Health visiting touches on the wider determinants of health, health improvement, health protection and reducing premature mortality. Councils have a responsibility for delivering all of these through the public health outcomes framework.
Councils are also responsible for delivering prevention and early intervention services that have an impact on wider determinants of health such as housing, welfare and the environment. They also deliver the support that wraps around children and their families. This ranges from social care support to short breaks, mental health support, children’s centres to libraries and leisure centres, parks to the arts and much more.
It is important to note that children in the most deprived areas are less likely to reach a good level of development by age five than those in the least deprived areas. Although many councils are targeting resources at the most deprived areas, these resources are limited.
Councils want to protect our world class health visiting service by attracting, training and keeping new essential workers. The LGA has offered to work with the Department of Health and Social Care, the NHS and Health Education England to get the right number of training places commissioned and to deliver policies to ensure health visiting remains an attractive and valued career.
We are calling for a properly resourced, integrated workforce plan that underpins the current refresh of the Healthy Child Programme. In addition to ensuring we have a sufficient supply of specialist public health nurses, a workforce strategy should recognise the benefits of having a diverse range of health visiting, school nursing, children’s centre and other early years staff in children’s and health services. We believe that this will lead to better outcomes for children and families
Councils need the flexibility to meet the public health needs and priorities of their local communities. Whilst the current five mandated health visitor checks provide an assurance for a universal service, they are rigid and do not necessarily reflect local priorities. Local joint strategic needs assessment and health and wellbeing strategies are the statutory tools that help identify the needs and priorities of local communities. They can also help to identify local health inequalities, gaps and pockets of deprivation and local strategies for tackling these. This is not something that can be done at national level.
In our recent report A Child-centred Recovery we outlined further recommendations to improve outcomes in the early years and wider children’s services:
- The Government should properly resource councils to enable investment in preventative universal and early help services to ensure that children, young people and their families receive the practical, emotional, education and mental health support they need, as soon as they need it, especially in relation to the long-term impact of Covid-19. Councils are innovative and adaptable, but we are approaching the point where there are no further efficiencies to be made, and no further innovations that can be cost-effectively delivered to protect local services.
- Dedicated action is needed to prevent the attainment gap from widening, including immediate work to stabilise the early years sector and support children and young people to attend school or to continue learning from home where required. The Early Intervention Grant has fallen from £2.8 billion in 2010/11 to £1.1 billion in 2018/19 – reinstating the lost £1.7 billion would provide a significant boost to early help services and the children and families who need them.
- The Government should review the early years system to ensure that investment supports its ambitions and that parents are clear on the best options for their children.