Health Committee: Government is missing important opportunities to tackle childhood obesity

The Government needs to take more robust action to tackle the impact of deep discounting and price promotions on the sales of unhealthy food and drink, says the Health Committee in its follow up report into childhood obesity.

The Government’s plan to tackle childhood obesity was published in August 2016. Although the Health Committee welcomes the measures the Government has announced on the sugary drinks levy, they are extremely disappointed that several key areas for action that could have made the strategy more effective have not been included.

The soft drinks industry levy

The Committee also calls on the Government to ensure that manufacturers pass on the cost of the levy to ensure that there is a price differential at the point of sale between high- and low- or no-sugar drinks.

The report welcomes the Government’s positive response to the Committee’s recommendation that the proceeds of the soft drinks industry levy should be directed towards measures to improve children’s health including through increasing access to school sports and to breakfast clubs.

Read full news story on Parliament website

New report – The performance of the NHS in England in transforming children’s mental health services

The Education Policy Institute has published a new report, The performance of the NHS in England in transforming children’s mental health services, which examines the progress made by the Government in improving children and young people’s mental health services (CAMHS).

The report analyses NHS England’s new ‘Mental Health Five Year Forward View Dashboard’, which tracks the performance of local Clinical Commissioning Groups (CCGs).

Dr Cheryll Adams CBE, executive director, iHV, commented:

“Clearly there is much to be done to improve child mental health services. Investing upstream into more preventative capacity, such as in health visiting, would help stem the flow of young people requiring help from these services.”

Key findings

When assessing the overall performance of children and young people’s mental health services, we find almost three quarters (73.2 per cent) of CCGs failed to meet NHS England’s own benchmark for improving services.
In order to meet NHS England’s standard for crisis care performance CCGs must have an agreed plan to develop better local services. However, across England, less than a third of CCGs (31.6 per cent) had a fully funded plan to improve crisis care, with one in nine CCGs (10.5 per cent or 22 in total) having no agreed plan or funding set out.
Government policy states that no one under 18 should be treated on an adult ward – yet children spent a total of 2654 nights on an adult ward between July and September 2016. This increased by over a third compared to the last quarter (April to June 2016), although it is not yet possible to establish whether this is due to fluctuation or a longer trend.
There is wide variation between CCG’s planned spending per head – with those in the top quarter spending over £52 per capita, while those in the bottom quarter spend just £23, or less. This suggests that there is a postcode lottery in children and young people’s mental health care.

Read report - The performance of the NHS in England in transforming children’s mental health services

iHV welcomes the results of the ‘Women’s Voices’ survey run by the Royal College of Obstetricians and Gynaecologists

Women with mental health problems during and after pregnancy reveal the impact of low rates of specialist referral, long waits, as well as lack of consensus over medication and little support for their partners, in a survey published today (22 February) by the Royal College of Obstetricians and Gynaecologists (RCOG) and supported by the Maternal Mental Health Alliance (MMHA).

The survey of over 2,300 women who had given birth in the last five years in the UK, explores their experiences of perinatal mental health problems, engagement with healthcare professionals and the quality of care they received.

Dr Cheryll Adams CBE, executive director, iHV, said:

“The Institute of Health Visiting, a member of the Maternal Mental Health Alliance, welcomes the results of the ‘Women’s Voices’ survey run by the Royal College of Obstetricians and Gynaecologists and launched today.

“This survey gives real life evidence on the level of support that women receive when suffering from perinatal mental illness (PMI) – and the variation there is in the level of services across the country. Health visitors are key healthcare professionals who are well-placed to identify and offer support to women suffering with PMI. However, our own surveys have shown that, although parents will turn to their health visitor for support, there is often insufficient time for the health visitor to offer the level of support required.

“We, at the iHV, deliver perinatal mental health (PMH) and infant mental health training to ensure standardised practice for health visitor professionals and the families they work with. Our PMH training has now been delivered to well over 10,000 health visitors and others across England. However, for this training to have the impact it should, more health visitors need the time to use what they have learnt to improve services, especially at the recommended contacts.

“Perinatal mental health is an incredibly important area of healthcare which can have a negative effect on the health and wellbeing of babies and families and ultimately on our society when we don’t recognise it early. Health visitors have always made a huge contribution to supporting pre-school children and their families and are the best-placed professional to help give all children the best start in life during the early years of life.”

Download Maternal Mental Health – Women’s Voices survey report

Read full press release from the Royal College of Obstetricians and Gynaecologists

New report from The Communication Trust

Professional development in speech, language and communication – new report from The Communication Trust.

Last summer, more than 1200 members of the children and young people’s workforce, including many health visitors, responded to a survey from The Communication Trust, which asked about their experiences of professional development in speech, language and communication (SLC). Their responses revealed that, although they were nearly unanimous in their belief in the vital importance of children’s SLC skills, there were significant gaps in their professional development in this area. The majority (53%) reported that they had had little to no initial training in typical speech, language and communication development, and 60% had little to no training in identifying and supporting children with speech, language and communication needs.

In England, there are likely to be at least two children in every primary school classroom with a clinically significant language disorder, and many more with delayed language development. The Communication Trust, in partnership with their consortium, works to maximise the impact of the voluntary sector and collaborate with government to devise effective solutions to improve the support that is provided to children and young people.

The Communication Trust has produced a report presenting the findings of their consultation with the workforce and offering recommendations to government and national bodies, local authorities and commissioners, the voluntary sector and training providers, and the workforce and service providers. Their recommendations were developed in consultation with their consortium and other key sector, practitioner, and academic partners.

Download Communication Trust survey report

Speech, Language and Communication Framework (SLCF)

The Communication Trust works to support the workforce in enabling all the children and young people they work with to communicate to the best of their ability through resources such as the newly updated and improved Speech, Language and Communication Framework (SLCF). The SLCF is a free online professional development tool which sets out the skills and knowledge that everyone working with children and young people need in order to support the speech, language and communication development of those they work with. The SLCF self-evaluation tool enables individuals and groups of practitioners to highlight their professional development needs and to find training, resources or information to ‘fill the gaps’ identified by the SLCF.

Find out more about the SLCF

If you have any queries on this, please contact [email protected]

Report: Helping parents to parent

iHV welcomes findings of RCPCH State of Child Health report

The Institute of Health Visiting (iHV) welcomes the findings of the Royal College of Paediatrics and Child Health (RCPCH) landmark report into the State of Child Health which calls for Government to introduce a comprehensive, national, child health and wellbeing strategy, reverse cuts to public health, and tighten controls over smoking, the sale of alcohol and advertising of foods high in fat, salt and sugar.

According to the report, a lack of strategic national focus and persistence of a wide gap between rich and poor in the UK is damaging the health of the nation’s infants, children and young people. Compiled by child health experts, with input from children and young people themselves, the report provides clear recommendations to improve child health.

Dr Cheryll Adams CBE, executive director of the iHV, said:

“The Institute of Health Visiting welcomes the findings of the report and fully supports all its recommendations. The snapshot of children’s health in the UK captured in this State of Child Health report is very worrying and upsetting. As a nation, we can’t afford to not invest in our children as they are our future, yet recently their needs seem to have become invisible against the many competing demands being made on government and the NHS. We know so much today with respect to what can influence children’s outcomes across their life course, and in turn benefit the whole country. It’s time to act, to help ensure the best health outcomes for all UK children today, and in the future, by giving them the best start in life. As an absolute priority and first step, the cuts to public health budgets must be stopped.”

The State of Child Health report brings together data for the first time on a comprehensive list of 25 measures of the health of UK children, ranging from specific conditions such as asthma, diabetes and epilepsy, risk factors for poor health such as obesity and a low rate of breastfeeding, to child deaths. The data provide an “across the board” snapshot of child health and wellbeing in the UK.

Nearly one in five children in the UK is living in poverty and inequality is blighting their lives, with those from the most deprived backgrounds experiencing much worse health compared with the most affluent. Despite some improvements in the health of UK children over the last decades, there is clear disparity with Europe and other developed countries, and major cause for concern.

Dr Adams added:

“We at the iHV will be working with the RCPCH to support their campaign to ensure child health becomes a key political priority, as only then will the prime minister’s aspirations for reducing inequalities become a reality.”

State of Child Health report:

Available on Thursday 26 January – www.rcpch.ac.uk/state-of-child-health

Read RCPCH press release

‘The economics of health visiting: a universal preventative child and family health promotion programme’ report launched

The Institute of Health Visiting (iHV) is delighted to announce the publication of its new report “The economics of health visiting: a universal preventative child and family health promotion programme”, which reviews the economic impact of early intervention services on the lives of children, families and society.

This is a member only document. Non health visitors who work in public health related areas may join the iHV as Friends to access all our documents. As a charity, the iHV relies on its member income to produce such documents.

Early intervention is taking action as soon as possible to tackle problems for children and families before they become more difficult to reverse. According to the Early Intervention Foundation (EIF), damaging social problems affecting young people such as mental health problems, going into care, unemployment and youth crime costs the Government almost £17 billion a year. However, research has proven that investment in early childhood development saves long-term costs and improves children’s outcomes – and the earlier the investment, the greater the return.

Dr Cheryll Adams CBE, executive director of the Institute of Health Visiting, said:

“The earliest years of children’s lives have a powerful influence on their subsequent development and health, with benefits both to themselves and to society that last beyond childhood – and health visitors play a critical role in these early years.

Our report shows that early years interventions, such as those covered by the universal health visiting service, deliver both social and economic benefits, including reducing long-term costs and improving outcomes, as well as increasing the economic productivity of the population.”

The focus of health visiting, an advanced and specialist public health nursing service, is the whole population of children in the foundation years (from pregnancy to age five). In particular, health visitors engage on a universal basis with the families of all children in the first ‘1001 critical days’ from conception to age two. This is described as the ‘age of opportunity’ (WAVE Trust, 2014) when the impact of social and other adversity can become biologically embedded in brain development – showing in a child’s social, emotional, cognitive and physical developmental outcomes.

Dr Adams added:

“Investing in an early intervention service, such as universal health visiting, reduces inequalities in the earliest years of a child’s life – giving all children the most important thing, the best start in life.”

Download The economics of health visiting: a universal preventative child and family health promotion programme report

iHV supports MMHA response to DH’s Safer Maternity Care report

The iHV supports the Maternal Mental Health Alliance’s (MMHA’s) response to yesterday’s publication of the Department of Health report ‘Safer Maternity Care: Next steps towards the national maternity ambition’.

MMHA highlights the mention of perinatal mental health in the report (on page 17) – but would really like to push for mums’ mental health to be embedded across all of the actions coming out of the report. Maternity safety is not just physical health: unless women’s mental health is looked after, their and their babies’ lives could also be at risk.

Dr Cheryll Adams, Executive Director iHV said:

“iHV supports the push by MMHA to keep maternal mental health at the forefront of the government’s drive to improve maternity care. We welcome the implementation of this plan, including maternal mental health, and call on the government to ensure that specialist mental health support is available in every maternity /health visiting service to provide support to every mother and her family who require this service.”

Dr Alain Gregoire, Chair of the Maternal Mental Health Alliance, commented:

“We welcome the announcement by the Secretary of State of a Safer Maternity Care action plan and the inclusion of improvements in perinatal mental health care in this. Mental illnesses are the most common serious health complications of pregnancy and the postnatal period, and a major cause of maternal death. There has been no sign of improvement in the effects of these illnesses on mothers and their babies in the past decades, despite significant improvements in physical health outcomes.”

Read Dr Alain Gregoire's full response and suggestions about how mental health could be embedded into the key themes and recommendations in the report

MMHA update: Independent Evaluation launch and funding announcement

As a partner and a member of the Maternal Mental Health Alliance (MMHA) operations group, the iHV is delighted to share this good news.

Launch of independent evaluation of Everyone’s Business Campaign

Today, Tuesday 19 July, sees the launch of the independent evaluation of the MMHA Everyone’s Business Campaign.

This evaluation highlights the substantial impact the campaign has had; the reasons for the impact, and where the campaign will need to focus in the future.

Please find below the direct links to the Briefing Paper (just two pages) and the full report:

2 page briefing paper, with a summary of the report's main findings

Copy of the full independent report

Please use #everyonesbusiness when mentioning in social media!

MMHA Everyone’s Business Funding announcement

Also, hot off the press, fantastic news! Comic Relief confirmed that the follow-up funding for the MMHA and the Everyone’s Business Campaign has been secured! See below:

A grant of £750,000 has been secured from Comic Relief. This is intended to:

sustain and build on the momentum of the first Phase of the Everyone’s Business Campaign
increase the Maternal Mental Health Alliance’s internal resource and capacity

The grant will continue to be hosted by Action on Postpartum Psychosis (APP) on behalf of the MMHA

MMHA says:

a huge thank you for all your on-going support – the outcomes of the evaluation and further funding is a reflection of how well the alliance has worked collectively.

Early Intervention Foundation publishes their Foundations for Life research report

EIF - Foundations for Life: What Works to Support Parent Child Interaction in the Early Years

This report seeks to look at the cost effectiveness of different programmes to support the development of healthy attachment. It is hoped to be of value to commissioners trying to decide where to spend their money.

Inevitably it’s been a challenging piece of work to do and some of the conclusions are being seen as controversial. For example, the originator and iHV ambassador of the MESCH programme in the UK, Professors Lynn Kemp and Sarah Cowley respectively, have been very disappointed at the fact that MESCH has been included in the attachment section, whereas it is a broad-based multi-faceted programme delivered as part of a universal service, rather than a targeted programme focused on attachment.

Please see their statement about the MESCH programme here

Dr Cheryll Adams, iHV director said:

“This report must be interpreted with extreme care. It was a very difficult piece of work to embark on and some of the recommendations will be seen as very surprising or disappointing. Indeed, there could even be an interpretation that it challenges the value of universal services, although that wasn’t at all its purpose.

We would challenge the report for promoting the commissioning of early intervention services to respond to overt problems which the EIF identifies as risk. This suggests intervention from age 2-3 years onwards, instead of the health visitor interpretation of early intervention where the recognition of risk is in the first year of life and intervening then when interventions can be most effective.

We must encourage commissioners to invest in services upstream of problems. Even if the evidence for the value of doing this hasn’t been invested in, there is a clear logic that prevention is better than cure. For example, how much better to pick up glue ear affecting hearing early, rather than speech delay and its social and emotional consequences at age 2½.”

We encourage health visitors to read the report and let us and the EIF know their thoughts on its value for strengthening commissioning to improve children’s lives. Also to be ready to challenge inappropriate commissioning decisions based on its findings.