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Pregnancy and Early Years

Sally Anderson
Healthy Child Programme Policy Lead

Central Hall, Westminster
Thursday April 2nd 2009

A healthy childhood is critically important

Children and young people are healthier than ever before

Supported by medical, technological, social and economic advances Helped by more information and support for parents and more skilled professionals To address inequalities, current trends and public concern

The past decade has seen continued improvements

But we need to do more to become world-class

The Strategy cements our standards and ambitions
Improving children and young people’s physical and psychological health, by investing in children’s health from the early years, through childhood and adolescence, will benefit children, families, society and the NHS.

Continued improvement to services to support families from pregnancy onwards
Support to parents to give their children a healthy start and partners to deliver change in every area Achieve long-term aims for children and young people’s health

Pregnancy and the early years School-age children Young people Children with acute and additional needs

World-class health outcomes Services of the highest quality Excellent experiences in using services Minimise health inequalities

Delivery systems Delivery systems transformation transformation

The Child Health Strategy cements our standards and ambitions Realising these ambitions will require partnership
Children and Young People The Strategy will help young people to make healthy choices.

Parents and Carers

The Strategy will help parents and carers to support their children’s healthy development.


The Strategy sets out how those delivering health services to children and young people will be supported.

From Child Health Promotion Programme to Healthy Child Programme
Following the publication of this strategy, the Child Health Promotion Programme will be renamed the Healthy Child Programme. The aim is to encourage parents to ask for and use those services that will promote their children’s health and wellbeing in the early years.

Support through pregnancy and the early years
A wide range of guidance and care is available for parents, babies and young children from before pregnancy through to the age of five delivered through Children’s Centres as well as GPs and other health settings. The core programme is the Healthy Child Programme:

Commitments to strengthen support in pregnancy and the early years
Health visitor workforce The expansion in the health visitor workforce to deliver the Healthy Child Programme for 0-5s, working with the NHS and the professions to promote recruitment and support professional development. A strengthened role for Children’s Centres through health-based programmes and each centre to have access to a named health visitor. The development and testing of a new Antenatal and Preparation for Parenthood programme for mothers and fathers. The expansion of the successful Family Nurse Partnership programme, providing intensive support for the most vulnerable first-time mothers with an interim milestone to cover 70 areas by 2011.

Role of Sure Start Children’s Centres

Antenatal and postnatal support

Help for vulnerable firsttime mothers

Action on Health Visiting Programme ● Launched in March by Alan Johnson ● In response to Lord Laming review on child protection ● Explores the role & competency of health visitors ● Looking at ways to improve training and recruitment ● Healthy Child Programme plays a key role in this agenda

The FNP journey
Small scale testing 07-10 10 wave 1 sites Large scale testing 08-11 20 wave 2 20 wave 3 20 wave 4 Evaluation 07/08 to 09/10 RCT 2b and wave1 Sharing the learning Roll out? 2011-19

Testing: Programme delivery, training, organisational and service context, workforce, commissioning, eligibility, recruitment pathways, roll out

FNP: what we have learnt so far……

We can deliver FNP in this country The materials work in this country It seems to be acceptable to clients We seem to be reaching those who benefit most Fathers are involved The nurses are highly committed The clients value their nurses The training is highly valued Early impacts look promising But it is difficult work and we have long way to go………

Pregnancy, Birth & beyond • Renewing how parents-to-be are prepared for pregnancy, childbirth and parenthood, using a progressive-universal approach • Current work - literature review, ‘market research’, scoping of existing practice • 2 strands to project
Universal model Antenatal and early postnatal preparation 09/10 – development of model and materials 10/11 – early testing and refining Progressive model Group-based Disadvantaged non-FNP clients Antenatal and up to 1 year postnatal, following FNP approach Early testing 09/10

Father involvement high

Young fathers show high levels of interest in FNP, and many want to be present for visits or complete the activities Out of 7500 visits, father present for 1820 visits 49% of clients, father present for at least one visit, most commonly for one to two thirds of visits

What are the actions that need to be prioritised to deliver the commitments identified in the pregnancy and early years chapter? What specific issues need to be picked up in the cross cutting workshops this afternoon to enable delivery for pregnancy and early years? What are the opportunities for integrated delivery through the following programmes and settings? - Family Nurse Partnership - Children Centres - Healthy Child Programme