A large scale joint review was undertaken in partnership with Leeds City Council and Leeds Community Health Care NHS Trust, following a six-stage plan involving consultations with parents, strategic leaders and frontline staff. Time was spent scanning the context and exploring local case studies. The key questions being asked were – What do families need? What do we need for our population? How can we build and develop real joint universal pathways?

The next stage was building trust across a large group of staff (approximately 650 Children Centre staff and 150 Health visitors). The vision was to build truly joint teams in hubs across Leeds.

Middle managers were brought together to talk through the vision and the issues that would need to be faced. This developed a sense of trust that all were involved in the new way of working.

Finally the reorganisation began and brought health visitor case files and workloads in line to match children’s centre cluster hubs. This has created alignment between caseloads and children’s centre patches, rather than with the GP surgeries. To strengthen the reorganised hubs Leeds have also developed:

Leeds are now at the implementation phase, with a planned rollout to cover 25 clusters, including a conference, road shows, toolkit launch and training events covering locality information sharing.

All this work has taken a good deal of time and effort – particularly the agreements on information sharing. This had been a problem for many years, as one local practitioner reflected:

In terms of the information sharing agreements – having worked for nine years setting up children’s centres it has been the ultimate frustration not to be able to share information with partners around families we are working with. Over the years we have tried many routes- one of the most successful being putting ’inserts’ into the Red book for parents[1] to give consent to health visitor to then share their name and addresses, obviously fraught with difficulty, but it was a step in the right direction.”


Finding a better solution meant involving a range of stakeholders:

“When we made a strategic decision to bring children’s centres and health visitors together under a jointly drawn up specification between health and local authority, we knew that information sharing was a key component of allowing the teams to work effectively. A working group was set up to tackle and work through all the thorny issues around sharing data, including agreement from the Caldicott guardians. It has taken twelve months but we now have in place an approved information sharing agreement across the community health trust and local authority which gives us a clearly defined and understood process for managing information sharing, confidentiality and consent. We are in the process of notifying every parent in Leeds with children under five about this change, the local authority using individual national health numbers, and data systems sharing- no easy task!”

Head of Early Help services

[1] The parent-held Personal Child Health Record is commonly called ‘The Red Book’.