What this consultation is about
We're seeking views on the following:
- Changes to the health visiting service in Derbyshire - 6 proposals are being considered to change the health visiting service in Derbyshire that offers support to families of pre-school aged children aged 0 to 4 years.
- Transferring the Integrated Specialist Intensive Home Visiting Service into the Section 75 Partnership Agreement, which is a way of delivering services in partnership with the local NHS. Our partnership works with Derbyshire Community Health Service NHS Foundation Trust (DCHS).
Changes to the health visiting service in Derbyshire
We commission local NHS provider Derbyshire Community Health Service NHS Foundation Trust to deliver the 0 to 19 public health nursing service in Derbyshire (excluding Derby City Council area).
The 0 to 19 public health nursing service includes the delivery of the following services:
- health visiting (ages 0 to 4)
- specialist public health nursing (also known as school nursing) for children and young people (ages 5 to 19)
DCHS, like the majority of other 0 to 19 public health nursing service providers across the country, is facing significant cost pressures and is having to review the way services are being delivered. We’ve been working with DCHS to identify proposals to change the way the health visiting service can be delivered that will both help reduce costs, whilst at the same time maintains a high-quality service for Derbyshire residents. The health visiting service include health visitors and community nursery nurses that support the families of children aged between 0 and 4 years.
The proposals included in this consultation are common ways of working in health visiting services within other local authority areas. We invite the views of the public on the 6 proposals under consideration to change the way the health visiting service is delivered.
Proposal 1 - most reviews for children aged 2½ years will be delivered by community nursery nurses not health visitors
Current service:
- the health visitor delivers reviews for all children aged 2½ years
Proposed change:
- all families will still be offered a review when their child is 2½ years
- community nursery nurses will deliver most of the 2½ years reviews instead of the health visitor
- health visitors will still deliver the review where they are already working closely with that family
Proposal 2 - most reviews for children aged 12 months old will be delivered by community nursery nurses not health visitors
Current service:
- the health visitor delivers reviews for all children aged 12-months-old
Proposed change:
- all families will still be offered a review when their child is 12-months-old
- community nursery nurses will deliver most of the 12-month reviews instead of the health visitor
- the health visitor will continue to deliver the review where they are already working closely with that family
Proposal 3a - offering antenatal reviews to those pregnant women who are more likely to need support from the health visitor
Current service:
- all pregnant women are offered an antenatal review in the home with the health visitor
Proposed change:
- first time parents and those most likely to need support will be offered an antenatal review in the home
- those who have had more than one pregnancy and who are less likely to need support from the health visitor will be provided with information and offered a chance to arrange virtual appointment (telephone or online) with the health visitor if they opt in
Proposal 3b - offering a range of ways to deliver antenatal reviews
Current service:
- all pregnant women are offered an antenatal appointment with the health visitor in the home
Proposed change:
- all pregnant women will still be offered an antenatal review with a health visitor as part of the antenatal review, but this can be offered as a home visit, telephone or other virtual appointment
Proposal 4a - offering the pre-school review at 3½ years to those that are more likely to need support from the health visiting service
Current service:
- all families of children aged 3½ years are offered an appointment with the community nursery nurse as part of a pre-school review
Proposed change:
- the families of those children aged 3½ years who are more likely to need support from the health visiting service will be offered a pre-school review
- those children who are less likely to need support from the health visiting service will be provided with appropriate information and advised to contact the service if they need any further support
- the health visiting service will continue to support all families of children aged 0 to 4 years if the child has a health or development need
Proposal 4b - stop delivering the pre-school review at 3½ years
Current service:
- all families of children aged 3½ years are offered an appointment with the community nursery nurse as part of a pre-school review
Proposed change:
- stop delivering the pre-school review for families of children aged 3½ years
- the health visiting service will continue to support families of children aged 0 to 4 years where the child has a health or development need
Transferring the Integrated Specialist Intensive Home Visiting Service into the Section 75 Partnership Agreement
The Integrated Specialist Intensive Home Visiting Service offers more support to families with the highest level of need. Families access the service via a referral process. The service is commissioned by us and is delivered via a contract held by DCHS to residents in Derbyshire (excluding Derby City Council area). Families can access the service from the antenatal period through to the child reaching the age of 2½ years.
The contract is due to end on 30 August 2026 and it is proposed that the service is transferred into the Section 75 Partnership Agreement between us and DCHS, which also delivers the 0 to 19 Public Health Nursing Service, the Oral Health Promotion Service and the Derbyshire Integrated Breastfeeding Support Service.
A Section 75 Partnership Agreement is a legal agreement between us and an NHS provider under the National Health Service Act 2006, which enables close partnership working to deliver and improve services. The transfer may also help create further efficiencies by:
- allowing for better integration with the other services in the Section 75 Agreement
- allowing us to work together more closely with DCHS to achieve positive outcomes for local families
- enabling innovation and adaptation within the service to meet the changing needs of families
The consultation on this proposal is required to be compliant with The NHS and Local Authorities Partnership Arrangements Regulations 2000 which stipulates that ‘the partners may not enter into any partnership agreements [under Section 75 of the NHS Act 2006] unless they have consulted jointly such persons as appear to them to be affected by such arrangements’.
On 25 July 2024 Cabinet approved the decision to consult with the public on:
- the 6 proposals outlined to change the health visiting service in Derbyshire
- transferring the Integrated Specialist Intensive Home Visiting Service into the Section 75 Partnership Agreement
To view the report, please see the Cabinet agenda on 25 July 2024 item 11.
We welcome your comments on the 6 proposals being considered to make changes to the health visiting service, as well as transferring the Integrated Specialist Intensive Home Visiting Service into the Section 75 Partnership Agreement. Please provide feedback via the consultation questionnaire to ensure your responses are considered.
The questionnaire should take no longer than 10 minutes to complete.
All consultation responses will be treated in confidence and will be kept securely for one year from the closure of the consultation, then destroyed.
We are unable to offer an individual response to all feedback given.
If you require a paper copy of the consultation questionnaire please email asch.publichealth.commissioning@derbyshire.gov.uk
Face-to-face events
A series of drop-in events will be held for anyone to get more information or provide feedback on the proposals being consulted on:
- Monday 16 September 2024 from 9.30am to 11.30am at Buxton Library, Kents Bank Road, Buxton, SK17 9HW
- Wednesday 18 September 2024 from 10am to midday at Ilkeston Library, Market Street, Ilkeston, DE7 5RN
- Thursday 19 September 2024 from 9.30am to 11.30am at Swadlincote Library, Civic Way, Swadlincote, DE11 0AD
- Monday 23 September 2024 from 9.30am to midday at Chesterfield Library, New Beetwell Street, Chesterfield, S40 1QN
- Tuesday 24 September 2024 from 9.30am to 11.30am at Bolsover Library, Church Street, Bolsover, S44 6HB
- Thursday 26 September 2024 from 10am to midday at Matlock Library, 8 Steep Turnpike, Matlock, DE4 3DP
- Friday 27 September 2024 from 10am to midday at Eckington Library, Market Street, Eckington, Sheffield, S21 4JG
There is no need to book on to the face-to-face events.
Online events
Two online events will be held for anyone to provide further feedback on the proposals being consulted on. These online events will be held via Microsoft Teams:
- Tuesday 17 September 2024 from 1pm to 2pm
- Thursday 26 September 2024 from 4pm to 5pm
To access an online event please email asch.publichealth.commissioning@derbyshire.gov.uk stating the date you wish to attend. A meeting invitation will be sent via email to enable you to access this on the day.