Healthy Start Factfile – Department of Health Healthy Start team

Healthy Start
Factfile
Healthy Start team – Department of Health
healthystart@dh.gsi.gov.uk
www.healthystart.nhs.uk
1
What does it provide?
Vouchers:
Vitamins:
Liquid milk
Fresh fruit and veg
Infant formula milk
For women
For children
AND: Information on breastfeeding and
healthy eating
2
The Voucher
• Worth £3.10 each
• Issued 4 weekly to
beneficiaries
• Double vouchers for
under 1’s or babies within
12 months of estimated
due date if born early
• Voucher value is
reviewed annually
3
Who for?
Pregnant women and families with children under
four getting:
• Income Support, or
• Income Based Jobseekers’ Allowance, or
• Income related Employment and Support
Allowance, or
• Child Tax Credit (but not Working Tax Credit –
except run-on) with an annual family income of
£16,040 or less.
And ALL pregnant under 18 year olds
(Once baby is born – entitlement ceases unless they fulfil qualifying criteria)
4
Why?
•
•
•
•
A statutory scheme
A nutritional safety net
Encourages breastfeeding/healthy eating
A public health tool
5
Facts and Figures 1
(England Sept 09)
• Healthy Start supports 558,500 women and
children in 439,500 families
• England average take up is 79%
• Healthy Start Issuing Unit (HSIU) issues over 2.6
million vouchers per 4 weeks
• HSIU gets 24,000 applications every 4 weeks
6
Facts and Figures
West Midlands
• Healthy Start supports over 60,000 women
and children in 47,000 families
• West Midlands average uptake is 80%
Facts and Figures 2
(England Sept 09)
• 90% of vouchers are used
• 30,000 retail outlets accept vouchers
•
•
•
•
•
•
Usage breakdown:
70% spent in supermarkets
16% spent with independent retailers
6% spent with milkmen
5% spent with chemists
The rest with box schemes/market traders etc
8
Healthy Start Retailers
All Healthy Start (HS) retailers must:
• Stock one or more of the HS products
• Sign up to the HS terms and
conditions
Retailer application forms available via
the Healthy Start Reimbursement Unit
(HSRU)
9
Healthy Start is a
Statutory Scheme
Health Professionals are given
the key tasks of:
• signposting the scheme and
• supporting applications
• PCTs have a duty to make
HS vitamin supplements
available
10
Healthy Start / Start4Life
• Start4Life Objectives/Remit
–
–
–
–
Reduce the proportion of overweight/obese children
Improve breastfeeding continuation rates at 6 weeks
Increase average weaning age to 26 weeks
Start4Life’s remit is Engand for 0-2 year olds
• Healthy Start Objectives/Remit
–
–
–
A statutory scheme, a nutritional safety net, encourages breastfeeding/healthy eating, a
public health tool
Healthy Start communications revamp (due October 09) will cover broader topics such as
post-natal depression, smoking, alcohol and child development.
Healthy Start is a UK wide scheme for pregnant women and children to 4 years old.
• Links between Start4Life and Healthy Start
–
–
–
Fundamental link is the consistent messaging around nutrition and physical activity
Start4Life = nationwide (England) campaign aimed at reducing obesity, Healthy Start =
ongoing communications to beneficiaries adding value to vouchers and supporting them with
broader public health messages
Sharing message where appropriate e.g ‘No rush to Mush’ and importance of vitamins
11
Healthy Start application process
Family becomes eligible
Midwife/Health Visitor
Invitation from HSIU
Tax credits helpline
Jobcentre Plus
Application leaflet in GP surgery
Someone on the scheme
Hear about Healthy Start
Leaflets on benefits or tax credits
Pregnancy or Birth to Five Book
Poster in children’s centre or clinic
DirectGov or HS website
Website
HSIU Helpline
Get application leaflet/Form
Complete Form
Midwife
GP Surgery
Health Visitor
Get signature from midwife or health visitor
Submit to HSIU
12
Key: HMRC – HM Revenue and Customs; JCP – JobCentre Plus;
BDP – Back Dated Payment; HSIU – Healthy Start Issuing Unit
HSIU receives application form
Fully completed
Clearly do
not qualify
Application for
pregnant
Applicant
Informed by letter
Vouchers Issued
Wrongly completed
Application
includes children
Validate against
HMRC and JCP data
Beneficiaries notify
HSIU with baby details
and start claiming CTC
Validation
with HMRC
and JCP
Vouchers
continue
Match found
Match not found
Inform applicant and invite to give
additional information. Repeat 2/4
weekly checks for 3 months
Vouchers Issued
Match found
Repeat validation
checks every 2 wks
(HMRC) or 4 wks (JCP)
Returned to applicant
(no BDP for wrongly
completed forms)
No match found
Vouchers not issued
Voucher Issued
Letter confirming match not found
13
Current Priorities
• Vitamins uptake!
•
•
•
•
•
Scheme uptake
Communications review
Streamlining links with tax credits system
Frozen fruit and vegetables?
Monitoring/evaluation
14
Priority Vitamin
Uptake!
• PCTs should make HS vitamin
supplements available
• Health Professionals have the key task of:
- alerting pregnant women to the
vitamin supplement scheme
15
Vitamin Uptake
(England)
• Vitamin take up through HS is less than
1% across the board
16
HS Vitamin products
• Children’s vitamin drops contain vitamins A, C
and D
• Women’s tablets contain vitamins C and D, and
folic acid
• The importance of both products has been
highlighted by NICE
• PCTs are responsible for supplying them
• Local promotion to clients is important
17
Why Vitamins?
• Enough evidence to convince COMA and
SACN to recommend supplementation
and
• NICE report on Maternal and child nutrition
(March 2008) places the onus on PCTs to
ensure supplementation happens
Key: COMA – Committee on Medical Aspects of
Food and Nutrition Policy
SACN – Scientific Advisory Committee on
Nutrition
NICE – National Institute for Clinical Excellence
18
Why Vitamins?
Folic acid – role well understood in
preventing neural tube defects
• Supplement readily taken, preferably in
early pregnancy; often acts as a ‘build up’
for the next pregnancy
19
Why Vitamins?
• Understanding of vitamin D role in
mediating many illnesses much better
understood
• Especially role in 3 trimester in foetal bone
mineralisation
• Knock on effect in later life?
20
Why Vitamins?
• Most vitamins are available easily through a balanced
diet
• Like folic acid vitamin D is not, obtained mainly from
sunlight, main food source is oily fish.
• Geographical latitude (above 52° N) available from
sunlight April – September only,
• Skin type, clothing, sunscreen all effect uptake
• Rising levels of insufficiency/ deficiency being recorded
with rising levels of admission for Vitamin D deficiency
as a primary diagnosis
21
Cost
• Children’s drops 6months – 4th birthday: £37.03
• Women’s tablets pregnancy to child’s 1st
birthday: Less than £9.00
• Treatment of deficiency for 1 year: £2600
22
Vitamin Facts
Women’s Tablets
Children’s Drops
Code:
ABX 073
Code:
ABX 072
Cost to PCT:
£1.61
Cost to PCT:
70p
Cost when
selling:
£1.77
Cost when selling:
77p
Available to:
Available to:
Children; 6 months –
1 year
Women; pregnant and until
child is 1 yr old
Contains:
70 mg Vitamin C
10 mcg Vitamin D
400 mcg Folic Acid
One bottle:
56 tablets (8 week supply)
Daily Dose:
1 tablet
Classification:
Multivitamin Food
Supplement
Contains:
233mcg Vitamin A
20mg Vitamin C
7.5mcg Vitamin D
One bottle:
10 mls (8 week
supply)
Daily Dose:
5 drops
Classification:
General Sales List
Medicine
Manufacturer:
Bayer
Manufacturer:
SSL International
Shelf life:
2 years
Shelf life:
10 months
23
Healthy Start Vitamins
(Ordering and reimbursement process)
PCT contacts
NHS Supplychain
Order vitamins
and make
payment
PCT records how
many vitamins
given out to beneficiaries
NHS Supplychain
delivers
vitamins to
designated NHS
location – PCT
to arrange
PCT gives out vitamins or passes
onto children’s
centres/clinics according
to local arrangements
DH send HSVR form to finance
contact in each PCT
PCT to send DH quarterly invoices
along with the HSVR form
DH reimburses PCT
24
Key: HSVR – Healthy Start Vitamins Return
Vitamin Uptake Success:
Key factors
•
•
•
•
•
•
Team working across boundaries
Training
Senior level support
Clear Communications
Distribution - accessibility
Make things simple!
25
More Info?
Healthy Start Website
www.healthystart.co.uk
Including a CPD module
26