The six high impact areas articulate the contribution of health visitors to the 0-5 agenda and describe areas where health visitors have a significant impact on health and wellbeing and improving outcomes for children, families and communities. One of these areas is school readiness, which is proving particularly important in deprived parts of Suffolk.
Suffolk County Council CYP South and West Ipswich Locality has 3,000 children under five years of age living in the population. Many of these children live in the 20% poorest households in the country. In February 2013 head teachers from local primary schools requested help from the Integrated Services Manager (Health) for assistance in preparing children for school learning. It was agreed that the most pressing need was toilet training as there were a high number of children in their reception years who were still in nappies or ‘pull-ups’ and this was diverting attention away from their learning.
The objectives of this pilot were:
- To give parents the confidence and skills to toilet train their children;
- Provide accurate information and guidance to families;
- Increase take-up and success rate by proactive promotion of literature;
- Ensure children are confident and that their emotional wellbeing and social skills are not compromised by not being toilet trained prior to the start of school; and
- To support children’s development
A display board was developed to stand in each children’s centre entrance with leaflets and potties to give to parents who wanted to join the toilet training pilot. The free potties were funded by the locality community development officer as part of the school readiness agenda. Drop-in advice was also available as part of the health visitor child health clinics, where parents could join the pilot and receive help and advice with toilet training during the process.
Awareness of the pilot was also raised at the school readiness champions meeting which was attended by schools, pre-schools, health visitors, school nurses, children’s centres workers and integrated team workers so that staff knew where to refer families who needed help to toilet train their pre-school children. The display stand was also taken to local school fetes by the children’s centre workers to promote being clean and dry before starting school.
During the two months trial, 79 potties were given out by health visitors and children’s centres. Parents who had attended the pilot sessions was contacted after four weeks by staff from the children’s centres to find out if they had successfully toilet trained their child. It was reported that 48% of children has been successfully toilet trained and a further 22% were actively following the guidance. Feedback on the scheme was highly positive, with many parents being surprised by how much the information and guidance had helped.
| “Really pleased with how toilet training is going. Getting on much better and is nearly there.”“Potty training guide was absolutely fantastic. Thanks to the information in the leaflet her child was toilet trained day and night within 2 weeks. Found information really useful and it has also helped with my older son who was not fully toilet trained”“Very helpful going well. Now fully toilet trained”
“I received loads of information from the children’s centre about potty training , I was amazed how much the leaflets covered, workers were so helpful , it’s still early days we have had a few accidents but I’m confident “ |
This was a joint project between Health and local authority staff and all involved found that this multi-agency way of working with a common focus and shared outcomes was very successful. The practitioners involved stated that it enabled them to recognise each other’s unique skills and learn from each other.
The pilot was so successful that the decision was taken to make this a mainstream service in the future. It was agreed that the costs of potties and information packs would be funded from the children’s centres budgets.
Clare Slater-Robins, Deputy Lead for Nursing and Clinical Services
