Brent proposes to combine Health Visitor and School Nurse services

A paper going to Cabinet on Monday proposes the procurement of a new 'joined up' 0-19 Health Visitor and School Nursing Service with a combined value of £6.6m.

Currently the Health Visitor and Family Nurse Service is provided by London North West Healthcare Trust and School Nursing by Central London NW Healthcare Trust.

There have been concerns, some of which I voiced in a delegation to Cabinet, about the lack of continuity between health visiting and school nursing, at the point where children start nursery. Early Years practitioners have found children arrive at nursery or reception with specific special needs that they haven't been informed about in advance.

One of the issues has been that engagement with health visitor services is not mandatory and that missed appointments are not followed up. Health Visitors are often the first people to become aware of a family's other needs. The paper LINK states: 

...The successful Provider will be required to demonstrate how their services and the staff teams employed will be pro-active and engage with families and their under 5s to support health needs and link into wider issues including housing, education, childcare, welfare and poverty. 

The service to be procured as outlined in this report will lead to the delivery of the Healthy Child Programme - the early intervention and prevention public health programme issued by the Department of Health which lies at the heart of universal services for children and their families. The early years are a crucial stage of life, and this service will provide an invaluable opportunity to identify families who are in need of additional support and children who are at risk of poor outcomes. 


To improve continuity across the services and age ranges, the Council is planning to combine health visiting and school nursing service so that professionals will be able to continue to work with the same children for a longer period of time rather than passing them to another service as they get 
older. This will improve the continuity for children and young people and their families. 

By commissioning these services together professionals will no longer be bound by the traditional age ranges of services, and both children and families can benefit by receiving support from the same professional for longer. It will also be expected to realise efficiencies through economies of scale and overhead and management costs. 

 The 'efficiencies' referred to in the last sentence are clearly something to scrutinise in the context of the impact of cuts on services but the joined up approach is something to be welcomed. The health of Under 5s was a matter of great concern in a report to Cabinet in January this year LINK.

There are an estimated 24,600 under 5s in Brent, an increase of 2,500 on 2010, but the rate of increase is expected to slow over the next few years. The resident population of 0-19 year olds is expected to increase by almost 10% over the next 5 years.

The new combined contract would start on April 1st 2017.

'The MDC is okay with me' says Pavey but others disagree

Brent's Cabinet met at Roundwood Youth Centre this afternoon, as part of a programme to move the meeting around the borough. It was followed by a walk-about in the area.  There was more discussion than usual with backbenchers and residents contributing but once again a Brent Council meeting was marred by the failure of councillors to project their voices and the lack of microphones.

Democracy must be HEARD to be done!

The Cabinet approved the action plan arising from the Brent Education Commission which includes partnership work between schools and support for the Brent Schools Partnership which has recently appointed a Strategic Director who will work a three day week.

One of the more controversial issues was  planning school places:

Objective: Ensure that the local authority is proactive in encouraging the best schools in Brent and free school providers  to set up new schools in areas where extra places are need.

Activities:

Work wuth the Education Funding Agency, DfE Free Schools team, the Regional Schools Commissioner and other partners to attract the best quality providers to Brent.

Promote the establishment of effective local chains/federations/partnerships to promote new schools and offer a local solution for schools at risk of failure.

A Labour Council supporting free schools and chains will stick  in the throats of many, particularly on the day the Michaela Free school opened in a building that remains a building site and when Gateway and Gladstone Free Schools failed to open on time.

Deputy Leader and former lead member for Children and Families, Cllr Michael Pavey, raised the possibility of the strategy changing if there is a change of government policy after the General Election.

Cabinet approved plans to make school expansion contracts more attractive to building companies by putting several into a package.

The London Mayor's plans for a Mayoral development Corporation in the Old Oak/Park Royal area provoked most discussion. As explained in an earlier blog Brent Council has not opposed the MDC in principle. Backbencher Cllr Dan Filson thought that was a mistake and said that Brent should start from the position that the MDC is undemocratic and limits the input of Brent council into the plans. He though that having the three council leaders (Brent, Hammersmith & Fulham, Ealing) sitting on the MDC would not solve the problem as they would not have time to get down to the nitty gritty. The focus of the MDC was on Old Oak rather than the important task of reinvigorating the Park Royal Industrial Estate and rescueing it from being mainly devoted to warehousing.

Resident John Cox said that in the Harlesden incinerator campaign there were 180 councillors they could lobby. With the MDC it would be just three.  He said much of the land was publicly-owned, which we purchased in 1948 when nationalising the railways. Instead of flogging off public assets for the maximum value to developers, and then being supplicants to try and get some (so-called) affordable housing, we should value some of the land as zero, in perpetuity, and the state should build social housing. We could even call it council housing if we wanted to. He said the area was more like the Docklands development rather than the Olympic site.

Cox said that there was no chance of Crossrail coming to Wembley Central station  but Cllr Butt said that the Council had not given up the battle to make Wembley Central a destination: 'We can't afford to not having trains stopping there'. It was essential for the housing planned for Wembley.

Cllr Claudia Hector, another Labour backbencher, said that housing in the new development must be 'genuinely affordable' not the London Mayor's 80% of affordable rent. Director of Regeneration and Major Projects, Andy Donald, said the council was aware of that and that there would be a mixture of housing.

Cllr Pavey said that he thought the MDC was the right structure, with the wrong Mayor.  He could not see a combination of the three local authorities (Ed: Ealing's suggestion) as working for such a large development.

Muhammed Butt said that the three councils were continuing to talk but he stressed that they must come up with a 'credible alternative': 'We will have to work with the MDC if we don't come up with anything else'.

The Cabinet approved a bid to the GLA to make Alperton and Wembley Housing Zones. 20 will be created across London at a cost of £400m to create 50,000 new homes and 100,000 associated homes over the next 10 years.

Margaret McLennan said that the Zones were essential, especially in Alperton, to provide much needed infrastructure including new schools, health centres, transport etc to kickstart the areas. Cllr Perrin, lead member for the environment was concerned that this was at the  cost of moving businesses out of the area and there were also issues over contaminated land near the canal at Alperton.

I was pleased to see that £6m has been set aside for the provision of school nurses but this is going to external procurement, rather than in-house and only one bidder has emerged. it was confirmed that the provision would be free to local authority, academies and free schools but not to private schools. There was no detail about how many hours per school would be involved.

There was a rushed discussion of the Borough Plan where the Council hope to engage young people in schools in discussions about the future of the borough and no discussion at all on the Quarter 1 Performance Report where council services are given a RAG (Red, Amber, Green) rating. Support to enable families to be independent, take up of 3 year olds nursery education grant and the number of in-year applications for primary places getting a place withion four weeks of applying were all given a red rating.