This project aimed to increase the uptake of Healthy Start Vitamins, to reduce Vitamin D deficiency / insufficiency and achieve a 'Rickets Free Sheffield'. Currently, there is a national scheme for eligible groups to have access to free Healthy Start Vitamins. In Sheffield, this scheme was extended further to include all pregnant women, breastfeeding women and eligible children at risk of Vitamin D deficiency. This coincided with the message from Public Health England regarding the importance of Vitamin D supplementation in promoting bone health. The anticipated outcomes were:
The stakeholders have included a variety of colleagues across the healthcare sector, engaging with them through steering group meetings. This involves representatives from the CCG, the city council. Midwives, Health Visitors, primary and secondary care clinicians, Early Years leaders and Children's centre co-ordinators. We have all worked together to promote the message regarding Vitamin D, on-going self care and safe sun advice to the young people of Sheffield, educating a new generation. The CCG have also taken a targeted approach to promoting the scheme including local events in areas with ethnic minorities, providing education and training to peers at city wide events and the development of a supporting email group to help champion the message.
Upon initiation of the scheme, we had the support of a Public Health Consultant trainee championing the message and providing links across health and social care to drive the scheme forward. There have been focused education and training events provided to GP's, Health Visitors, Midwives and Pharmacists to spread the message regarding the project and the importance of self care. We have worked with our communications team to raise awareness through various avenues including the use of social media and the local radio station.
The extended Healthy Start Scheme project has been shared with colleagues in other CCG's through existing networks. All resources have been shared with a neighbouring CCG within the Integrated Care System (ICS) as they have identified a poor uptake of the Healthy Start Vitamins in their area, and looking at the lessons we have learnt.
The project follows on from the current national scheme and extends the scheme to preconception women, pregnant women, breastfeeding mothers and all eligible children. Preconception women are entitled to free vitamins prior to pregnancy as are pregnant women throughout the duration of their pregnancy. Breastfeeding mothers benefit from a free two month supply upon discharge. Breastfed babies are entitled to a free two month supply as are formula fed babies once on less than 500mL of infant formula. Those children at risk of Vitamin D deficiency are entitled to free vitamins up until their fourth birthday.
The following outcomes have been measured:
The Sheffield Healthy Start initiative had already optimised patient care by getting the right preventative care to people who are more vulnerable. This is playing an important, intelligent led role in improving the public health of the children of Sheffield at a population level. The initiative supports greater quality of life for children no longer needlessly suffering from the adverse effects of Vitamin D deficiency. The collaborative approach by all agencies in contact with the target population enhances the effectiveness of the service delivery. The initiative has the added efficiency of reducing cost associated with patient care when the potential for Vitamin D deficiency has not been addressed. Using Health Visitors, Midwives and Children centre staff to deliver the message and distribute the vitamins has enable us to target hard to reach and vulnerable patient groups who otherwise may not have accessed this.
