What this consultation is about
This consultation is seeking views on proposed changes to the Derbyshire Healthy Families Service.
Derbyshire Community Health Services NHS Foundation Trust (DCHS) currently delivers the Derbyshire healthy families service, offering breastfeeding support in the first few weeks of a baby’s life to Derbyshire residents (excluding Derby City) using a peer support model. The service also delivers weaning groups and offers other support around infant and toddler nutrition. The Derbyshire healthy families service is delivered as part of the infant and toddler nutrition contract which is commissioned by our public health.
On 1 April 2023, this service will be transferred into a Section 75 Partnership agreement between ourselves and DCHS. As part of this process, we've developed a new service delivery model along with DCHS (including staff who deliver the current service), to help improve the service. This consultation is seeking views on these proposed changes. These proposed changes include:
Offering a more flexible service around breastfeeding support
The current service offers a strict programme of 5 key contact points. All expecting mothers are invited to an antenatal group. An additional 4 contacts are offered to all breastfeeding mums at the following time points after the birth of the baby:
- 24 to 48 hours - via the telephone
- 2 to 4 days - one-to-one appointment
- 7 to 9 days - one-to-one appointment
- 16 days - via SMS text message
Moving forward all expecting mums will continue to be invited to an antenatal group unless there is a specific need to offer a one-to-one appointment. All breastfeeding women will also continue to receive 24 to 48-hour telephone contact and offered a 2 to 4-day face-to-face contact in the same way as is currently being delivered. However, any further breastfeeding support between 4 and 14 days will be offered to those women that need additional support, meaning the service will no longer deliver routine 7 to 9-day appointments and send text messages out at 16 days to all breastfeeding women.
The reason behind this change is that peer support workers currently spend large amounts of time chasing and delivering appointments to all breastfeeding women at all contact points whether they need additional support with breastfeeding or not. Offering support to those that need it between 4 and 14 days will allow the peer support workers to focus more time on supporting those that need extra help, advice, and support with breastfeeding. The service will also be able to react to a client's need more easily as they may be able to offer support when a client needs this as opposed to waiting until the next scheduled contact point. When the baby reaches 14 days they should have been seen by the health visitor as part of the new birth visit between 10 and 14 days. From this point, the health visitor will be the point of contact for the family if they have any concerns about breastfeeding.
Stop delivering weaning groups
Offering a more flexible approach to breastfeeding support means there will no longer be capacity for peer support workers to deliver weaning groups as part of the Derbyshire healthy families service. Currently, parents are invited to attend weaning groups around the time their child reaches 6 months of age to gain information and advice on safe weaning. This will not be offered as part of the proposed service delivery model. However, weaning information and advice will continue to be given to all families at the 6 to 8-week review with the health visitor. The health visitor will also continue to be the point of contact if a family has any concerns with regard to weaning. DCHS has also developed a series of videos that parents and families can be signposted to that offers information about safe weaning and other elements of infant and toddler nutrition that would be covered as part of the current weaning groups.
The new service delivery model proposed to start on 1 April 2023 will:
- continue to invite all expecting mums to an antenatal group session, although this will be offered as a one-to-one appointment where there is a specific need for this
- continue to contact all breastfeeding women at 24 to 48 hours via the telephone
- continue to offer all breastfeeding women one-to-one contact when the baby is 2 to 4 days old
- offer extra breastfeeding support to those that need this between 4 and 14 days - this means not all breastfeeding mums will be offered support during this time
- continue to offer an online chat function to enable breastfeeding mums to gain information and advice on breastfeeding
- continue to offer a Saturday service offer to ensure breastfeeding women receive support from the service during the weekend
This consultation is seeking views on these proposed changes to the Derbyshire Healthy Families service by completing a short online survey. Paper copies can be requested by email asch.publichealth.commissioning@derbyshire.gov.uk