Empowering Parents 19 June 2013
Financial Inclusion Service in a Children s Hospital Setting Lesley Nish Senior Health Improvement Officer, Health Services Division, Public Health. NHS Greater Glasgow and Clyde Copyright NHSGGC
Preparation for the pilot Health Improvement Steering Group Action Plan. Carer s Needs Assessment Healthier Wealthier Children Project Funding Multi-disciplinary Steering Group Project starting point and scoping exercise Evaluation plan EQIA
Service Provision Aim to reduce poverty, inequalities in health and improve financial capability. Four Clinical Specialist areas identified for phase 1 Diabetes, Renal, Neurology and Cardiology service areas. Referral pathways developed Staff role in raising the issue identified and supported
Raising the issue Clinical Nurse Specialist raises the issue with parents / carers Financial Inclusion Support is for parents/ carers of all ages regardless of their working status. The role of staff is to: reassure that support is available gain consent for referral refer to the service
Referral route I Phase l Establish if parent/ carer has any immediate financial concerns. CNS - Diabetes, Cardiology, Renal and Neurology teams. Patient has urgent concerns Patient has non-urgent concerns Complete referral form and ask parent / carer to sign for consent. Advise parent / carer that the FI worker is on site Complete referral form and ask parent / carer to sign for consent. Advise parent / carer that the FI worker on site Advise parent/ carer that FI worker will contact them immediately for urgent cases and within a week for non urgent cases. Contact FI worker and ensure all fields of referral form are completed. Ensure referral form sent to FI worker.
Service Provision CAB Income Maximiser on site Provides Type 1 (signposting) & 2 (casework) Provides Type 1 - core services welfare benefits, money advice, financial capability, employment, housing and legal advice to families at Yorkhill Children s Hospital Clients resident out with Glasgow City who require a Type 2 (casework) or 3 (representation) services should be referred to an appropriate agency in their local area, if appropriate.
Monitoring and Evaluation Findings 135 referrals made to the service from 20 th August, 2012 to 31 st May, 2013 126 currently engaged with project. The case work facilitated has involved money advice, welfare rights, financial capability, housing, employment, legal and other advice for families. 202,647.61 current financial gains. A further 99,408.80 potential financial gains in next quarter. Evaluation currently quantitative. Plans to explore using a qualitative paradigm.
Pilot Strengths Location / environment is non judgemental and non threatening EQIA Change of service days to suit service user s needs. Low numbers of DNA s and non engagement A named worker who is visible to staff / parents on wards Enhanced skills of worker Good relationships with other departments e.g. Social Work and Family Support. Clear referral pathways
Pilot Challenges Demand and capacity Rely on staff identification of need Not advertising the service Limited availability Wide geographical spread of service users Managing emotions Numbers of return appointments not easily captured in data.
Pilot findings Initial findings demonstrate: Low numbers of non engagement Low numbers of broken appointments Considerable financial gains Families returning to service at a later point (2-3 months after initial contact) to address other financial issues.
Thank you for your time and for listening.
Community Food Work - training and delivery Fiona Smith RD RNutr Public Health Dietitian
Community Food Work Government funding for 6 CFWs delivering food skills programmes Direct contact with 1500+ parents and carers across 40 Early Years establishments 400 parents attended 1550 hands on sessions 4 or 6 week programmes (average 4 x 2 hour sessions per person)
Evaluation of Impact Evaluation by Public Health Researcher 102 participants completed before and after questionnaires Covered confidence, frequency of eating fruit, veg and ready meals One year on follow-up evaluation with Glasgow University interviewed 44
Confidence on cooking using basic ingredients
70.0 Confidence on following a simple recipe 63.7 60.0 56.8 50.0 % of participants 40.0 30.0 28.4 24.5 34.1 32.4 20.0 10.0 0.0 1.0 19.6 12.7 8.8 9.1 4.9 2.9 0.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1 2 3 4 5 6 7 Baseline (n=102) Post-intervention (n=102) Follow-up (n=44)
50.0 45.0 Confidence on preparing and cooking new foods 46.1 45.1 40.0 38.6 35.0 % of participants 30.0 25.0 20.0 20.6 23.5 29.5 17.6 29.5 15.0 10.0 5.0 0.0 5.9 12.7 9.8 9.8 7.8 2.3 1.0 0.0 0.0 0.0 0.0 0.0 0.0 1 2 3 4 5 6 7 Baseline (n=102) Post-intervention (n=102) Follow-up (n=44)
Patterns of ready-meal, vegetable and fruit consumption Where: 7= more than once/day and 1= never Ready meals Before After One year 4 3 2.5 Fruit 2 5 5.5 Vegetables 4 5 5
Other benefits from the course at one year follow-up 98% of the participants agreed that there were benefits to family members from the cooking skills group. 86% participants agreed that the cooking skills group has improved their overall confidence. 84% participants agreed that the cooking skills course had improved their confidence to learn other skills. 70.4% participants felt more employable after the cooking skills course.
What did you like? For me it was more about reinforcing skills and enjoyment (normally I hate cooking) It was fun and relaxed but the same time learning new skills and information It taught me things I could never do before. CFW gave me more confidence in cooking This course has made me think about making changes for the better Enjoyed learning more in depth information on basic foods Something you think you know but you don't I enjoyed meeting new people and being part of a group. I really enjoyed learning new healthy recipes
Nutrition and Food Skills for the Early Years To support others who s role includes food, to deliver confidently and competently on food knowledge and skills Half theory and half practical Level 1 - for those who work with children Level 2 for those who work with children and parents and have a practical role Free, local, access to additional resources
Who attends? Level 1 - Childminders, childcare workers, early years workers, oral health staff 96 trained Level 2 - Staff from:- Early years (LA and private), Early years children and families team (NHS), Family centres, Social work, Community learning, Leisure and Recreation, Youth services, residential carers 124 trained
Learning Outcomes 1 day Explain and use the Eatwell Plate Demonstrate a basic knowledge of current nutritional recommendations Recognise the relevance of Nutritional Guidance for the Early Years. Identify any changes to be made in their own establishments to meet the criteria of the guidance. Provide/prepare healthy food and drink options for children in their care. Know where to signpost clients for resources and more professional support.
Learning outcomes - 2 day Assess own level of nutritional knowledge Recognise the definition of health and its relevance to families Explain and use the Eatwell Plate Demonstrate a basic knowledge of current nutritional recommendations Identify common barriers to adopting healthier eating habits. Support families at different stages of health behaviour change. Be confident in using a range of nutritional resources to support learning among adults and children. Gain confidence and skills to deliver practical cooking sessions. Adapt menus or recipes to meet healthier eating guidelines. Identify practical considerations to run cooking skills groups.
Nutrition and food skills evaluations 100% felt training met their needs Reach to clients almost 3000 over a year Learning on the course equally divided knowledge and skills Follow up More support from managers to deliver Support from CFW team for venues, equipment, resources, health and safety. Funding!
Benefits to work role Speak more knowledgably and confidently With children 60% With parents 90% Providing healthier food for children 40% Cooking with children or parents 30% 70% say they are planning to do cooking
Additional comments? In all honesty this was the best training course I have attended all year and really increased my confidence and knowledge of cooking and food I found it scary - that I had less knowledge than I realised regarding the content of packaged food I am more confident now both at home and working with parents, and now have a waiting list of parents for our cooking group and weaning group This has given me the confidence to try cookery classes with parents. Very practical. For both work and personal life this course has made a great difference to me
Current and future Community food work Continue to source funding for permanent staff Develop the role for other client groups Hands-on workshops for people with long term conditions Practical support for home carers Support for people undergoing bariatric surgery Practical support for children with therapeutic dietary need Development of additional training and e- learning modules for NHS and non NHS staff Eatwell plate Maternal nutrition Weaning "If you give a man a fish you feed him for a day. If you teach a man to cook you feed him for a lifetime."
Thank you and questions? How to best target cooking skills for parents? How to support staff we have trained and how best to deliver training in the future?
Discussion Questions Consider your current practice, what do you do at present use asset-based approaches to develop services for parents? How will what you have heard today influence this? What could you do differently? Who/what can help to support this? (might be policy/people/programmes/structures etc.)