This item provides an update on the Health Visiting Service, detailing the best practice and innovation, the issues and challenges faced and it seeks the Board’s support for proposed actions.

The Board received a comprehensive update and presentation on the 0-5 Health Visiting Service (HVS) from Rob Sabin, WCC commissioner and Sarah Foster, Deputy General Manager for 0-5 HVS, SWFT.

Background was provided on the role of the service to protect and promote the health and wellbeing of children and their families through the delivery of the nationally mandated Healthy Child Programme (0-5). The HVS was key to delivering the Warwickshire Health and Wellbeing Strategy priority around helping children and young people to have the best start in life. The current service was delivered by SWFT, with the contract due to expire on 31 March 2023.

A summary was provided of service performance.  This service met a wide spectrum of needs for all children (birth to five) within Warwickshire, with some key areas that delivered more targeted needs. The service continued to innovate and adapt its practice, with examples being provided. Developmental reviews and checks were mandated, and contract performance was monitored against five HV mandated contact performance indicators. The provider's performance in this area had declined with tables providing data to demonstrate this.

The report then set out the identified service issues and challenges. It included challenges around recruitment and retention of qualified HVs, which was a national issue. It was coupled with increasing caseloads, increases in population, complexity of cases and level of need.

SWFT and WCC had co-developed a joint recovery/restoration plan in the Autumn of 2021. The report set out the short-term and longer-term actions proposed. The recovery plan was reviewed monthly involving service and commissioning leads, with oversight from the WCC Assistant Directors. A presentation was provided to highlight key messages from the report.

The following questions and comments were submitted, with responses provided as indicated:

• The re-employment of retired HVs was discussed. Such people had vast experience and recently a retired HV had recommenced work in the Rugby area.
• The value of nursery nurses was recognised, it being questioned how they could contribute to HV roles. It was also asked what WCC could do to assist. It was noted that some HV functions could not be undertaken by other personnel.
• The recommendation was to note this report but there were concerns. Reference to the challenges observed at the Rugby Family Centre, specifically around HV caseloads. Also, the increasing complexity of cases identified at a body which determined grant funding applications. These included concerns around mental health and drug/alcohol issues. There was a national staffing shortfall in HVs. In the Rugby area a meeting to discuss the Joint Strategic Needs Assessment had included a number of aspects relevant to this discussion. However, there was no awareness of the concerns around the HV service, which showed the need within the system to better connect. Co-production was seen as a good way forward and it was about ‘how’ organisations could work together and enabling that to happen.
• Another speaker echoed the points around how WCC and other organisations could help, focussing on recruitment aspects and making the  ...  view the full minutes text for item 3