Breastfeeding Friendly Awards/Healthy Start)

DATA LABEL: PUBLIC

HEALTH AND CARE POLICY DEVELOPMENT AND SCRUTINY PANEL

MATERNAL AND INFANT NUTRITION (BREASTFEEDING FRIENDLY AWARDS/HEALTHY START)

REPORT BY DEPUTE CHIEF EXECUTIVE, COMMUNITY HEALTH AND CARE PARTNERSHIP

A. PURPOSE OF REPORT

To inform the Panel of the local venues with Baby Friendly Awards by providing facilities for breastfeeding; and to report on the uptake of Healthy Start Vouchers and free vitamins in NHS Lothian.

B. RECOMMENDATION

That the Panel:

1. supports the ongoing work required to implement these strategies, and 2. supports the recommendation that all major council/partnership centres work towards Breastfeeding Friendly Award status.

C. SUMMARY OF IMPLICATIONS

I Council Values x Focusing on our customers' needs x Making best use of our resources x Working in partnership

II Policy and Legal (including None. Strategic Environmental Assessment, Equality Issues, Health or Risk Assessment)

III Implications for Scheme of None. Delegations to Officers

IV Impact on performance and Implementation of these strategies will have a performance Indicators positive impact on health and wellbeing indicators.

V Relevance to Single SOA 2, 3, 4 We are better educated and have Outcome Agreement access to increased and better quality learning and employment opportunities.

1 SOA 5 Our children have the best start in life and are ready to succeed.

SOA 6 We live longer, healthier lives and have reduced health inequalities.

VI Resources - (Financial, Within current resources. Staffing and Property)

VII Consideration at PDSP Reported to Health and Care PDSP annually. Relates to item 8, Action Note, Health and Care PDSP, 17/4/14.

VIII Other consultations None.

TERMS OF REPORT

Breastfeeding Friendly Premises Within West Lothian, premises which have breastfeeding policies and provide suitable facilities are able to apply for the Breastfeeding Friendly Award.

The Breastfeeding Friendly Award is part of the UNICEF Breastfeeding Welcome scheme, to which NHS Lothian is in the process of becoming accredited. This will roll out the Award to community NHS facilities, such as GP surgeries.

There are a range of council and private enterprises across a local communities which currently hold this award:

x All Xcite West Lothian sports centres i.e. in Armadale, Broxburn, Craigswood, Livingston, East Calder, Fauldhouse, Linlithgow, Livingston, and Whitburn.

x All libraries i.e. Almondbank; Bathgate; Blackburn; Blackridge; Fauldhouse; Linlithgow; Pumpherston; West Calder; East Calder; Carmondean Connected; the Lanthorn, Dedridge; Armadale; Broxburn; Whitburn and library headquarters at Blackburn.

x All CIS premises i.e. Armadale CIS; Bathgate Partnership Centre; Broxburn CIS; Strathbrock Partnership Centre, Broxburn; Linlithgow CIS; The Library; West Calder CIS within the library; West Lothian Connected, Almondvale Centre, Livingston; Whitburn CIS; Blackburn Connected, The Mill Centre; Carmondean Connected, Deans, Livingston; Fauldhouse Partnership Centre; Almondbank Centre, Craigshill, Livingston.

It is recommended that all major council/partnership centres should in future be expected to apply for Breastfeeding Friendly Awards. This includes the West Lothian Civic Centre and the forthcoming Blackburn Partnership Centre.

Work is ongoing to encourage businesses to apply for the award. In 2014-15, this will be promoted through the West Lothian Chamber of Commerce.

x Local enterprises with the Award are:

Broxburn Family Centre (Broxburn) Kidzeco (Livingston) Craigsfarm Campus, (Craigshill) Almond Valley Heritage Centre (Livingston) Blackburn Family Centre (Blackburn) 2 Cafés Mistura in Strathbrock and Fauldhouse (Broxburn and Fauldhouse) Low Port Centre (Linlithgow) Five Sisters Zoo (West Calder) Veitch’s café (East Calder) Community Centre café (Armadale) Toast and Tea café (Armadale) Costa Café (The Centre, Livingston) Debenhams (The Centre, Livingston) Love Food Café (The Centre, Livingston) Howden Café, St John’s Hospital (Howden) Dining Room, St John’s Hospital (Howden)

Currently working towards the award are:

Green Room (Kirknewton); Traders group (eight businesses) (Armadale)

Healthy Start vouchers

Healthy Start provides free vouchers every week to spend on milk, fresh and frozen fruit and vegetables, and infant formula milk for women who are pregnant or have children under the age of four who qualify for certain benefits, or if pregnant and under 18.. In addition to Health professional promotion, Healthy Start is being included in the Anti-Poverty strategy, Advice Shop general welfare advice and CAB advice within Early Years settings.

Current uptake of free Healthy Start vouchers and vitamins has varied. Overall, uptake of Healthy Start vouchers across NHS Lothian is 75% of the eligible population. This figure is the third highest in Scotland, slightly below Lanarkshire at 76% and Glasgow which has an uptake rate of 79%. These figures represent the most recent national data, from August and September 2013.

Within NHS Lothian Health Board area, Healthy Start voucher statistics are available for postcode areas, not local authority areas. Recent statistics for the postcodes that match best to West Lothian local authority area for the period 7/4/14 to 4/5/14 are shown below. The overall uptake of 74.7% is close to the national average of 74.8%, and slightly below the NHS Lothian overall rate. Whilst uptake of the vouchers is 75% in Lothian, current use of vouchers, however, is approximately 66%.

WL PC Receiving Total % of eligible receiving sector* vouchers eligible vouchers EH27 12 14 85.7% EH30 30 45 66.7% EH47 288 382 75.4% EH48 285 388 73.5% EH49 38 61 62.3% EH52 110 159 69.2% EH53 52 68 76.5% EH54 480 622 77.2% EH55 72 91 79.1% Total 1367 1830 74.7% *see appendix 1

Healthy Start vitamins

The Healthy Start scheme also provides vitamins to breastfeeding families on specific 3 benefits. Uptake of Healthy Start vitamins should be viewed as linked to overall breastfeeding rates in West Lothian, and it should be noted that breastfeeding rates are lowest in areas of deprivation.

Across Lothian, reported uptake of the vitamin element of Healthy Start is very low at only 1% (this is similar across Scotland). In West Lothian, premises which disburse the Healthy Start vitamins for women and children are spread across the locality but saw very low uptake during 2013.

For example, during August and September 2013, the premises (as below) dispensed only between one and three packs each.

x Boots in Almondvale, Livingston; Blackburn; Whitburn and Linlithgow x Lloyds Pharmacy in Bathgate and Linlithgow x N R Gordon in Armadale x Deans Healthcare in Ladywell x Manorport in Boghall

Due to such low uptake, it was decide to widen the dispersal of the vitamins through health visitors and Family Centres.

The Health Improvement Team and NHS Lothian Midwifery are looking at ways of improving uptake rates for eligible women during pregnancy. Health visitors have the opportunity to see eligible families at core visits and clinic appointments and to offer the vitamins. Early information is that this is much more successful in reaching eligible children and their mothers.

Family Centre distribution aims to begin in the coming weeks and staff will test improvements using the improvement methodology of the Early Years Collaborative.

Within NHS Lothian, ways to increase uptake of Healthy Start during the antenatal and postnatal period are being tested in the Leith Early Years Collaborative Pioneer Site work. Improvements are being demonstrated, with an increase over 11 weeks in self- reported entitlement to Healthy Start from 11% to 23% at antenatal booking. West Lothian will benefit from the pioneer work being carried out in Edinburgh, as work is being spread across to other parts of Lothian. Further evidence of improvement is to be reported in Summer 2014.

E. CONCLUSION

The Breastfeeding Friendly Premises Award is supported by a range of staff in NHS Lothian and West Lothian CHCP, including the Health Improvement Team. Work is ongoing to increase the number of venues with the award.

While the uptake of Healthy Start vouchers is around three-quarters of eligible families, use of them is lower than expected. A wide range of activities is ongoing to try to understand and tackle the very low uptake of Healthy Start free vitamins.

F. BACKGROUND REFERENCES

Scottish Government statistics on Healthy Start and Vitamins

Leith Early Years Collaborative Pioneer Site

Appendices/Attachments: 1 4 Contact Person: Jane Kellock [email protected] 01506 281920

CMT Member: Jim Forrest, Depute Chief Executive, CHCP

Date of meeting: 29 May 2014

Appendix 1: Postcode areas incorporating West Lothian local authority ( http://www.postcode- info.co.uk/west-lothian-postcodes-428.html ):

WL PC sector EH27 Kirknewton, Wilkieston EH30 Abercorn (Dalmeny, South Queensferry – Edinburgh) EH47 Blackburn, Whitburn, Fauldhouse, Longridge, Seafield, Stoneyburn, Whitburn EH48 Armadale, Bathgate, Blackridge, Torphichen, Westfield EH49 Bridgend, Linlithgow, Philipstoun (Blackness – Falkirk) EH52 Broxburn, Uphall, Dechmont, Ecclesmachan, Newton, Winchburgh EH53 East Calder, Mid Calder, Pumpherston EH54 Bellsquarry, Livingston, Uphall Station EH55 Addiewell, Breich, Polbeth, West Calder (Tarbrax, Woolford – S Lanarkshire) Total

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