CONCERNS have been raised about changes made to health visitor provision across Hampshire.

A senior manager answered questions about the impact of an increasing number of vulnerable children alongside a countrywide shortage of health visitors to board members of the Hampshire Community Health Care.

Nicky Adamson-Young, divisional director for the children’s division of HCHC, said a new multi-agency was working well and that the department was taking preventative measures to get to children before they become at serious risk.

Board members questioned the increased workload for health visitors and how many children were under supervision as high risk.

HCHC, the operational arm of Hampshire PCT, undertook a review of its child health services for 0 to 5-year-olds in order to deliver requirements laid out in the national ‘Healthy Child Programme’ from the Department of Health in 2008.

They have created a core programme of universal interventions, additional interventions for the most vulnerable families and implemented skill mix into teams.

The teams consist of health visitors, community staff nurses, community nursery nurses and administrative support workers.

There has been controversy nationally that ‘skills-mix’ is actually leading to a worse service especially as the number of health visitors is declining.

At a recent board meeting of the HCHC, at Winchester's Wessex Hotel, Ms Adamson-Young gave examples where the children’s centre, care support workers, staff nurses and health visitors had worked together to provide support.

Ms Adamson-Young said challenges included health visitors reaching retirement age or leaving.

She acknowledged there was a high level of vacancy in children’s services, but said recruitment had improved and of 60 new community staff nurses that had come into HCHC, six had gone on to undertake the health visiting qualification.

She said to address a national shortage of health visitors and school nurses with an increase in vulnerable families, the tactic was to be more pro-active.

She said that half the work with 0 to 4 year-olds involved non-vulnerable families, but that the benefits of this work would take years to come to fruition Trevor Spires, non-executive director, said with increased vulnerability comes an increase in workload and with a national shortage of health visitors how many children did Children’s Services need to keep an eye on.

She said 13 per cent of children across Hampshire Community Health Care were real risks and concerns.

Ms Adamson-Young said: “The vulnerability framework is much broader than that, it’s about preventing children getting to that point, it’s getting them the right support to get the best outcomes.”

Jim Park, non-executive director, said: “I’m just wondering how we’re assured the outcomes are more effective, I’m not sure I got enough out of that.

“How do you satisfy ourselves that we have got an effective outcome through the service redesign?”

She said children’s services was able to offer different packages of care for different vulnerabilities.

Asked by the board chairman Mike Petter about whether initial resistance by health visitors to the bringing in of staff nurses had changed, Ms Adamson-Young said: “The majority absolutely see the benefits of having the skill mixed workforce.

“They have been expecting staff nurses to be undertaking even more, they feel they have the competency and skills to do more than they are doing.

“It has been a journey, but a very positive one in the main.”

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