Decision details

Councillor Mark Ingleby, Chair of the Panel, informed the meeting that he had received a request from Councillor Joan Millbank to consider a decision taken by the Mayor and Cabinet on 15 June 2022 relating to “Permission to Procure for 0-19 Public Health Nursing Services”.

Councillor Millbank addressed the meeting on the topic, advising that she welcomed the decision because of the unified strategy and the multi-disciplinary approach to deliver across agencies.  She however expressed a concern about safeguarding and the potential of creating barriers to access child assessment and antenatal care services via virtual appointments.  Councillor Millbank also enquired why an Equality Impact Assessment (EIA) was not undertaken when formulating the proposals upon which the Mayor and Cabinet decision was based.

In response, the Joint Commissioning Lead Officer informed the Panel that because of social distancing requirements at the peak of the Covid-19 pandemic, appointments with service users were via the telephone, but that medium was not as effective.  The introduction of a National Health Service (NHS) software made it possible to deliver an improved service to women and families via virtual interactions.  It was stated that feedback collated from users who accessed health appointments via the NHS virtual medium showed their experiences were good and that they would recommend the facility to their families and friends because they felt listened to and supported.

The Joint Commissioning Lead Officer also responded to a follow-up question, clarifying to the Panel that information from the feedback collated from service users was considered as part of the review.  Therefore, the NHS software would remain an option within the new service specification so that users with digital capabilities who had expressed a preference to access support virtually based on their individual experiences would be granted video appointments.  However, in order not to digitally exclude families, the default option for health visits and consultations would remain physical via face-to-face.

The Panel received confirmation from the Joint Commissioning Lead Officer that face-to-face appointments would be provided during the first two visits for new births and the 6-8 weeks’ reviews thereafter due to a recognition that most families would require hands-on support during those periods, regardless of needs.  Thereafter, it would be a clinical judgement by health visitors to decide whether the one or two-year reviews should be held virtually, or if a blended approach to include face-to-face appointments would be required.  It was stated that in situations where there were concerns about safety and wellbeing, particularly for those families identified as ‘vulnerable’, it was likely that clinical judgements would enable them to access services face-to-face for all health reviews including antenatal appointments.

The Head of Service for Joint Commissioning also confirmed to the Panel that an EIA review was underway.  It was stated that the process would include all factors relating to protected characteristics for equality considerations, and be completed in time for the award of the contracts.

Commenting on the responses, Councillor Millbank thanked the Officers for the clarifications, and expressed satisfaction that parents’ feedback and views would continue to be considered as part of the review process, commenting that it would have been inappropriate for professionals to insist on virtual consultations to access health and antenatal care.

Councillor Sorba commented that there had been media publications where safeguarding of children could have been handled better, therefore, allowing parents to self-select based on their preferences to access health and antenatal services, and the reliance on health visitors to make clinical judgements were potential risks.

In response to concern by Councillor Sorba, the Joint Commissioning Lead Officer gave an assurance to the Panel that safeguarding plans in the new service specifications to support families using a multi-discipline approach included the involvement of General Practitioners as well.  She reiterated by stating that every parent would be seen in the home environment more than once.  Thus, face-to-face consultations would continue alongside effort to improve digital access, with a view to diversify universal health visiting offers for families.

RESOLVED that the report be noted.