Rose Curtis gave a presentation on the commissioning of children’s CAMHS and maternity services.  Rose gave an overview of the changes in services over the last 3 years, which include a unified management structure, area based teams, an improved reach to vulnerable families and the establishment of the Family Nurse Partnership. New changes to be made to commissioning include the move to the National Commissioning Board and from 2015 the transfer to Public Health within the Local Authority.

Viv Harrison, Nurse Manager for Health Visiting, gave an update on National Policy Developments to Health Visiting arrangements.  Wirral was an early adopter of the new model by implementing the new model for 2012.

The new Health Visiting Services provides universal services to all families and more focussed intensive work with families.  Health Visitors are located around the Borough geographically based on need.  The Health Visitors deliver the Healthy Child Programme and make contact with women antenatally and at various stages throughout the first 2- 2½ years of a childs life.  There is a strong focus on maternal mental health, which impacts on levels of care and bonding between mother and child.

The service is doing well and the numbers of children being seen at 9-12 months and 2-2½ years is now almost 100%.  The Health Visitors also provide breastfeeding support; and access to services has been improved with a Healthy Child clinic and a “choose and book” system for appointments and evening parent classes.

Health Visitors receive training to enable them to deliver the HCP, including screening techniques and observation of parent and child interaction.Further developments include a move to a ‘paperless’ office and a move to electronic records.

Ann Buckley, supervisor of the Family Nurse Partnership, outlined the role of a Family Nurse (FN).  FNs work with families and young women, this service is offered to first time mothers under twenty, as these are the most at risk group.  They work intensively with young parents for the first 2½ years of the child’s life.  The FNs work to support young mothers with their parenting and external studies have shown that FNP intervention can lead to reduced levels child injuries, improved school readiness and an increase in levels of employment and paternal involvement.  The approach is a therapeutic alliance with the client with a focus on bonding and attachment.

Councillor Smith thanked the team for their presentations and hard work within the services.

Councillor Smith asked about the capacity issues at nurseries for children referred to the service.  Viv responded that the decision on place allocation is based on the vulnerability of the child.  Councillor Clements asked if this was a funding issue which should be addressed.  She asked to clarify the difference between the EYFS 2 year check and the HCP 2 year check.  Rose responded that work is undertaken locally to align these checks.

Dennis Charlton asked how fathers are engaged by the FNP and how that is embedded throughout services.  Ann responded that the mothers are the link to fathers and involvement depends on them.  Carrying on engaging young men is difficult and a possible gap.  There is also a lack of male workers across the health and social care arena.  Ann commented this was a challenge.

Julia Hassall added that the LA will be investigating further funding from Big Lottery, adding that the presentations were informative and showed how well the changes have impacted children in a positive way. She continued to say that evidenced based provision of services is key to efficient targeted support and the Trust should continue to work together to ensure services are shaped this way.

Caroline McKenna added that the engagement of men is a key challenge to all services. Rose noted that to get the best engagement comes with appropriately trained staff with solid supervision structures.

Councillor Smith thanked the visitors for their time.