This is an example of full integration of health and local authority services. Children’s centres are managed as a city-wide service, led by three Neighbourhood Sure Start Service Managers, two with health visitor backgrounds and one from social work. The entire health visiting service for the city has been seconded into the Council through a Section 75 agreement and work as an integral part of the children’s centre service.
The integrated children’s centre teams are led by health visitors, who supervise outreach workers. In addition there are specialist city-wide teams offering specific support – for example, breastfeeding coordinators to encourage initiation and sustain breastfeeding in areas of the city where this is low. Traveller and asylum seeker families are supported by a specialist health visitor and early years visitor post. Teenage parents are supported by named health visitors and early years visitors at each children’s centre.
This model has delivered value for money, transparent and effective use of resources, and safe evidenced based health care delivery. The impact is evident in improvements in breastfeeding rates, obesity rates and a sharp rise in the percentage of children living in the most disadvantaged areas who achieve a good Early Years Foundation Stage Profile score – from 33% in 2008 to 55% in 2011. The most recent children’s centre to be inspected by Ofsted was judged to be outstanding in every area; inspectors noted that the health-led model plays a fundamental part in streamlining services and integrating provision. Ante-natal and post-natal services are delivered directly from this Centre. As a result, the Centre reaches 100% of children aged under five years living in the area and has made an impressive impact on children’s welfare and family well-being.