The Early Intervention Transformation Programme Workstream 1 Engaging

The Early Intervention Transformation Programme - Workstream 1 “Engaging With Parents” Barbara Strawbridge – Getting Ready for Baby / Getting Ready for Toddler Hilary Mc. Evoy – Getting Ready to Learn “The Early Intervention Transformation Programme (EITP) is a Northern Ireland Executive/Atlantic Philanthropies Delivering Social Change Signature Programme, funded jointly by the Delivering Social Change fund, Do. H, DE, Do. J, Df. C, Df. E and The Atlantic Philanthropies. EITP aims to improve outcomes for children and young people across Northern Ireland through embedding early intervention approaches. ”

WORKSTREAM 1 – What is it? � The coming together of six Government Departments and Atlantic Philanthropy, as part of the Delivering Social Change initiative, to jointly fund a programme of early intervention � The programme will seek to: 1. 2. 3. equip all parents with the skills needed to give their child the best start in life support families when problems first emerge, out-with the statutory system positively addressing the impact of adversity on children by intervening both earlier & more effectively to reduce the risk of poor outcomes later in life

POLICY CONTEXT Re-orientating the system towards early intervention. Focus on collaborative working with individuals, communities and partner organisations. Evidencing and improving outcomes for children and young people. Making Life Better (2013 -2023) Healthy Child, Healthy Future (DHSSPS, 2010) Healthy Futures 2010 -2015 (DHSSPS, 2010) Learning to Learn: A Framework for Early Years Education & Learning (DE 2013) A Strategy for Maternity Care in NI 2012 -2018 (DHSSPS) Breastfeeding: A great start 2013 -2023 (DHSSPS) /UNICEF Baby Friendly Initiative Bamford Action Plan (2012 -2015) NICE guidelines Making best use of resources Improving foundations for better physical, emotional and mental health Laying the foundations for effective parenting and learning for life Supporting and empowering parents, families and communities

COMPONENTS OF WORKSTREAM 1 Getting Ready for Baby Getting Ready for Toddler Getting Ready to Learn

GRFB Programme Overview ANTENATAL CORE CARE PATHWAY 6 GROUP SESSIONS S PUBL LTH A E H IC N PARE AGE S S E M SHIPS TION A L E BY R T/BA CO NTA INM ENT S O L I H U L L BEHAV INFA REC IPR NT M IOUR M OCI T ENT ANAGE Y AL H EALT MENT H

Programme Aims Highlight importance of infant mental health with focus on Baby Brain development and attachment Opportunities for midwives, families and others to work in partnership together Better engagement with fathers Uses evidence based Solihull Programme Combined Group Based Care and Education for first time parents Provide social opportunities for expecting parents Consistent care from the same midwives delivering on important health messages

Facilitation Techniques FEELINGS MAP GROUP WORK COMMUNICATION TOOLS FLIP CHART CONTAINMENT ACTIVITY

Breakdown of Sessions 16 weeks – Helping You and Your Baby Through Pregnancy and Birth 25 weeks - Getting To Know Your baby In The Womb 28 weeks – You, Your Baby and The Stages of Labour 31 weeks - Helping You and Your Baby Through Labour and Birth 34 weeks – Feeding Your Baby 36 weeks – Caring For Your Baby

Session 1 - Helping You and Your Baby Through Pregnancy & Birth Ø Settle into group Ø Recognise and understand their own feelings Ø Recognise what/who helps them process their feelings relating to their baby during the pregnancy Ø Think about the support needed during pregnancy Ø Learn about Relaxation and Breathing

Session 2 – Getting to Know your Baby in the Womb – Brain Development BUILD RELATIONSHIPS WITH UNBORN BABY BRAIN, SENSORY AND PHYSICAL DEVELOPMENT POSITIONS IN THE WOMB PARENTS BEHAVIOUR COMMUNICATION TOOLS: DVD – THE BABY BRAIN GROUP FEEDBACK FLIP CHART

SESSION 3 - YOU, YOUR BABY AND THE STAGES OF LABOUR UNDERSTAND SIGNS OF LABOUR WHAT THE MOTHER, BABY & BIRTH PARTNER EXPERIENCES GET TO KNOW YOUR BABY CONTAINMENT AND RECIPROCITY

SESSION 4 - HELPING YOU AND YOUR BABY THROUGH LABOUR Understanding Positions Before Labour Understanding Active Birth Positions Understanding the Process of Labour and how the Baby helps Pain Relief and the effects on the baby Support in Labour Plan for Support at Home

SESSION 5 - FEEDING YOUR BABY How Feeding, bondng, stroking and touching baby is integral to developing a relationship That their baby will want to interact with them How to keep their baby safe by reducing risk of cot death Containment and Reciprocity to help prospective parents understand Baby Blues and Postnatal Depression How feeding is part of developing a relationship with their baby Benefits and concerns regarding breastfeeding Frequency of feeding Types of milk Support available

SESSION 6 - CARING FOR YOUR BABY INTRODUCES THE PRACTALITIES OF HOW TO HOLD A BABY HOW TO BATH A BABY HOW TO CHANGE A BABY'S NAPPY

IMPACT ON SERVICE � Over 2300 women have attended GRf. B � Around 10% of all women booked � Around 24% of first time mothers booked � Xxx groups started � Xxx groups completed � Xxx sites in 5 Trusts

OUTCOMES BASED ACCOUNTABILITY DATA COLLECTION Parent evaluation using Solihull at each session 36 week questionnaire Karitane Questionnaire 14 -16 wk Postnatal Monitoring Database

Solihull Approach Antenatal Parenting Group Evaluations November 8 th 2017 ©Solihull Approach 19

Parent Evaluations � Data collection period Oct 2016 - Sept 2017 � Data collection is ongoing � To date we have collated over 350 evaluations for every session with more partial data where data has not been included yet � Data collection is presented as an overall data evaluation � Not possible to identify every full set of data for all groups Your data collection is impressive ©Solihull Approach 20

To help you relax and share experiences? OK , 6. 1% Poor; 0. 1% Great ; 93. 8% ©Solihull Approach 21

To help you get to know your baby? OK, 8. 1% Poor ; 0. 2% Great; 91. 7% ©Solihull Approach 22

KARITANE PARENTING CONFIDENCE SCALE Regionally Between Sept 2017 – Jan 2018, 199 Karitane responses have been received. 75% of new mothers breastfed their baby 59% fully or partial breastfeeding on discharge

; th wi ives & s las idw sses c c ti le m cla ; s a ab he er nt Fa edge ing t geth ed & k wl hav ps to y car than o kn yed k-u eall ve c r ti jo en che ives roac dw y p you! mi ver re we WHAT PARENTS SAY Brilliant concept; really helped me to recognise my worries/fears of labour & becoming a first time parent; it was reassuring to know that I wasn't the only one with these worries & we are all in the same position Extremely enjoyed each session; as a father, was made to feel a lot more confident due to information provided; would strongly recommend this group to first time parents & its great to see the passion the midwives have for their job Re this ally en j con group; oyed b wer fident; I feel v eing p mak e frie Midw infor art of m iv ing ndly the & w es lea ed & d e e enjo xperie lcomin ing yab nce r g, le eall y Absolutely invaluable sessions; reassured in terms of looking after & handling baby; now know what to look out for baby, mum & dad's wellbeing; easier to learn through demonstrations in a group environment; great to share experiences with others & have expert advice at the same time

3+HEALTH REVIEW & ALIGNED HEALTH VISITOR

3+ HEALTH REVIEW- Why is it needed? Age 3 -4 critical point in child development and an essential part of the Universal Child Health Promotion Programme. Audit of the core Healthy Child, Healthy Future delivery found the recommended 3 year review is not carried out in any Health and Social Care Trust area.

Parents highlighted a gap in current universal programme for face to face contact between 2 years and Primary One Consultation with health and education colleagues found evidence of preventable developmental delays in: Speech & Language Peer relationships/social skills Behaviour Toilet Training

PHASED APPROACH Stage 1 -A named health visitor will aligned to every DE funded pre-school education setting across Northern Ireland. The HV will work in partnership with her colleagues in education to provide a public health service to support and promote healthy child development Stage 2 - A 3 + Health Review with a focus on the child social and emotional wellbeing is introduced capturing 92% of children. The review will take place in the pre-school education setting. Following evaluation of the pilot , the aim will be to roll out this programme across all DE funded pre-school education settings in Northern Ireland: Year 1: 10% Year 2: 20% Year 3: 50% Year 4: 100%

Health Visitor Alignment Aligned to DE Funded Preschool settings Contact made each school term NAMED HEALTH VISITOR The HV will keep the pre-school principal/leader updated on current health protection advice (e. g. flu vaccine), health improvement information and current campaigns (e. g. dental health). Promotes health by providing health information to parents and teachers and to offer guidance and support in respect of the whole school population or in respect of individual children.

AIMS OF 3+ HEALTH REVIEW ASQ OBA/DATA COLLECTION FOR CODESIGN AND COPRODUCTION 3+HR PARTNERSHIP BETWEEN HEALTH AND EDUCATION REFERRAL

3+ HEALTH REVIEW DVD

NHSCT ENGAGEMENT 2016 -2017 � 20% DE Funded Preschools involved � 1161 DE Funded children targeted � 989 3 & 4 year olds in NHSCT participated in 3+ HR by completing ASQ � 943 assessed – 97% � 6 required an interpreter service

Getting Ready to Learn Objectives: • to support staff within early years and pre-school settings to engage and empower all parents to create and sustain positive home learning environments • to use the strength of universal services to deliver support to parents • to develop and deliver an agreed set of key messages

Key Strands • To support improved early attachment and bonding, improve speech and language development • To support improved motor skills, nutrition, dental health, bedtime routines and positive parenting • To help improve parents understanding of developmental milestones and what they can do to support this at home Getting Ready to Learn

Education Works in Pre-school Aims: • To provide information on the 6 areas of the Pre-school Curriculum • To enrich understanding of how children learn through play • To advise parents/carers of ways to support children’s learning through play at home • To reduce screen time at home Getting Ready to Learn

Happy Healthy Kids Aims: • To develop healthy lifestyles • To explore the benefits of exercise for pre-school children • To share how experiences in pre-school support physical development • To support parents to increase children’s physical activity • To reduce screen time at home • To develop healthy eating habits Getting Ready to Learn

Ages and Stages Aims: • To help parents understand the developmental milestones for 3 -4 year old and ranges within the norm. • To provide user friendly materials to be used as a guide so parents have a realistic expectation of their child’s development i. e. what to expect and when • To reduce screen time at home Getting Ready to Learn

Big Bedtime Read Aims: • To explore the importance of reading to young children • To share ideas about how to enjoy a book together • To provide resources to support Bedtime Reading • To encourage reading throughout the day • To encourage use of Library services • To reduce screen time at home Getting Ready to Learn

Online Support Participating settings have access to online support, including: Getting Ready to Learn

Cluster Support Practitioners come together to explore themes and share practice • Centre-based - facilitated by the Getting Ready to Learn team • Setting-based - facilitated by practitioners Getting Ready to Learn

Story So Far…. . • 502 settings currently participating • 90% of settings reported that every family engages in some way • 10% of settings delivered more sessions than planned indicating parents buy in • 37% of settings reported an increase in attendance from session 1 to session 2, indicating the positive impact of the programme • 96% reported improved levels of parental engagement As a result children are developing: A love of books, more imagination, better listening skills, increased concentration, improved language skills and vocabulary as well as better coordination and motor skills Getting Ready to Learn

Is anybody better off? Feedback from participating settings 2016 -17: I now have lots of ideas of different ways to help my child with her physical skills instead of always taking her to the park. I was previously unaware of the brilliant library service available and the Big Bedtime Read has opened up the world of the library to my child. Now that we have story time before bed, it is so much easier to get him to sleep and to get him up in the morning. I didn’t realise until this scheme how much play impacts on my child’s development or how my child could play with day to day things we have at home instead of always needing new toys. It has been so informative for me as a parent! Getting Ready to Learn Our child’s love of books has grown and I really think his imagination has as well.

Video of a young participant enjoying the Big Bedtime Read! Getting Ready to Learn

Application Process Guidance booklet and application forms are available to download, please visit: www. gettingreadytolearn. co. uk Application closing date: Friday 27 th April, 2018 Getting Ready to Learn

Early Intervention for Happy, Healthy Kids!