iHV regional conference: Josephine Johnson - Health Visitors as leaders in the transition to Public health commissioning - Leeds
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The document discusses the role of health visitors in leading the transfer of 0-5 public health commissioning to local authorities in England. It emphasizes the need for strong leadership skills, collaboration with wider teams, and understanding local authority priorities to deliver effective health outcomes for young children and their families. NHS England provides support and resources for health visiting transformation and aims to ensure health visitors can improve community health through evidence-based interventions.
iHV regional conference: Josephine Johnson - Health Visitors as leaders in the transition to Public health commissioning - Leeds
- 1. www.england.nhs.uk Health Visitors as leaders in the transfer to local authority commissioning Sabrina Fuller Head of health improvement NHS England
- 2. www.england.nhs.uk • Context for health visiting leadership going forward: transfer of 0-5 commissioning to local authorities; what are health visitors leading? who are they leading? • What is leadership? what makes a good leader? What sort of leader are you and how can you develop your strengths? • How can you apply leadership principles in the context of the transfer? What are the opportunities? What are the challenges? • NHS England’s support for health visiting transformation work: service spec; transformation programme; outcomes work Health visitors as leaders: leading through influence 2
- 4. www.england.nhs.uk • October 2015 commissioning (not employment) of 0-5 PH services transfers to local authorities • Local authorities already commission range of 0-5 services including early years and social care. • Local authorities already commission public health services including 5-19 services. • Local authorities are democratically accountable to their electorate. • Certain universal checks and reviews will be mandated for time limited period. • Many local authorities face considerable financial challenges Context: transfer of 0-5 PH commissioning
- 5. www.england.nhs.uk • A four-tiered progressive model of delivery • Community • Universal • Targeted packages of care • Multiagency working to meet complex needs eg safeguarding, troubled families • Delivery of the evidence-based healthy child programme • 5 mandated checks and reviews: antenatal, NBV, 6-8 weeks, 12 month, 2-2 and a half year. • Improved outcomes for young children and their families • E.g. 6 high impact areas: maternal mental health, early attachment, breastfeeding, healthy weight, child development and school readiness, accident prevention 5 What are health visitors leading?
- 6. www.england.nhs.uk • Health visitors already lead skill-mixed health visiting teams. • Many health visitors, as the early years experts and HCP leaders, are now leading wider teams including early years staff. • The future is the wider team – with health visitors leading on improved health and wellbeing outcomes for young children and their families. • The wider team includes early years workers, local authority commissioned workers, primary care, voluntary sector and many others. • LEADING THROUGH INFLUENCE RATHER THAN LINE MANAGEMENT RESPONSIBILITY. 6 Who are health visitors leading?
- 8. www.england.nhs.uk • These individuals have had a significant effect on how regular people live their lives today and have had a large impact on how modern society works. " 8 Significant leaders or good leaders? Of course, significant doesn’t always mean good………
- 9. www.england.nhs.uk • Self awareness – how can you optimise the way you come across to others? • Working with others – building and maintaining relationships • Managing the resources available – people, budgets, and realising potential resource • Improving services: safety, evaluation, improvement, innovation, transformation • Setting direction: context for change, knowledge and evidence, making decisions and evaluating NHS Leadership Academy 9 What makes a good leader?
- 10. www.england.nhs.uk • What were we born with? Our own natural tendencies to lead (or not). • What motivates us to lead (a desire to make a difference: to give the best opportunities to all children and families?) • What are our existing strengths, weaknesses and development needs? • What resources will help us develop our strengths and address our development needs? 10 Our own leadership journey: reflecting on who we are, who we can become and our own leadership style
- 11. www.england.nhs.uk Applying leadership principles in the context of transfer of commissioning
- 12. www.england.nhs.uk • Are you shaping the future or despairing about it? • Do you take opportunities to communicate what it is you contribute? • Do you take opportunities for self development (work- based and outside work, as well as CPD) • Do you manage your stress levels and enjoy what you do? • Are you seen to act with integrity? 12 Self awareness
- 13. www.england.nhs.uk • Working within teams: wider 0-5 teams, early years, social care, troubled families. Shared purpose and understanding each others’ contribution. • Building and maintaining relationships: with children’s centres and early years, with social care, schools, 5- 19 services, troubled families etc. • Encouraging contribution • Developing networks: knowing about good practice in other areas and sharing your own good practice and successes 13 Working with others 1
- 14. www.england.nhs.uk • Shared purpose and understanding each others’ contribution is critical: • What are the local priorities in terms of 0-5 outcomes? • What does the evidence base tell us re effective interventions? • What competencies are needed to deliver to who? • So agreeing most effective and cost-effective roles, contributions and pathways (see core HV spec) Working with others 2
- 15. www.england.nhs.uk • Planning: know your local authority priorities for 0-5s; workin in the context of their Starting Well strategy; know your data and use it to inform the local authority’s priorities • Performance: know your service specification; plan to deliver against performance managements requirements; ensure decent data systems • Resources: know your budget, service costs (and fill your vacancies) • People: take a wider view of the resource available to you – working with the wider team. 15 Managing services
- 16. www.england.nhs.uk • Ensuring patient safety: safeguarding is major local authority priority – ensure the preventive elements eg early attachment, parenting skills, are valued. • Critically evaluating: parents’ and staff perspective on what you do well. Using your data. Building intelligence. • Encouraging improvement and innovation: ensuring that you act on intelligence gathered for continuous improvement. • Facilitating transformation: have you a plan in place to meet requirements of service specification – the 4, 5, 6 model. 16 Improving services
- 17. www.england.nhs.uk • Record keeping systems • Working with other agencies • Skill mix • Continuity of care • Case load and clinics • Clinical supervision • Supportive management Christine Bidmead 17 Improving services 2: Evidence on what supports success in meeting your parents’ needs:
- 18. www.england.nhs.uk • Identifying the context for change; knowing your local authority priorities and how you deliver them. • Applying knowledge and evidence: health visitors as early years experts – delivering evidence-based interventions. • Making decisions: in partnership with commissioner and other providers – who needs to do what in order to deliver effectively and cost-effectively. • Evaluating impact: demonstrating your value and ensuring that commissioners and elected members know about your successes. 18 Setting direction 1
- 19. www.england.nhs.uk Setting direction 2: Meeting local authority priorities: the evidence base
- 20. www.england.nhs.uk • NBO and NBAS to promote secure attachment • Baby friendly in the community across the system • Use of Ages and Stages 3 to assess development at two to two and a half years • Incredible Years Pre-school Basic - parenting groups • HENRY: tackling childhood obesity Setting direction 3: examples of evidence-based initiatives 20
- 21. www.england.nhs.uk • Use case studies of health visiting impact at different levels for commissioners • Local councillors are interested in people • Explain how your service meets LA priorities eg safeguarding children, promoting a positive home learning environment, school readiness Setting direction 4
- 22. www.england.nhs.uk • Joined up working with early years and children’s social care services; for joint care planning and delivery – child centred. • Joined up working of 0-5 public health services with 5-19s services to allow a family centred approach. • Closer links to early intervention services such as Troubled Families • The ability to contribute effectively to public service reform through the evidence base on early attachment, school readiness, attainment and its links to building local economies. • Ability to affect the wider determinants of health through links to commissioning of housing, planning etc. • Full potential of expertise and leadership role that health visitors can offer in improving health and wellbeing outcomes for 0-5s and their families. Opportunities 22
- 24. www.england.nhs.uk • NHS England core service specification (basis for local specification) 2013-14, 14-15, 15-16. • Investment in Area Team-led service transformation initiatives – involving LA commissioners + providers. • 0-5 benchmarked PH outcomes: profiles and guide with PHE http://atlas.chimat.org.uk/IAS/dataviews/earlyyearsprofile NHS England: supporting sustainable transformation through the commissioning process 24
- 25. www.england.nhs.uk • Take responsibility for making a success of transfer of commissioning • Understand your local authority priorities and how you deliver to meet them. • Work closely with partner organisations around agreed priorities and evidenced based delivery. • Ensure that commissioners and elected members have the opportunity to understand what you do. Health visitor leadership 25