Children and Young People Scrutiny Panel Public Health Update 2 -2 - PDF document

28/09/17 Children and Young People Scrutiny Panel Public Health Update 2 -2½ year Health Checks Tooth decay Immunisation Dr Imran Choudury – Director of Public Health 2 -2½ year Health Checks Assessing a child’s skills and development, providing support in a timely way to families and supporting school readiness “uptake of the two and a half year heath review is poor (there was only a 46.4% uptake April – Nov 2016)” Hounslow Health Visiting Transformation programme October 2015 – March 2017 • Co-designed a new model for Hounslow • Focus on Hounslow priorities • Partnership working • 1

28/09/17 Transforming Health Visiting New Model for Hounslow Skill Mix - Increased the role of community nurses  Competency Framework - peer review, mentoring, bespoke training  Regular supervision  Delivering the 5 mandated visits in the best way for Hounslow  Focus on antenatal and 2 ½ year review  Improving the 2 ½ year review offer to parents Using behavioural insight  Audit with parents  Offering Saturday clinics  Chasing non respondents & text message reminders for appointments  Home visits if necessary  Promoting the 2 ½ year Health Checks Children Centres and Nurseries Family Service Directory GP system alerts 2

28/09/17 2 -2½ year Health Checks Performance Continual improvement and focus on improving the uptake July 2017 65.3% Tooth Decay Poor oral health can affect children having the best start in life, their school readiness and school absence rates “The rates of children with decayed, missing or filled teeth and the rate of hospital admissions for dental caries in under 4s both significantly exceed the national averages” The 2015 national BASCD survey showed Hounslow  had one of the highest rates of child tooth decay experience in London, although lower than the Area 5 year olds having neighbouring boroughs of Ealing and Hillingdon experienced dental decay 101 hospital episodes for children under the age of  Hounslow 30% 5 for extraction of one or more permanent teeth. Rate of 0.47 per 100 children under 5 compared to London 27.2% the London rate of 0.42 England 24.7% 468 hospital episodes for tooth extractions in  children and young people under the age of 19. A BASCD tooth decay data for 2015/16 rate of 0.68 per 100, compared to the London rate of 0.63 Hospital episodes data for 2015/16 3

28/09/17 Hounslow Oral Health Programme Oral Health Promotion service Enhanced BASCD survey Schools’ dental outreach OH promoter supporting outreach Providing ward level data to programme (4-7 year olds) programmes and training other staff target support 2015/16 groups 12 primary schools Offered to over 3000 children Tooth Champions Aims over 1,600 applications of FV Training health & non-health staff to “Make every contact count”: Increase dental access for 1- 4 yr olds 2016/17 2015/16 – over 56 staff 30 primary schools 2016/17 – over 80 staff Lower rates of tooth decay at age 5 Offered to over 6500 children Over 3,300 applications of FV Reduction in hospital admissions for multiple Junior Citizen Scheme dental extractions and fillings OH promotion to 10-11 year olds, moving to secondary school “Now You Have Teeth” Over 2,200 Foundation Dentists delivered OH awareness: Health Visitors GPs 2015/16 - 17 CCs + EYs’ settings OH advice and tooth brush packs distributed at OH section on the 1 year 2016/17 – 10 CCs (x2) child development checks from 2015 to 2017: immunisations child 5000 packs given to 0-3 year olds health template on 1000 packs given to 3-5 year olds SystmOne Schools’ dental outreach programme 2015/16 and 2016/17 4

28/09/17 Tooth Decay – Increasing dental access Outcomes achieved Access rates (the number of children accessing dental practices) Uptake of dental services for children in Hounslow is better than the average for London Access rates have gone up 56.4% in March 2014 to 60.2% in March 2015 0-5 year olds - Lowest access is in Feltham North 31.3%, and highest in Cranford ward at 43.8% 6-9 year olds – Lowest access 58.8% in Chiswick Homefields and highest in Syon ward at 95.5% Immunisations and Vaccinations “By the age of 2 years, 84.8% of children have received their first dose MMR and by 5 years, only 73.3% of children received their second dose of MMR immunisation.” 5

28/09/17 Low coverage rates In London, immunisation uptake rates remain below the 95% levels required to achieve herd immunity. The increasing birth rate in London results in a growing 0-5  population and puts pressure on existing resources such as GP practices London has high population mobility  Difficulties in data collection, call/recall systems, lack of incentives  for GPs, data collected outside of timeframes doesn’t count in the figures Parental concerns around vaccinations  Complexity of the schedule of vaccines  Variation between practices performance 6

28/09/17 What are we doing? Co-ordinate a multi-agency network for Hounslow  Health Visitors check immunisation and encourage parents to see GP  Young parents in the Family Nurse Partnership have 100% of immunisations at  age 2 Looked After Children - NHS England identified Hounslow as an area of good  practice with high immunisation rates for LAC  Children Centres  Supporting Early Intervention, families with known incomplete immunisation supported to access immunisation at GP practice  Post Easter 2017 targeting parents at ESOL and Parenting classes with immunisation information Latest data 7