by Sarah Rollason | 23 November 2016
In England the commissioning of Health Visitor Services will transfer from the NHS to local government in October 2015.
The Director of Public Health in the London Borough of Merton wished to review local Health Visiting Services ahead of this transition in order to understand current service costs, delivery and effectiveness to inform future commissioning decisions.
This work is currently on-going and our solution is centred around a two-staged approach.
In Stage 1, now complete, we carried out fieldwork and desktop research to review services. We are currently using our findings to develop a costed Options Appraisal for future commissioning arrangements.
Our approach to Stage 1 was to review service deliverables and performance in the light of population health needs and national and local strategic priorities. We carried out a health needs analysis to determine local health and social care needs, benchmarked to statistical neighbours. We undertook a policy and research review to describe the evidence base for health visiting services/interventions.
Subsequently, through an extensive piece of stakeholder engagement which included one to one interviews, focus groups with practitioners and parents, and surveys to wider health and social care professionals and parents, we mapped services against national and local priorities, population health need and evidence of what works in health visiting.
We worked closely with service providers to understand current service configuration and performance and our qualitative findings were triangulated with performance data.
We carried out a gap analysis which highlighted what services were doing well as well as gaps in service provision and unmet need. We also collected cost and activity data to describe the productivity and value for money of current services.
The findings from Stage 1 are informing an Options Appraisal in which we are modeling differing configurations of future service delivery to develop costed models of service which will deliver predicted outputs and outcomes. This will support future procurement of Health Visiting Services in LB Merton.