Creating an appropriate infrastructure - English presentation
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  • These workshops cover the services which could support or affect families, in the transition to parenthood. Its not what NCT provides, although in the future it is possible there will be more overlap. The purpose was to outline some current services for people becoming parents and draw from those attending ideas on what they felt parents needed at this stage in their lives. We value enormously the knowledge, thoughts and input of NCT workers.
  • Yes we are senior advisers but we most certainly do not know everything.
  • We start by trying to set out a wide approach to what we mean by ‘services’. Some are obvious, like maternity care, which the majority of people expect to get free of charge via the NHS. Other things that parents need are not usually called services but are part of the accepted legal and economic provision for parents, like maternity/paternity leave and pay, child benefit and tax credits. Goods and equipment may be bought commercially, obtained via voluntary sector sources or sometimes hired from the NHS, a charity or local authority in certain circumstances.
  • These criteria describe a ‘perfect’ solution that should be snapped up by the ‘powers that be’. Unfortunately, even if we can find one that meets all of these, there may be other obstacles to acceptance or implementation. However, we know that the better we can argue in these terms, the more success we are likely to have.
  • Most people have been affected by reduced incomes in the last couple of years, through pay freezes, unemployment - particularly affecting women and young people and increased inflation, which affects necessities such as food, fuel and transport costs . Government cuts in services have also affected women and the poorest families most. F amilies have lost the Child Trust Fund, the Health in Pregnancy grant, any increase in Child benefit, Maternity Grant for subsequent children. Some families have also lost entitlement to Child tax credits and the proposed cap on benefits affects many people. As an example of our work, NCT is a member of End Child Poverty and the End Fuel Poverty Coalition. It is estimated that 1.3 million children live in poorly insulated, F and G-rated properties. Children living in cold homes are more than twice as likely to suffer from respiratory problems as children in warm homes, and mental health is affected negatively by fuel poverty and cold housing.   Along with the rising birth rate mainly due to due to economic/social migration, women experience more complex pregnancy and birth, partly because mothers’ age is increasing and there are more women with long-term medical conditions On a positive note, the right to take paternity leave has been increased with the aim to encourage shared parenting but is only paid at statutory rate, i.e. approx £130 per week.
  • NCT has always been clear about the value of parent representatives involvement in the planning, design and evaluation of services. We would like to expand participation in Children’s Centre boards, Health Watch Patient Forums, MSLCs, Labour ward forums, infant feeding groups and other groups which design or run services for families. The planning of health services in England remains unclear including how user input will be organised; this may differ from one area to another. The Joint Strategic Needs Assessment will be crucial and the Health & Wellbeing Boards very influential.
  • Apologies for the mass of information here. Since this slide was created GP consortia now known as Clinical Commissioning Groups. 1. The Sec of State sets a mandate for the NHS commissioning board, which includes priorities for maternity and neonatal care and public health 2. The NHS CB will directly commission primary care and specialised services 3. The NHS commissioning Board will issue Commissioning guidance, set the Contract framework, pricing structure and provide on-going oversight and support for Clinical Commissioning groups. 4. Clinical Commissioning groups (CCGs) and local authorities will develop local Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies . These cover the NHS, social care and public health through the Health and Wellbeing Boards . 5. The CCGs hold budgets and contract for services.
  • Public Health will be under Local Authority control, with a ring fenced budget, although Public Health England will commission some national services and campaigns Public Health England will directly fund and commission some services such as national campaigns Local authorities will have a new statutory duty to improve the health of their population. A ring fenced grant will be paid to LAs to fund these activities LAs will contract for services with a wide range of providers and incentivise and reward those for improving health and wellbeing outcomes and tackling inequalities in health. Public Health England will ask NHS to commission some public health services such as screening, funded from the public health budget.
  • Local Health Watch could be an important player. Responsible for Influencing commissioning, provision, local intelligence and potentially advocacy and information to members of the public.
  • NCT has promoted this idea, encouraging the idea of networks to be strengthened to become Maternity Trusts. Funding of maternity services could be more appropriately organised when maternity care is not provided in the context of an acute care institution.
  • Families come is all shapes and sizes, and everyone has different needs. NCT needs to draw on the knowledge and resources of members and other organisations to improve our ability to influence services which are appropriate for all families.

Transcript

  • 1. Creating an appropriateinfrastructure of services for those in the transition to parenthood: What are families offered, what do they want and how can NCT make sure they get it?
  • 2. Elizabeth DuffNCT Senior Policy AdviserRosie DoddsNCT Senior Policy Adviser
  • 3. People in the transition to parenthood (TTP) arelikely to need services in acute and communityhealth, public health, early education andchildcare.Parents also have needs for employment,income, housing, nutrition, transport, goods &equipment for babies, security, social support,leisure, communication and information, allappropriate for themselves and their families.
  • 4. To lobby for what we know parents want …NCT provides, offers or stimulates solutions- which meet the needs of politicians, policymakers and service providers- for both short-term successes and long-termbenefits- in terms of finance, efficiency and outcomes
  • 5. Current policy ‘snapshot’• Families have reduced incomes• Midwife shortage in England• Rising birthrate• Paternity leave has been extended, mothers may lose some entitlement• 4,200 more health visitors promised
  • 6. Commissioning Public Health
  • 7. Maternity networks•should extend choice by encouraging providersto work together.•bring together all maternity services – linkinghospitals, GPs, charities and community groupsto share information, expertise and services.
  • 8. Families – how do we see them?
  • 9. NCT’s new strategy – ways of working•Growth – we will continue to increase our reach, bothgeographic and social, to all parents and expand our postnataland early years services.•Thought leadership – we will use our position of influence tochange the perception of parenthood and create breakthroughsolutions to address the dilemmas parents face.•Partnership – to deliver on ambitious targets we will work moreformally with other organisations to increase the supportavailable to new parents and expand their availability to reacheven more of the population
  • 10. • Thank you for viewing our workshop Please stay in touch and feed through any news, thoughts and ideas.• Contributions, further information or thoughts to e_duff@nct.org.uk or r_dodds@nct.org.uk