Agenda item

To consider a report of the Executive Director Core Services and the Director of Public Health (Item 4a attached) in respect of Barnsley's Public Health Nursing Service including the Staffing Structure (Item 4b attached) and Role Descriptions (Item 4c attached).

The following witnesses were welcomed to the meeting:

Julia Burrows, Director of Public Health

Alicia Marcroft, Head of Public Health

Tracy Letchford, Service Manager 0-19, Public Health

Helen Mills – Healthy Child Programme Lead, Public Health

Nicola Ellel – Specialist Community Public Health Nurse (Health Visitor) Alison Evans – Clinical Quality and Development Lead, Public Health

Councillor Jim Andrews, Deputy Leader of the Council & Cabinet Spokesperson for Public Health

The report was introduced by the Director of Public Health.  The Head of Public Health then explained that the report provided an update of the transition of the Health Visiting and School Nursing Services known as the 0-19 Public Health Nursing Service (0-19 PHNS) to Barnsley MBC.  Members were made aware that a full staffing restructure had taken place and that staff had been given the opportunity to help shape the service structure and that the workforce structure had been co-designed with staff and delivery partners where appropriate to ensure effective delivery of the Healthy Child Programme (HCP).

In the ensuing discussion, Members asked a number of questions and the following points were raised:

·         Workshops have been held with staff to evaluate the impact of the new structure and model, which provided valuable information about how the service can be improved.  The ‘Family Star’ model is being explored, which is a licensed programme to assess service users’ journeys from initial contact through to intervention.

·         Communication, particularly face to face, is always challenging, but barriers are being broken down to solve this problem.  In terms of clinical records, although some systems do not ‘talk’ to each other, information sharing agreements are in place.  System One will be further developed in the future which will improve access to clinical records. 

·         The multi-agency stakeholder group was established in June 2017 and a positive working relationship has developed across all stakeholders, including the CCG, GPs, Practice Managers, Maternity Services, Speech and Language, Early Years and Health and Social Care.  The group met three times last year but is currently on hold whilst the Terms of Reference are being reviewed, with a view to being re-established.  It was felt that Area Councils should be represented on the stakeholder group.

·         The new staffing structure is now ‘live’ and all HCP leads are in place.  A recent recruitment drive had proved to be very successful.  Each Area Council has an assigned Lead Officer who will be making contact with Area Councils and developing closer working links.  Now the service sits within BMBC this will be hugely beneficial as the same systems and processes will be used (e.g. IT), aligned to Public Health, which makes it easier and quicker to support vulnerable children.

·         School readiness is a priority and improvements need to be made.  Sharing of information and joint working between practitioners and schools at an early stage is essential.  Children who are not school ready are identified in early years settings but this can be a problem when mandated contact ends and children don’t access services – they can fall through the gap. 

·         Childhood obesity is also a priority.  Children are weighed and measured at various stages and intensive work takes place with vulnerable families around healthy eating and physical activity. 

·         The Breastfeeding Service transferred to BMBC in April 2017.  Promotional materials have been reviewed and the service will be driven forwards.

·         The 0-19 Service is no longer classed as ‘high risk’ on the corporate risk register due to improved joint working.  There are still some concerns around GPs and access to Health Visitors but communication is improving and working relationships are being built.  All GPs have a named Public Health Nurse and an agreed referral route.

·         A Project Lead has just been recruited to oversee the implementation of a clinical record system, which may take 12 months to fully implement due to the complexities of the project.  It is expected that significant improvements will be made in the next 3 to 4 months.

·         In terms of the Speech and Language Therapy (SALT) service, difficulties were experienced previously due to staffing problems but the service is now up to capacity and is taking referrals.

·         There is a good relationship with CAMHS and options to increase access to psychological services are being explored.  Lots of Future in Mind resources have been used in schools and there is a need to look at how this will be sustained when FIM resources are no longer there.

·         Sexual health services for teenagers are being extended to 19 year olds and will include work around risk-taking behaviours.    

RESOLVED that:

(i)            Witnesses be thanked for their attendance and contribution;

(ii)          Members will be provided with more information on the ‘Family Star’ service;

(iii)         Consideration will be given to Area Council representation on the Stakeholder Group.