The first of October 2015 sees the commissioning responsibility for 0-5 years services transfer from the NHS to local government. This will have the effect of bringing the health visiting service to the forefront of the minds of children’s services commissioners. Indeed, in many parts of the country, plans are already well advanced for the re-commissioning of 0-5 services, aimed at achieving greater degrees of service integration.However, in many areas, health visiting has had a relatively low profile within their NHS organisations.
The transfer sees the last piece of the jigsaw put together that is the public health family; school nursing and the wider public health budgets transferred to local government back in 2013. With a single commissioning structure in each local authority area, there is an exciting opportunity to achieve even greater joined-up working across the whole early years’ agenda.
It is important that health visitors from October take every opportunity to use the greater visibility that the service will have and to use their influence in the development of the overall children’s policy and practice at a local level. It is up to us, as highly skilled public health professionals and experts within the 0-5 years field, to promote a better understanding of the contribution that the universal health visiting service contributes to a comprehensive and robust children’s service structure.
We know that effective universalism has the potential to identify at an early stage a range of development, behavioural or attachment issues and to address them before they get more ingrained. By working in a more integrated way, we can demonstrate how potential child protection issues can be picked up at a much earlier point, early intervention measures put in place through partnership working, and so positively contribute to reducing the need for progression on to formal child protection plans.
Local Government, and directors of children’s services are feeling the full pressures of public spending reductions and need to be assured that our service is not a luxury but a core component that we cannot afford to lose. We can and do assist in preventing ‘upstream’ formal child protection interventions and so contribute towards reducing budget pressures.
Health visiting is in a strong position; it has been through a period of unprecedented growth in our numbers, and transfers across with a ring-fenced or protected budget. We are well placed to be making a real impact in the design of new service models. But we must be willing to embrace change, be ready to look for innovation. This will include ever-closer working with local government children’s social care services.
We must recognise that while we bring important skills and expertise to the table, we can also gain a lot from working more collaboratively with other professions. We must see ourselves as equal partners in the delivery of modern comprehensive children’s services – willing to sharing skills and expertise.
So, let's seize this moment in history to embark on creative, child and family-centred, fully integrated advice, guidance and early support services.
Times are, indeed, hard; but by working with our communities to come up with the best we can together, we will, most importantly, help them to help themselves.
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