The Health and Care Act 2022 was given Royal Assent today and puts children at the heart of NHS integrated care. The Health and Care Act 2022 will change the way that services are planned and delivered by the NHS, local authorities, and other key organisations.

 

The iHV has been a member of the Health Policy Influencing Group (HPIG) which is hosted by the National Children’s Bureau (NCB) and the Council for Disabled Children (CDC). HPIG membership spans across 70 leading organisations who represent a strong, independent voluntary and community sector voice for babies, children, and young people (CYP) aged 0-25 years. After nearly a year of collaboration, determination and hard work, babies and CYP are now at the heart of the Health and Care Act reforms.

 

Members of Health Policy Influencing Group (HPIG)

Alison Morton, iHV Executive Director, said:

“Today’s Royal Assent of the Health and Care Act is a cause for celebration, representing a significant step towards improving health legislation for babies, children and young people. We were delighted to work with others as part of the Health Policy Influencing Group and support the drafting of the amendments to the Bill as it progressed through Parliament. This positive movement for change has been instrumental in bringing greater recognition of children’s needs (including babies) within the final Act. I would like to thank colleagues at the NCB who do a brilliant job leading the HPIG and all the members of the group that were instrumental in making these changes.”

The Act introduces two-part statutory Integrated Care Systems (ICSs), comprising an integrated care board (ICB), responsible for NHS strategic planning and allocation decisions, and an integrated care partnership (ICP), responsible for bringing together a wider set of system partners to develop a plan to address the broader health, public health, and social care needs of the local population.

The most significant change relates to the expectations of the 42 ICBs that are replacing Clinical Commissioning Groups (CCGs) across the country from 1 July. The Act sets out the steps it will take to address the needs of babies and CYP under the age of 25 in their five-year forward plans.

Further positive changes include:

  • New statutory guidance, which will be produced by NHS England, will require ICBs to nominate an executive children’s lead, responsible for ensuring the ICB sets out clearly the steps it will take to address the needs of babies and CYP.
  • NHS England issuing statutory guidance which will include a statement that each ICB must nominate an executive children’s lead, ensuring leadership for babies and CYP on every ICB.
  • ICBs reporting annually on how they are delivering their child safeguarding duties.
  • Steps to improve information sharing to better support children and keep them safe. The Government has acknowledged serious and distinct challenges around the sharing of timely and relevant information about children between agencies, particularly vulnerable children, and has committed to delivering change in this area. The Government will now lay a report before Parliament within a year, setting out:
    • A policy on a consistent identifier for children and its approach to improving information sharing more generally.
    • How this can be achieved across health, children’s social care, police, and education settings.
    • Cross-government actions that will be taken to implement the policy set out in the report.

Much more work is needed in this area and HPIG plans to support the implementation of this, alongside more detailed policy development. However, the Act represents a fantastic achievement, ensuring that babies and CYP are at the heart of integrated care, and this is something which needs to be celebrated!

The iHV would like to express a heartfelt thank you to the NCB and CDC for leading this important work. We are proud to be members of the HPIG and look forward to continuing our work as part of this group, providing a united voice for babies and CYP, now and in the future!

If you missed out watching the Petitions Committee debate on the impact of Coronavirus on maternity and parental leave on Monday afternoon, then don’t worry the links are below for you.

There were powerful speeches in the debate including the opening speech by Catherine McKinnell, Chair of the Petitions Committee and other MPs.

You can watch the session on Parliament TV or read the transcript (there were 22 mentions of health visitors).

 

The Petitions Committee has scheduled a debate on the impact of Coronavirus on maternity and parental leave – taking place this afternoon (Monday 5 October) from 4:30pm and Catherine McKinnell MP, Chair of the Committee, will open the debate.

The debate will be available to watch online here.

Following the Prime Minister’s appearance in front of the Liaison Committee last week, where the Chair asked him about the Government’s response to the maternity report, the Committee has written to the Prime Minister to ask him to read the report and respond before the debate.

You can read the letter here: https://committees.parliament.uk/publications/2698/documents/26693/default/

Watch the Chair question the Prime Minister at the Liaison Committee session here: https://youtu.be/mv8SXHGIgWQ?t=1815

The Committee has also written again to Paul Scully MP, Minister for Small Business, Consumers and Labour Markets, to ask for an update on his department’s plans for meeting with representatives of the baby group sector. In the letter, the Committee highlights how the new restrictions on meetings of more than six people have caused further confusion to this sector, and requests urgent clarification.

You can read the letter here: https://committees.parliament.uk/publications/2699/documents/26695/default/

Yesterday there was a debate in Parliament on the First 1001 Critcal Days – the motion relating to the Inter-Ministerial Group on Early Years Family Support, opened by Andrea Leadsom MP.

We are delighted that health visiting got mentioned on a number of occasions. The work of the iHV and Cheryll got a particular mention by Tim Loughton (and a well deserved hear-hear for her tireless work to promote all the work that health visitors do- starting at 17:10:30 ) – with Tim also quoting from our statement.

Prior to the debate, iHV sent a position statement and briefing paper to several Ministers and MPs providing information and background on the services that health visitors are able to offer, and that have seriously disintegrated since 2015 and are now at tipping point – affecting the lives of generations of children.

 

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.

On Thursday last week (19 July), there was a debate on perinatal mental illness in Parliament. It was so encouraging to hear MPs and ministers talking about health visitors.

In an extract from the debate, Dr Paul Williams MP said:

Perhaps a little less well known is the dramatic fall in the number of health visitors. Since 2015, there has been a loss of more than 2,000—almost a 20% drop—so each health visitor has to work harder. I commend health visitors for the work they do but, overall, women are experiencing a drop in services.

He further added:

The disinvestment in health visiting is significant; there can be no solution to the problem while health visiting is not properly resourced.

We are grateful to the Minister for Mental Health and Inequalities, Jackie Doyle-Price MP, for sharing her very positive views on health visiting and the work of the Institute, following her recent visit to Manchester to find out more about health visitors and iHV PIMH Champions.

An extract from the debate – Jackie Doyle-Price MP said:

I want to come back to health visitors. I am a firm believer that health visitors are uniquely placed to identify mothers who are at risk of suffering, or are suffering, perinatal mental health problems and to ensure they get the early support they need. In fact, I visited the Institute of Health Visiting only a couple of weeks ago and heard a moving story from a new mum who had gone through a mental health crisis. It is striking that she had experienced all the feelings we have talked about—she felt there was something wrong with her, she could not bond with her baby, and she got more and more depressed and withdrawn about it. The other interesting thing about that case was that it was dad who felt utterly powerless to do anything. Only their relationship with their health visitor enabled them both to reach out for help.

I am under no illusions about the importance of health visitors. I was privileged to meet so many fantastic advocates for them as part of the NHS’s 70th birthday. They are our eyes and ears in so many ways, and they are our intelligence network in tackling adverse childhood events. I am full of praise for the important job they do in supporting new parents and families through a child’s early years. I am really pleased about the success of the Institute of Health Visiting perinatal and infant mental health champions training programme. Those 570 champions play a crucial role in spreading good practice and early identification of mental health problems.

Some hon. Members raised concerns about the decline in the number of health visitors. There was a substantial increase in the run-up to 2015, and there has been a fall since. I am bothered about that, so I will look at how we can encourage local authorities to alter that situation, recognising that in some areas local leaders have realised that health visitors can do so much more to deliver better outcomes for their communities. Blackpool, for example, has substantially increased the number of visits. I am really looking forward to seeing the outcome of that work, so that we can encourage that good practice in other local authorities.

 

Following the relaunch of the 1001 Critical Days manifesto on Monday 14 December, MPs took part in a debate on a motion relating to the conception to age 2, the first 1001 days, in the Commons Chamber on Thursday 17 December.

This very well informed MPs debate is worth reading/listening to.

Mother interacting with her baby daughter