Transcript Slide 1

Public Health
School Nursing Review
Marmot Review of Health Inequalities
“Giving every child the best start in life is crucial for
securing health and reducing health inequalities
across the life course. The foundations for
virtually every aspect of human development –
physical, intellectual and emotional – are laid in
early childhood.
What happens during these early years, starting in
the womb, has life-long effects on many aspects
of health and well being – from obesity, heart
disease and mental health, to educational
achievement and economic status”
It’s not just about Early Years…
“The effects of poor health during the
teenage years can last a lifetime.
Keeping adolescents healthy is a
valuable investment in the nation’s
future.”
Chief Medical Officer 2007
What do CYP say they need?
• 'Someone you can go to with the kind of problems
we have, to treat you properly, listen to you, not just
sit back in the chair... confidentiality is important, and
the way you're treated.‘
• 'It's mainly just getting hold of information, that's the
hardest thing - you're not sure where to go,
especially if it's something you're embarrassed about
- that's what people are afraid of, that you might be
laughed at, so people don't try.'
Local vision
“We want Nottinghamshire to be a place
where children are safe, healthy and happy,
where everyone enjoys a good quality of
life and where everyone can achieve their
potential.”
Nottinghamshire Children, Young People and Families Plan 2011 to 2014
WHY HAVE A REVIEW?
Big Changes
Impact on school nursing
• Responsibility for
commissioning public
health services for
children and young
people aged 5-19
• In the longer term all
public health services for
children and young
people
• Immunisation and
specialist nursing care for
children become the
responsibility of NHS
Commissioning Board
The Purpose
To gain evidence to shape the
commissioning of Public Health
nursing services from 2013/14
onwards (including school
nursing).
Principals of the review
• Services should be based on need not
historic demands
• Services should be evidence based in
terms of provision and impact and where
evidence is lacking seek to develop it
• Views of all stakeholders (including
children and young people) should be
taken into account
Included
• The core Public Health offer to school
aged children aged 5 to 19
• Provision of service to school aged
children whether at school or not
• The whole of Nottinghamshire (including
Bassetlaw)
Excluded
• Specialist nursing care in special schools
(though the core public health offer to
special schools is included)
• Vaccinations and immunisations (this will
be the responsibility of the NHS
commissioning board.)
What are we doing now?
• Pulling together data by district and school
family to identify the level of health needs
• Getting the views of key stakeholders
about school nursing
• Pulling together views of children and
young people on what they want from
school nurses from national research and
local survey data
DAY IN THE LIFE
IDENTIFYING PUBLIC HEALTH
NEEDS
Scale of the challenge in
Nottinghamshire
• 135,500 children aged 5 to 19
(~17% of population)
• 10% from a Black or Minority Ethnic Group
• 17% of children live in poverty
• 346 schools
– 284 Infant/Junior/Primary
– 51 Secondary
– 11 Special schools
Reaching children and young
people
• 4,410(4.8%) of children and young people
are persistently absent from school
• 1,210 (4.5%) young people aged 16 to 18
are NEETS
• 110 permanent exclusions in 2010/11
• 4,870 fixed period exclusions in 2010/11
Medical Issues
• 70 children/young people with Cystic Fibrosis
• 70 children/young people with Sickle Cell
Disease
• 240 children/young people with Crohn’s
Disease
• 360 children/young people with Diabetes
Mellitus
• 280 children/young people with a neoplasm
such as leukaemia
• 10,690 with asthma
Source: Nottinghamshire JSNA
Safeguarding
• 593 Looked after children
• 297 children referred to social care in
September 2012
• 426 Children on a child protection plan
Wider determinants of health
Variations in Poverty
25%
% children in poverty
20%
15%
10%
5%
0%
Ashfield
Bassetlaw
Broxtowe
Local Authorities
Source: HMRC 2010
Gedling
England
Mansfield
Newark and
Sherwood
Nottinghamshire
Rushcliffe
Child poverty
Variation in Rushcliffe
70.0%
60.0%
% Children in poverty
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
all children
Rushcliffe
Child poverty
Variation in Mansfield
70.0%
60.0%
% Children in poverty
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
all children
Mansfield
How are using the data
• Looking at data from the children's JSNA
• Building a profile of public health indicators
by school family and district
• The data will support commissioners and
providers in targeting areas of high need.
NATIONAL DRIVERS
National Guidance
Getting it right for children,
young people and families
Promoting services,
working with the
community to promote
and protect health
Healthy Child
programme
Early
intervention
and
signposting
Additional services for
vulnerable children,
young people and
families working with
partners