CYP(3) PAP 27
Children and Young People Committee
Inquiry into Parenting Action Plan
Response From Hywel Dda NHS Trust
Hywel Dda NHS Trust was formed in April 2008 and comprises of 3 former separate NHS Trusts namely Pembrokeshire & Derwen, Ceredigion and Carmarthenshire.
The Trust provides acute, community and mental health services to the populations across Pembrokeshire, Ceredigion and Carmarthenshire.
The new Trust is divided into 4 divisions - Pembrokeshire Acute & Community, Ceredigion Acute & Community, Carmarthenshire Acute & Community, Mental Health and Learning Disabilities across the above 3 regions.
This response is from the Pembrokeshire Acute & Community division of the Hywel Dda NHS Trust. Within this division, children’s services are delivered via an integrated model which encompasses universal support to children and families from health visiting and school health services.
Delivery of the Parenting Action Plan
Implementation of this plan has been partly effective: it has made organisations aware of the needs of parents to be more fully supported and opened discourse and the beginning of planning to address those needs.
The amount of support locally to parents has increased; we have voluntary organisations such as Plant Dewi providing parenting courses. Selected Health Visitors have undertaken Webster Strattan training and deliver this within groups that referred into by other health professionals. Work is currently underway to develop more partnership working of this delivery i.e. pairing a Health Visitor with a Plant Dewi Worker to deliver programmes. Also Webster Strattan programmes are delivered locally to targeted parents such as those with complex needs or disabled children. We have placed a school health nurse in each of our secondary schools to help provide support to both young people and their parents.
Support is accessible via Health Visitors to all parents with newborns and those families who move into the area who might not have seen one of our health workers previously. School Health Nurses also undertake family home visits to those families who have moved into the area and may need extra support.
Via a universal service which is taken into the home as via a health visiting service, part of the work and assessment with those families is identifying and working with hard to reach and engage families who maybe struggling. Within schools there is also an attempt to identify those families who do not readily present themselves as having a need for support.
Parents of young children receive information in the form of Birth to Five, Parenting Positively information, the child development programme and other selected information depending on the need presented.
Parents of older children receive information from school and the local Children’s Information Service. The focus has certainly moved to identifying and supporting parenting needs.
Participation in planning is really just beginning to build steam. Use of parent stories as in listening to experiences of parents and their feelings of where gaps are in relation to support, is a development to pursue
Access to information about services and support relies heavily on parents of older children being literate and able to understand web based information.
For parents of younger children Tier 1 universal workers seek to discuss and explore parenting issues and signpost parents to services on an individual family basis this enables barriers to be broken down or resolved.
Within Pembrokeshire there is a multi agency steering group looking at integrated working practices of tier 1 and 2 services. All partners are involved including statutory and voluntary. The aim is to build teams around children and families organised into family of schools communities. The objectives of those teams will focus on delivering services tailored to the presenting needs within families, with parenting skills being one part of the whole picture. The teams would work together to address the more complex needs of those families where more than one service is required.
Continued work on Parenting
Key parenting issues which remain to be addressed relate to the understanding that promoting blanket parenting courses does not meet the need within families.
Indeed there are different levels of parenting support needed within services.
Clear direction on the evaluation of outcomes of parenting support and the impact on the child’s well being as well as the community’s well being need to be developed within services. It is not enough to measure how many parents have accessed support, it is crucial to understand whether a difference is made to parenting skills. There is currently the potential for parents to access different courses offered by different organisations more than once, without recognition of effecting change within the parent’s skills.
What has worked and what hasn’t?
Within our own services we have parental support which focuses on supporting, enhancing and promoting the developing relationship between parent and child which is the foundation for building parenting skill. Our SCBU NNEB’s offer baby massage for premature infants promoting the attachment between parents and babies which due to their health condition can be difficult to establish.
The skill mix in the varied programmes of early interventional support offered to parents using our Sure Start NNEB service. Parents through the Health visiting service are identified as needing extra support which is delivered either by the Health Visitor or by the Sure Start NNEB under the supervision of the health visitor. We are also currently working on an Early Bird service in partnership with NCH and Educational psychologists to support parents of those children identified early with presenting behavioural problems. Our Speech & Language therapy service offers a feeding support service initiated by Health Visitors for those parents experiencing difficulties in this area.
The development of parenting services has grown since the introduction of the plan - it has also helped to start discussions as to how effective those services are and whether menus of services should be more varied and tailored to need rather than trying to push the need into a 'best fit’ service provision.
It has also opened discussions on which programmes have the most reliable evidence as to their efficacy and the governance issues in delivering them.
Programmes for parents will be most effective where services can work together in an integrated practice to support need. Parents cannot be stigmatised by accessing those services therefore they must be built into the normal infrastructure of community support.
Isobel Hall
Patient Care Manager
Children’s Services
Women, Children & Community Health Directorate
Withybush General Hospital
19th June 2008
