Leicestershire lays groundwork for under-5s public health transfer

The move will see councils take over from NHS England the planning and funding of HCP - incorporating services such as childhood obesity, child wellbeing and maternal health - for all children under the age of five.

It has been championed by the Department of Health, which believes local authorities are better placed to lead on public health because of their closer links to communities.

Councils are already well versed in public health commissioning following the transfer of the bulk of public health services to local government in April 2013.

Leicestershire County Council is further ahead than most, having been praised for its public health work with the over-fives.

Mike Sandys, the council's director of public health services, says the experiences of the past 18 months will stand authorities in good stead in their preparations for next October.

"A lot of this (preparation) is about learning from the past," he explains. "It was really useful to have an implementation group so that as we worked through the implementation plan, everything ran according to time, and I believe that is critical."

Another crucial factor, he says, is communication with health visitors and Family Nurse Partnership staff, who provide frontline health services to under-fives.

"We have to provide absolute assurance to the health workforce that all that is transferring at this stage is the commissioning of services," he explains.

"They are not going to have to move across to the local authority."

"We have to make certain that they are really aware of what is going on, what it does and doesn't mean (for them), and that they are kept abreast of what will happen in, say, a few years time."

Luckily for Sandys, Leicestershire is one step ahead of the game on creating the necessary infrastructure thanks to the development of the region's health visitor assurance board, which will oversee the transfer of responsibility for commissioning the HCP.

"We took an early decision that, since we had the right people around the table (from the local authority and providers), it made sense for us to give that board additional powers in terms of joint working and what needs to happen (after the council gains responsibility for commissioning the HCP)," Sandys explains.

He says each local authority will adopt a different model for commissioning public health services for under-fives, but he is keen to explore the option of redesigning his service to provide an integrated 0 to 19 offer, including the Food for Life Partnership.

As part of this, he says he would consider "embedding" health visitors and school nurses within children's centres. "It would be a really good thing to bring together," he adds."It's where there would be a chance for us to have an integrated child health service."

Regardless of whether Leicestershire takes this route, Sandys is clear about his intention to keep HCP as a commissioned service.

"Some areas have plans to bring them in-house, but our thinking would be to maintain it as something we commission in from the NHS," he explains.

"The interesting redesign for me would be how do we take those existing providers into a redesigned service that is relocated into the existing children and families services that (we) provide."

Sandys says that the council's public health team is set to begin transfer preparations in November.

At-a-glance guide to the transfer of public health for under-5s

• From 1 October 2015, councils will be responsible for planning, commissioning and funding public health services for under-fives
• Councils' new responsibilities will include health visiting and Family Nurse Partnership services
• Public health staff will continue to be employed by the NHS or their current provider
• NHS England area teams are already working with local authorities to plan for the transfer
• At a national level, the Department of Health is working with the Local Government Association (LGA), the Society of Local Authority Chief Executives, the Association of Directors of Children's Services and the Association of Directors of Public Health to prepare for the successful transfer of responsibilities
• Regulations for the new arrangements are expected to be in place by May 2015
• Negotiations on funding allocations are still taking place
• The LGA will host a series of regional events in October where local authorities will be able to debate the transfer

Source: Department of Health