Decision details

This report will look at how NHS England is commissioning Health Visiting Services on behalf of the borough, whether the services are responsive to local need and how the service can be developed ahead of commissioning responsibilities transferring to the Local Authority in 2015.  

Nicky Brown (Commissioning Manager, NHS England) introduced the report to the Board.

The Board asked if funding for the Health Visitor (HV) posts was guaranteed. It was explained that the cost pressure of recruiting additional Health Visitors is guaranteed. However, if HV posts are unfilled after the transition process finishes in April 2015 then funding for those posts will be lost. The Board sought clarity on this issue as it would be problematic for local authorities to assume responsibility for commissioning HVs without the necessary funding to recruit the workforce needed to deliver the service.

It was noted that NHS England is trying to reduce provider’s dependency on agency HVs as these are more expensive than permanent staff. The commissioning arrangements encourage providers to reduce their vacancy rates by releasing funding once its use of agency staff is below a target percentage.

The Board raised concerns with regard to safeguarding as a minority of children do not receive a health visit within the first 2 years of life. It was confirmed that 6% (roughly 3,000) of children in Barking and Dagenham were not in receipt of a health visit within the 14 day target. The Board stressed the importance of reaching families early to give support and to ensure that children get the best start in life. Safeguarding and performance issues related to the HV programme will be discussed at the Children and Maternity Group.

The Board noted that the MESCH programme (described in Appendix 2) will be taken forward by a dedicated officer within the CCG. Nicky Brown confirmed that funding is in place to give to the CCG to make the appointment.

The H&WBB agreed to:

·  Note the progress against the Health Visitor Implementation Plan is on track to deliver the required outcomes and outputs and that in order to do so the service is undergoing significant service redesign.

·  Note the progress being made to deliver the national programme, which will considerably increase Barking and Dagenham’s health visiting workforce by 2015, enabling NELFT to develop the capacity to deliver the Healthy Child Programme within the context of an integrated model with a view to improving children’s health outcomes and reducing demand for targeted services.

Further to the recommendations in the report, the Board agreed to:

·  Receive a report at its meeting of 25 March 2014 to explore the transition arrangements for the handover of commissioning from NHS England to the Council.