1. Sefton 0-19 Service Healthy Child Programme
Anne Tattersall - Assistant Director
North West Boroughs Healthcare

2. NWBH Contracts - Sefton
Sefton Council (Public Health) and NHS England
South Sefton CCG /
Mersey Care (Sub-Contract)
0-19 Healthy Child Programme:
Health Visiting
School Nursing
Enhanced Nursing to replace Family Nurse Partnership
School aged immunisations
Contract start date
3 years with option for 1+1 year contract extension
Specialist Services:
Youth Offending Service
Looked After Children
Safeguarding
Community Equipment Service (Section 75 agreement with Sefton Council)
Phlebotomy
Walk-in-Centre (Urgent Care and Diagnostic Centre)
Contract start date
4 years with option for 1 Year contract extension

3. 0-19 Healthy Child Programme
Principles:
Child and family centred holistic approach
Focus on early intervention and protection
Universal reach but focused where needs are greatest
Flexible and tiered range of support
Underpinned by asset based approach
Commitment to co-work, co-locate, co-design, integrate and collaborate, driving delivery into community and third sector settings

4. 0-19 Healthy Child Programme Delivery of evidence Based Practice
4 Improving early years – a public health approach

5. Service Implementation
Initiated service review to integrate Health Visiting and School Nursing - whole person/family approach
Estates Review – immediate pressure and future fit - potential for co-location across partner agencies
Pan Borough Immunisation Service established
Enhanced Service Model - to replace FNP
Lancaster Model introduced
Breastfeeding Peer Support
Educational Leads appointed

6. 1. Integration of the 0-19 Service
Alignment of Health Visiting, School Nursing and Emotional Health & Well-being.
Integrated workforce to provide a service for the 0-19 population in defined geographical localities with a focus on the whole family.
Reduce duplication across the workforce and minimise multiple handoffs
Improve efficiency and experience of the children, young people and families.

7. 2. Estates rationalisation
Reducing existing estates from 13 to 7 bases:
North - Hampton Road Clinic, Southport; Hoghton Street, Southport
Central – Formby Clinic; Maghull Health Centre
South - Bootle Health Centre; Feelgood Factory, Netherton; TBC (Crosby/Bootle)
Each base to host an integrated 0-19 team including Health Visitor, School Nurse skill mix and administrative/clerical support.
Number of staff to reflect population size and complex needs of area, with dedicated team leader provision.
Set number of schools and GP practices for each base to aid communication and localised health offer to communities.

8. 3. Pan-borough Immunisation Service
NWBH Pan-Borough Immunisation team recruited to work across Sefton, Knowsley and St Helens Boroughs.
Dedicated Sefton staff to include:
4 WTE Immunisation Nurses
2 WTE Clinical Support Workers
1 dedicated Admin Support
The team delivers national immunisation programme requirements including new Fluenz delivery for reception and year 4 children.

9. 4. Enhanced Service Model
Enhanced Health and Wellbeing (EHWB) Service developed to replace FNP
Emphasis on early intervention, targeting high impact areas in line with the Healthy Child programme model
Ensures parity of esteem between mental and physical health and meets requirements of:
Future in Mind Policy (2015)
No Health without Mental Health Strategy (2011)
The National Service Framework (2004)
Every Child Matters agenda (2003)
Referral criteria, pathways and visiting plan developed following engagement with families and colleagues.
Self-harm pathway being developed to include school aged CYP and a pathway in collaboration with CAMHS, adult mental health and safeguarding
New pathways will see increased number of CYP receiving a comprehensive health assessment with a targeted approach to the most vulnerable.
Training and support on EHWB provided to school age nurses, underpinning and enhancing practice and providing better outcomes for children and young people.
Key partners include Early Help, Children’s Centres, Voluntary Sector, Midwifery, CAMHS and adult mental health services, substance misuse services , LSCB.

10. 5. The Lancaster Model (TLM)
Implemented across NWBH School Health services 2017/18
Structured programme to drive service improvement with emphasis on public health and early intervention
Health needs assessment completed by parents and children at key transitional stages – reception, Year 6, 9 and 11 through on-line portal (HAPI)
Highlight potential areas where extra support may be needed.
The School Nurse [SCPHN] reviews questionnaires to identify individual support needs and key themes for school.
SCPHN and Head Teacher devise bespoke school health plan to address 3 key themes.
Plan can be used to tailor PHSE lessons
Overall results can be used to inform future commissioning of services and workforce planning
Next steps:
Roll out Year 6 and Year 9 health needs assessments, followed by a year /19
Increase of skill mix within the school health teams as the service aligns to a 0-19 focus, providing school health with valuable Nursery Nurse skills
Development of bespoke evidence based public health plans for individual schools
School Health to have more contacts with young people and be in a position to intervene earlier to support families before they reach crisis point.

11. 6. Breastfeeding Support
Volunteer Ambassadors recruited to support women to breastfeed their babies
Information and support provided during the antenatal/ postnatal period .
Aim to increase initiation and duration of breastfeeding.
Progress since April:
25 volunteers trained and completed Level 1 Open Awards accredited training
Ambassadors providing breastfeeding support within 5 locations across Sefton.
Social Media Facebook page has 456 members with an average of 39 new members joining each month and 3 requests for help posted daily.
Ambassadors have recruited 33 new venues to the breastfeeding friendly scheme and all Sefton Libraries.
In addition, NWBH Infant Feeding Coordinator, appointed to work closely with the Breastfeeding Support Service.
Next steps :
Increase breastfeeding education across antenatal services
Actively promote across social media and community support provision
Encourage a balanced approach to support women to achieve their own infant feeding goals.
Achievement of UNICEF Baby Friendly Initiative in Sefton
Work in partnership with council to ensure all shops, service providers and organisations are aware of their responsibility under the Equality Act 2010 to not discriminate against breastfeeding and provide opportunity to display a Breastfeeding Friendly Sticker
Safe sleep: guidance to ensure mums have up to date information and resources to protect their baby’s physical and emotional well-being and reducing the risk of (SIDS)

12. 7. Educational Leads
6 educational leads appointed, 5 with Health Visiting qualification and 1 with School Nursing Qualification to work across 0-19 Service
Key areas of priority:
Audit
Pre-registration and SCPHN students – welcome pack for new starters
Perinatal mental health
EMIS recording
Skills analysis / competencies

13. Sefton Borough Leadership Team Who are we?
Contracts managed corporately:
Safeguarding ,
Looked After Children,
Youth Offending Service
Corporate Enablers:
People Services Directorate
Learning & Development
Human Resources
Finance and Performance
Information Technology
Communications
Kerrie France
Assistant Clinical Director
Anne Tattersall
Assistant Operational Director
Helen Moore
Matron for Quality
Surinder Goyal
Head of Service
Dr Rachel Williams
Lead GP
Dot Tinsley
Operational Manager 0-19 Services
Gaynor Rumsby
Urgent Care Centre Matron
Mirrors NWBH BLT structure
Infant feeding coordinator
0-19 Children's Services
Phlebotomy Service
Walk in Centre
Community
Equipment Stores
In partnership with Sefton Council

14. Any Questions?