School Nursing; Health Visitor Child Protection Health Assessment

This initiative challenged current practice and established a vision for School Nurses and Health Visitors to create an environment focussed upon improving health outcomes for children with a Child Protection Plan  as they are at risk of ‘significant harm’ and are likely to have unmet health needs (Marmot, 2010, Working Together, 2013).

From January 2015 all children supported by a Child Protection Plan in both Shropshire and Telford & Wrekin Local Authorities have a health assessment completed by a School Nurse or Health Visitor. This change in policy came about following a robust pilot study from April 2014 – December 2014.

The initiative aims to address the unmet health needs of children with a Child Protection Plan. It has introduced a standardised health assessment through the extension of the service currently offered to Looked After Children.

Outcomes are improved by:

• Focussing on a holistic health assessment

• Providing an opportunity for identification of health needs through; - Observation - Building relationships - Reflection and review

• Empowering professionals

For practitioners it has been a radical change to practice. Vulnerability and child protection are known to correlate; these health assessments have been a big improvement on previous service and make a positive difference to the lifetime outcomes of these children. Working Together (2013) suggests improved outcomes are noticed when professionals have defined roles within the child protection process and work together to achieve them. This along with the Department of Health led School Nursing Development Programme (2012) and Health Visiting Implementation Plan (2011) provided a firm evidence basis for change.

A clear pathway has been developed by the team that underpins the assessment process. School Nursing and Health Visiting safeguarding leads have ensured smooth implementation of this new way of working through effective training, excellent communication, support with transition and robust supervision.

Nurses and stakeholders have already seen a positive impact including:

• Identifying and addressing unmet health needs

• Improvement of information sharing across professionals – positive feedback received from community paediatricians and social care professionals

• Providing a baseline for future health assessment

• Providing a standardised framework for health assessment and intervention planning

• Clarification and strengthening of health visitor and school nurse role locally within child protection

• Reduced time spent by health Visitors and School Nurses on child protection reports or unnecessary input.

• Focused intervention and input of health professionals on focussed health outcomes

• Improved relationships – better care and communication with children, young people, parents and carers

The effectiveness of the health assessments are closely reviewed through regular School Nursing and Health Visitor safeguarding leads meetings, two way communication and feedback at locality team meetings and safeguarding supervision. As a result of excellent leadership and clear communication school nurses and health visitors have an effective health assessment which focuses on improving the health outcomes of children and young people.
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