdown organisational and professional boundaries. We would welcome a similar ambition for health visiting services.

We are concerned that there is a notable absence of new policies for children and families once discharged from maternity services and limited national levers to reverse the current unwarranted variation in the quality and quantity of support that families receive based on where they live, rather than their level of need.

Ultimately the success of any programme will rest on sufficient resources being allocated nationally through a cross-departmental plan, and the Spending Review funding settlement for local government will have an important impact on whether wider improvements in population health and prevention can be delivered. We will continue to advocate for a strengthened health visiting service as set out in our recent letter to the Treasury.

 

Stop Press

Dr Paul Williams MP

The Institute is delighted to announce that Dr Paul Williams MP, Chair of the First 1000 Days of Life inquiry for the Health and Social Care Select Committee, is to address the Institute of Health Visiting conference – Health for All Children Now – on 9 May in Manchester.

Book early to avoid disappointment – and to get your earlybird ticket!

Earlybird ends 29 March 2019.

 

The Institute of Health Visiting very much welcomes the Health & Social Care Committee’s visionary report on the First 1000 Days of life – which calls for cross-government action to improve support and services for children and families in England and to reduce health inequalities in childhood through a range of actions.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“We know every health visitor will join us in being delighted that the Health & Social Care Committee’s six principles reflect our own health visiting priorities for offering effective early years services for every infant and reducing health inequalities.

“We particularly support the H&S Committee’s call for the Government to produce a long-term cross-government strategy for the first 1000 days of life to give every child the best start in life supported by joint NHS/Local Authority joint commissioning. We believe the vision could realistically be enhanced by adding an objective of reducing the number of children requiring referral to mental health services, something not unrealistic if the recommendations are implemented, and this would quickly demonstrate an economic benefit to the NHS from doing so.

“We also warmly welcome the report’s call for the Healthy Child Programme (HCP) to be revised, strengthened and given more importance in policy. We are pleased that an extra mandated contact at 3-3½ years by a health visitor is recommended to extend the current reach of the HCP and we continue to recommend there should also be an extra contact (home visit) at 3-4 months, and for these mandated contacts be seen as the minimum and to all be done by a health visitor.

“The report helpfully endorses most families’ desire to have continuity of care with a named midwife and health visitor and we welcome the call for strengthened links between obstetricians, midwives, health visitors and primary care services – this is so fundamental alongside continuity of care. Health visitors, who are often trained to master’s level are well placed to build relationships with families and identify those at risk of poor outcomes who would benefit most from targeted interventions. We fully support the strengthening of early identification of families’ needs during pregnancy, with provision available at all levels (universal, targeted and specialist). Movement between levels of intervention needs to be fluid as needs may change over time; some families only require short-term additional support whilst others require much longer-term input involving a range of partners, as so importantly stated in the report.

“The Committee’s recommendation that the Government uses the forthcoming Spending Review to focus public health funding towards early intervention for children and families is essential. This will also reduce future expenditure in later life for children requiring high levels of support which is the unfortunate cost from not acting early.

“We look forward to seeing how this report is accepted by the Government and hope that its recommendations could receive early endorsement if the ‘Prevention’ green paper takes a pathway approach from pregnancy to old age. We further hope that, if it attracts additional validation by the Taskforce led by Andrea Leadsom MP, its recommendations and framework for action can quickly be implemented, offering an early years building block to the Government’s new prevention strategy and creating some parity in the quality of early years services for infants across the UK.”

Find out more about iHV’s written and oral evidence to the inquiry

Following the collation of evidence for their Evidence-based early-years intervention inquiry , the House of Commons Science and Technology Committee has published their report and is calling on the Government to draw up a new national strategy for early intervention approaches to address childhood adversity and trauma.

The Evidence-based early years intervention Report urges the Government to capitalise fully on the opportunity that early intervention provides to transform the lives of those who suffer adversity in childhood, while also saving long-term costs to Government.

This is a very important and hugely interesting report which includes the call for secure funding for early interventions and also cites the Institute in one of the recommendations:

Recommendation 9.

The Healthy Child Programme is the only mechanism in place through which all children in England should receive early years practitioner support before the age of five. Its coverage is therefore critical for identifying ACEs and other child development issues early. The Government should review the current provision of the
Healthy Child Programme across England and set out, as part of the new national strategy, a date for achieving complete coverage in the number of children who receive all five mandated health visits. Given existing workforce pressures, the Government must ensure that this required increase in coverage does not negatively impact the quality of health visits. It should consult the Institute of Health Visiting on how this can be managed, and be ready to recruit additional health visitors as required.
(Paragraph 54)

The Committee’s Report identifies examples of early intervention working well around the country, but also the challenges that local authorities and their partners currently face in delivering effective, evidence-based early intervention. It concludes that the overall provision of early intervention in England is fragmented, with varying levels of support, focus on evidence, and success.

The Committee calls for a new national strategy to be drawn up to ensure that the opportunity provided by early intervention—to transform lives and save long-term costs to Government—is seized fully, and by all local authorities in England.

Yesterday, 13 November 2018, Dr Cheryll Adams CBE joined a fantastic group of leaders from the sector to give oral evidence to the Health and Social Care Select Committee into the First 1000 Days inquiry.

There were lots of discussions about the important role that health visitors can play and also lots of support from others giving evidence to the committee – making the case for early intervention, prevention, relationships and  babies in the First 1000 days. But key was that as a society we need to value early childhood and encourage and support parents in their role.

Cheryll’s oral evidence starts from 15:46 on the link to Parliament TV.

 

 

 

 

This oral evidence session follows the submission of written evidence from iHV to the committee earlier this year and published on the inquiry website.

 

 

 

The Institute of Health Visiting (iHV) has published its written evidence submitted to the parliamentary Health and Social Care Committee inquiry into the First 1000 Days of Life.

The bulk of public spending during a child’s life comes in their teenage years, but there is a significant case for investing public money much earlier – i.e. during a child’s first 1000 days of life. There is strong evidence showing spending then has many later benefits to individuals and society – the problem is the gap between that evidence and what is currently provided.  This inquiry is to review that gap.

Dr Cheryll Adams CBE, Executive Director, Institute of Health Visiting said:

“We welcome this inquiry into the First 1000 day of a child’s life. Evidence supports a specific priority for focusing spending on early intervention, prevention and inequalities as they affect children in the first 1000 days of life. We know that this would have a significant impact on their future health and development across the life-course. Investing more resources in the first 1000 days, would lead to less investment being needed for secondary and tertiary care in later life, by preventing problems (and increased costs of later healthcare) from occurring in the first place.

“Health visitors have highly developed skills in assessment and the formation of trusting relationships with families, each being critical to effective engagement with families in the first 1000 days.  Adequate resourcing of the service could be delivering enhanced and earlier support to prevent problems or reduce their impact and in so doing reduce later expenditure for the NHS.”

The parliamentary Health and Social Care Committee inquiry into the First 1000 Days of Life is not re-examining the evidence base, or the economic case. Instead it plans to focus on the following three key areas: national strategy, current spending and barriers to investment and local provision.

Dr Adams continued:

“On national strategy, we propose that the NHS should act with others to strengthen the governance of the Healthy Child Programme (HCP) across all partners.  This should be through joint integrated NHS and local authority commissioning within a national quality framework for systems-based practice for child and family public health.  That should realise the benefits of closer working both with NHS child health services and primary care, alongside local authority services such as children’s centres. In such a context, health visitors are well equipped to more realistically fulfil their long-recognised mandate to both deliver in practice and to lead the HCP at system level.

“On current spending and barriers to investment, we highlight the impact of recent reductions in public health funding and evidence of the impact of reductions in the resourcing of health visiting. We also recommend that health visitor caseload size should not exceed 250 children per full time health visitor or a maximum ratio of 1:100 in more deprived areas.

“Our written evidence submission lays out what the Institute believes a high-quality evidence-based approach to service provision would look like for the First 1000 Days of life if more spending happened during this period.  Health visitors, with their highly developed skills, are well placed and critical to supporting this agenda.”

The Health and Social Care Committee has launched an inquiry into the early years of a child’s life. The early years of a child’s life, from conception to age 2, is vital to their ongoing physical, mental and emotional health and development.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“This inquiry into the first 1000 days of life is an opportunity for health visitors to feed in their views of what needs to change to support infants during the period from pregnancy to age two.  Local evidence of good practice would be particularly helpful during these difficult times for the profession.”

Call for written submissions

The Committee would like to receive written submissions on the following questions:

1. National strategy

  • The top priorities for a national strategy, based on existing evidence and lessons from other countries, particularly the devolved administrations.
  • The current roles, responsibilities and functions across Whitehall, executive agencies and other non-departmental public bodies for the First 1000 Days, including suggestions for how these arrangements could be made more effective.

2. Current spending and barriers to investment

  • Recent public spending on services covering the First 1000 Days.
  • Difficulties in making the case for investment nationally and locally.

3. Local provision

  • The scope, scale and current performance of provision for First 1000 Days of life, including universal and targeted approaches.
  • Barriers to delivery (e.g. workforce shortages, financial constraints on councils)
  • What a high-quality evidence-based approach to service provision would look like for the First 1000 Days of life.

Deadline for written submissions is Friday 7 September 2018.

 

Targeted call for evidence (local councils and CCGs)

In addition to the open call for evidence above, the Health and Social Care Committee would also like to invite local councils and Clinical Commissioning Groups (CCGs) to supply evidence on what provision looks like for the first 1000 days across the country, along with the factors that have influenced the current landscape of provision.

The All-Party Parliamentary Group (APPG) on Social Media and Young People’s Mental Health and Wellbeing has today (29 June 2018) launched an inquiry to establish what actions must be taken both to tackle the negative impacts of social media use, and to maximise the positives for young people.

The inquiry aims to build on the work of the Royal Society for Public Health (RSPH)’s 2017 report, #StatusOfMind, which found that although social media use has many potential positives for mental wellbeing, such as maintaining friendships and providing a source of emotional support, for young people the impact is primarily negative, fuelling feelings of anxiety, depression, and ‘fear of missing out’.

Polling conducted by RSPH in April 2018 on behalf of the new APPG found that more than half of the UK public (52%) say not enough is being done by social media companies to address the impact of social media on mental health and wellbeing, with two in five (41%) also saying the Government is not doing enough. Four in five (80%) say tighter regulation of social media companies is needed, with almost half (45%) saying this should be done through a self-regulated Code of Conduct, and more than one third (36%) saying it should be legally enforced by Government.

The APPG’s inquiry aims to determine what should be contained in any such Code of Conduct, and how it should be enforced. It will also seek out and recommend other progressive and practical solutions that can help maximise the positives and mitigate the negatives of social media for young people.

The inquiry will be open to receive written and recorded evidence until 13 August 2018, with a number of oral evidence sessions to be held in Parliament in the autumn. The APPG hopes to engage with expert stakeholders including academics, charities, government officials, social media industry representatives, parents and young people themselves, in order to answer four broad questions:

  1. What is the latest evidence of the impact of social media on mental health and wellbeing?
  2. What constitutes a ‘healthy’ and beneficial relationship with social media for young people?
  3. What should be done by government and by the social media industry to address these issues?
  4. What solutions can be provided in terms of technological innovation and education?

Organisations and individuals interested in submitting evidence to the inquiry should download the Call for Evidence from the APPG website at www.rsph.org.uk/socialmediaappg.