Andrea Basu and Sarah Powell-Jones
Betsi Cadwaladr University Health Board
Background:
Healthy Start is a UK wide scheme supporting eligible pregnant women and families (with children under 4 years old) by providing weekly food and vitamin vouchers.
The Healthy Start vitamins provide folic acid and vitamin D which are recommended for supplementation in these key population groups.
Watch the video below to find out more:
Within Wales, the vitamins are typically distributed via local midwifery and health visiting teams however, the COVID-19 pandemic has impacted on access for many families, and presented an opportunity to explore additional points of access, particularly in supporting ongoing provision of the vitamins beyond the initial 8 week supply.
Project Aims:
The principle aim was to increase accessibility to the Healthy Start vitamins for eligible families in the counties of Wrexham and Flintshire (BCUHB- East) by:
- Scoping the journey of eligible families to access the vitamins
- Clarifying local distribution arrangements
- Identifying possible solutions to improve access (and consequently uptake) of the vitamins
- Implementing solutions
- Cascading clear and consistent information to eligible families about how to access the vitamins in their community
Challenges:
- Identifying existing distribution arrangements for the vitamins, including who held responsibility for ordering, documenting, and reclaiming costs of the vitamins
- Establishing links with, and achieving ‘buy-in’ from community pharmacy to enable wider access to the vitamins in the community, at a time when their services were in demand and were being extended to support the pandemic
- Traditional promotional opportunities were hindered due to the COVID-19 lock-down. For example face to face contact with the public at local community groups, events, and within settings such as supermarkets. However every opportunity to utilise social media networks via BCUHB and established stakeholders was harnessed.
Feedback:
“During the Covid-19 pandemic, women often have not gone out due to social distancing and lockdown hence reducing their absorption of Vitamin D from natural sunlight also. This project by means of supplying vitamins from designated pharmacies can only improve the uptake in pregnancy and now they are more easily accessible from designated pharmacies in Flintshire and Wrexham.”
Flying Start Midwife
“The project has been instrumental to increase awareness amongst parents in Flintshire of the benefits of the Healthy Start voucher scheme. By collaborating with local pharmacies there has also been a greater accessibility to vitamins for mothers in their pregnancy and for their babies. Feedback from local parents has been positive stating that by accessing the free vouchers it has helped them to access vitamins for themselves in pregnancy, for their babies if required and to buy fruit, vegetables milk etc. and really helps towards the shopping bill each week.”
Health Visitor
“The pilot project is an excellent idea and an excellent opportunity for eligible families to access free vitamins as part of a healthy diet. The pharmacy setting is an ideal for this pilot as it also gives the families who request a vitamin supply to access other healthcare treatments, services and advice.”
Community Pharmacist
“Speaking to parents who have come in with the Healthy Start vouchers they say it is great to know where they can now come to get their vitamins, it has made it a lot easier for them. They are telling their friends too and we have handed out the application forms as well.”
Pharmacy counter – staff member
“I’m really glad I can pick them (the vouchers) up from here now, it makes it a lot easier for me.”
Healthy Start Parent (recipient)
Key Outcomes:
- Mapped ‘the journey’ for Healthy Start families to obtain the vitamins.
- Identified shortfalls in current distribution and lack of availability for eligible families.
- Increased access points for families in Wrexham and Flintshire counties- 12 pharmacies (6 in each county) now stock the vitamins. An audit of all community pharmacies at the outset of the project identified that none currently stocked the vitamins and several were not aware of the scheme and/ or wanted more information.
- Produced a suite of stakeholder briefings, media posts, educational tools, promotional materials, and social media infographics to widely communicate to key stakeholders and eligible families, about the scheme and new points of access for the vitamins.
- Pharmacy staff across the 12 sites have increased awareness and knowledge of the scheme.
Next Steps:
- Audit uptake across participating pharmacies (July 2021)
- Pause/ reflect – do we need to extend our ‘test’ period to enable sufficient time to assess true impact on access/ uptake
- Evaluate the experiences of partnering pharmacies & opportunities to sustain provision/ extend across the 4 remaining North Wales counties (i.e. the entire BCUHB area)
- Share learning with fellow health boards across Wales
Our Exemplar Experience:
Extremely positive! We have benefited immensely from the mentoring, networking, and range of learning events. The kudos of being a Bevan exemplar project has most definitely helped us to navigate through some of the challenges we’ve faced, and we believe it has helped us to achieve solutions more quickly than we would have otherwise.
Showcase:
Contact:
Andrea Basu: andrea.basu@wales.nhs.uk, @AndreaBasu1
Sarah Powell-Jones: sarah.powell-jones@wales.nhs.uk; @jonesSarah17
