County Council Cabinet to consider changes to support for pre-school families

Proposed changes to health services for pre-school families which aim to ensure those most in need continue to be supported will be considered by Derbyshire County Council next week.

Members of Cabinet, who meet on Thursday 20th February, will hear that 729 people responded to a joint consultation run by the county council and Derbyshire Community Health Services NHS Foundation Trust (DCHS).

The public’s views were sought on plans to change health visiting services with the aim to deliver them more effectively to ensure they remain sustainable and finite resources are targeted at families who need the most support.

The report being discussed says significant cost pressures resulting from escalating health needs and inflationary rises mean the council has to consider how it continues to deliver services it is required to by law to ensure it supports those who need it most.

In Derbyshire, the health visiting service is commissioned by Derbyshire County Council as part of the 0 – 19 Public Health Nursing Service and is delivered by DCHS.

Cabinet will be asked to approve a phased implementation to change the health visiting service in the next financial year to:

• Allow community nursery nurses to work alongside health visitors to deliver universal face-to-face reviews for children when they reach 2.5 years old. Health visitors would continue to deliver this review for families who are identified as needing the most support as they do now and would continue to support all families where a health or developmental need is identified at this review.
• Offering all expectant parents an antenatal review with a health visitor with a choice of a face-to-face appointment at home or a virtual appointment to fit in with their other commitments.
• Provide targeted face-to-face reviews to those families with children aged 3.5 years where they are known to have developmental or health concerns. All other families would receive information about virtual support available.
• If significant cost pressures are identified in 2026/27, routine reviews for all other families with children aged 3.5 years would be stopped. The council is not legally obliged to carry out these reviews but has chosen to offer this. However health visitors would continue to support families of pre-school children who have a health or developmental need until they start school. All other families of pre-school children would be able to contact the service for support if they need it.

After consideration of feedback received during the consultation two other proposals are no longer under consideration:

• To use a mix of different staff, such as community nursery nurses, to support with carrying out reviews on babies when they reach 12 months old. These would continue to be carried out by health visitors as they are now.
• To introduce routine antenatal reviews only for would-be parents having their first baby or those identified to be more at risk. It means everyone who is expecting a child, regardless of their circumstances, would continue to receive the same level of support as offered now.

Councillor Carol Hart, the county council’s Cabinet Member for Health and Communities, said: “With demand for support rising and continuing uncertainty around increasing costs, it means we have to consider how we continue to support those who need us most while continuing to deliver the services we are required to by law.

“We recognise that every family is different and there will be times when some might need more support than others. We’ve listened to what people told us during the consultation so these proposals will continue to support all families but also ensure professionals continue to work together to identify where a child’s needs change and provide targeted support where that’s needed.”

As part of the consultation, people were also asked for their views on transferring the Derbyshire Integrated Specialist Intensive Home Visiting Service into a Section 75 Partnership Agreement – a legal agreement between the county council and DCHS to improve services, either by joining up existing services or developing new, co-ordinated and co-produced services.

Heather Longbottom, divisional director of specialised community services and deputy chief operating officer for Derbyshire Community Health Services NHS Foundation Trust, added: “We are grateful to everyone who has contributed their input into this consultation. Over 700 responses to the consultation have helped to shape the proposal for how our health visiting services can best provide support to families with young children from now on into the future.  

“Our health visitors – otherwise known as specialist community public health nurses – have a vital role to play in providing healthcare guidance to children and young families to give them the best start in life. The consultation is designed to help target that specialist help to those in our communities who most need it. We are working closely with the council on this to ensure we provide the best possible outcome to local families.”

A copy of the Cabinet report can be found on the county council’s website