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Nursing Times Awards 2010

Child Health Award

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WINNER: Children and young people health mentors, Judith Grigg, Hilary Garrett, Anita Farmery and Daryl Weston, Tameside and Glossop Primary Care Trust

Background

The health mentors project was undertaken to provide health and wellbeing help and advice for children and young people. It offers an accessible, personalised service which addresses adverse local healthy lifestyle issues in Tameside and Glossop. The objectives are to achieve 13,500 early interventions across the programme by 2011 including:

  • Smoking;
  • Healthy weight;
  • Alcohol and drugs;
  • Emotional health and wellbeing;
  • Risk of repeat teenage conceptions.

The programme is needed to help deliver the Tameside Children and Young People Preventative Strategy (2008-11), which confirms the approach to early intervention needs of 4-16-year-olds to reduce high demand for more intensive resources in later years. The Department for Children, Schools and Families Children’s Plan, Building Brighter Futures, sets out the vision of achievement of goals for children through to 2020, including improvements in the integrated local delivery of early intervention and preventative services. Every Child Matters includes “be healthy” with the aims of physical activity, emotional health, sexual health, healthy lifestyles and choosing not to take drugs.

The service is a pioneering national pilot which provides one-to-one and group behaviour change sessions, tailored to the young person’s needs. It works in partnership with school and child health services, schools, children’s centres, extended schools, youth services and primary care, takes a whole family approach to promote health changing behaviour, and improves the accessibility of the service. For example, self-referrals can be made at www.healthmentors4life.net

The process

The service delivers interventions through one-to-one support to motivate health behaviour change, provide a personalised health plan for 4-16-year-olds rising to 18 for risk of repeated pregnancy. It signposts young people into specialist services when required. The service performance is managed by key performance indicators as agreed with commissioners.

The programme works with other agencies to develop the following pathways; smoking, obesity, repeated teenage pregnancy, emotional health, drugs and alcohol. These indicate the escalation points and entry and exit thresholds thereby ensuring that health mentors work within the scope of their skills.

Health mentors are clearly identified as offering early interventions, including one-to-one behaviour change through brief advice and intervention during which individual needs are identified. The brief intervention involves an agreed personal health plan, tailored to the needs of the child or young person.

Advice to other organisations

Advice for others planning similar activities would include ensuring that the programme manager is in post 3-6 months prior to the launch date to establish the care pathways and how the programme will be delivered. We encountered operational problems as the health mentors went into post. The management structure was initially deemed too flat so we recommend having a band 5 or 6 in post as well the manager, to oversee operational issues on a day-to-day basis.

Ten health mentors were allocated to the programme but 6.7 FTE were recruited initially in October 2009. This increased to 7.7 FTE in March but gives capacity issues. Our advice would be to recruit earlier and ensure the manager is included from the beginning of the process.

Marketing of the service is key to success and should be planned for the start of the programme. Communication with partners should be established well ahead of the start of the activity; our programme tried to promote its service as it went along, which meant awareness levels were low among partner agencies.

Benefits of the initiative

The first six months of the pilot have yielded the following:

  • The number of young women contacted at risk of having repeat conception was 120 against a target of 72 — none of the young women referred have gone on to have a repeat conception to date;
  • Of children and young people with a personal health plan 50% maintained change for three months;
  • We receive 20 new contacts for brief advice or brief interventions per week;
  • Client evaluation shows 100% satisfaction with the health mentors service;
  • We have made 169 referrals to reduce overweight and obesity;
  • We have made 156 referrals to reduce uptake of smoking;
  • We have made 43 referrals to reduce alcohol consumption and drugs;
  • We have made 160 referrals to improve emotional health and wellbeing.

Other benefits include shared learning across the partnership, which is realised from actions agreed at the regular steering group meetings which supports and oversees the development of the programme.

Financial implications

The cost of launching the project was £8,000. Ongoing running costs are £330,561 broken down into staff costs of £269,178 and non-pay costs of £61,384. £20,000 of branding costs were saved by adapting the Change 4 Life brand platform.

Contact

For more information on this initiative please contact David Bourque: david.bourque@nhs.net

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