Agenda item

Lorna Quinn, Public Health Intelligence Specialist, to present the evaluation of the 3-4 months Health Visit

Lorna Quinn, Public Health Intelligence Principal, presented the initial findings from the implementation of an additional visit within the Healthy Child Programme (HCP).

The following powerpoint presentation was also shown in conjunction with the report:-

Background

-        Successful application to work with the National Institute for Health and Care Research (NIHR) Public Health Intervention Responsive Studies Teams (PHIRST) based at Nottingham University

-        The aim was to evaluate the impact of the 3-4 month health visit, an additional visit which was previously available to only families requiring enhanced support but offered to all parents through Family Hubs funding until March 2026

-        Practitioners review child development, provide guidance on breastfeeding and safe weaning and support parental mental health

Methods

-        Qualitative

·        15 individual interviews with parents

·        2 focus groups with parents (including one with parents who had not taken up the visit)

·        Focus groups with 7 nursery nurses, 4 Public Health staff and commissioners

·        Factors associated with delivery and uptake of the visit were examined

-        Quantitative

·        Tracking month-by-month how many eligible babies received it and whether it happened on time.  Visit completion was described by demographic factors including socio-economic deprivation, ethnicity, maternal age and parity and developmental scores at 3-4 months

·        The children’s 12 month development scores were compared before and after the review controlling the demographic factors

Reach

-        The 3-4 month visit began in September 2023 but was targeted

-        General rollout to the entire population began from January 2024

-        On average just under 200 babies and their families received a 3-4 month visit each month

Qualitative Key Findings

-        Parents valued having an additional visit between the 6-8 week and 9-12 month reviews and the visit was positively supported

-        There were positive opinions of the service and family hubs

-        Community groups, such as those delivered at a local mosque, provided an important way of delivering information and support to diverse communities

-        Parents felt the visit was more developmentally focused than other visits, aligning with nursery nurse skills in developmental screening

-        The visit supports parents’ knowledge and preparedness for upcoming developmental milestones, providing parental reassurance

Quantitative Findings - Demographic

-        3-4 month visit rates stabilised at around 80%

-        Before adjusting for potential confounders, 3-4 month visit rates were lower for older mothers, those who already had a child and those in IMD deciles 5 and 6

Quantitative Findings - ASQ

-        Of those who received the visit, the ASQ completion was around 80%

Quantitative Key Findings

-        The 3-4 month visit uptake was equitable across socio-economic deprivation, ethnicity and maternal age group but families with more than one child were around 70% less likely to receive a visit

-        Maternal mood recording rates were consistent across deprivation quintiles and ethnic groups

-        At the 9-12 month visit, children eligible for a universal 3-4 month visit had higher likelihood of scoring above the close-monitoring cutoff in the ASQ domain of problem solving

Next Steps

-        These findings provided evidence for Rotherham stakeholders to consider when deciding on the future of the review and may contribute to the wider national debate on delivery of the Healthy Child Programme

-        A detailed report would be published by November describing the findings further

-        Meetings with Public Health Senior Management Team and Family Hubs Operational Group would share the detailed report and to discuss the future commissioning options

Conclusion

-        Overall the evaluation indicated that the 3-4 month review was a valued addition to the Healthy Child Programme, offering a point of contact between the 6-8 week and 9-12 month visits and supporting families during a period of rapid developmental change

-        The visit appeared feasible to deliver, culturally adaptable and acceptable to parents

-        Work remained for ongoing data collection to monitor outcomes and to discuss future commissioning options

Discussion ensued with the following issues raised/clarified:-

-        The term ‘parent’ was used to refer to the parents, carers and guardians eligible for a 3-4 month visit

-        Parents were suggesting that  that the additional visit would be more beneficial (5-6 months), however, the 3-4 months visit was in line with the national Child Programme

-        No studies since 2015 had specifically assessed adding a universal 3-4 month review.  The review was not nationally mandated; the Council was evaluating its impact to assess the case for retaining it locally and to influence wider national debate on delivery of the Healthy Child Programme

Resolved:-  That the findings from the 3-4 visit within the Healthy Child Programme be noted.