Good health is one of the most important determinants of a child’s life chances. All professionals working in the foundation years need to be involved in promoting and encouraging children’s healthy development.

The Healthy Child Programme

The Healthy Child Programme is the NHS framework for provision in the foundation years. It consists of a mixed approach of preventative programmes for all children and families with targeted and additional support to meet identified needs.

Health visitors deliver the programme, which is being made available to all families. It is evidence based and the interventions within it, such as vaccines and immunisations, tests and screening programmes, help drive up public health across the board.

Families need different levels of service and may need different services at different times. This is reflected in the new service model, which has five key areas where health visiting services will have a major role:

  1. Interactions at community level:Building capacity and using that capacity to improve health outcomes and leading the healthy child programme for a population.

  2. Universal services for all families:Building strong relationships in pregnancy and early weeks and planning future contact with families, including being the lead professional for the healthy child programme for individual families.

  3. Additional services that any family may need some of the time(i.e. episodic for a specific health problem). For example, care packages for maternal mental health, or a baby/toddler sleep problem where the health visitor may provide support, delegate or refer.

  4. Additional services for families requiring ongoing extra supportfor a range of vulnerabilities or special needs. For example, families at social disadvantage or families who have a child with a disability.

  5. Health contribution in high intensity multi-agency services for families where there are safeguarding issues.

Since October 2015, certain universal elements of the Healthy Child Programme are delivered by local authorities as planning for public health services for 0 to 5 year olds transfers from NHS to local authorities. This factsheet explains how and why the commissioning and associated funding are being transferred to local authorities.

Public Health England are due to update the Healthy Child Programme from 2019, focusing on the early years to begin with.

Family Nurse Partnership

In a growing number of areas across the country the Family Nurse Partnership programme is being offered to first time disadvantaged mothers, giving intensive, structured support by specially trained nurses, and improving the outcomes of the most vulnerable families.

Quality provision is typified through partnership working between health and education professionals on identifying and responding to needs as early as possible in order to have an impact on outcomes.

Midwives and health visiting teams

Children’s health development begins in pregnancy and it is the responsibility of midwives to assess the health and social care needs of mums by the 12th week of pregnancy. The midwife will co-ordinate the support of other professionals as needed to support the mum and family as required.

Midwives and health visitors have a focus on promoting positive parenting and good parent–child attachments and relationships as well as ensuring healthy development.

The National Health Visitor Plan: progress to date and implementation 2013 onwards sets out how partner organisations will work with the health profession, families and communities to achieve government’s health visiting commitment.

The Department of Health has developed a fact sheet for parents: Getting to know your health visiting and school nursing service. It outlines what parents can expect from their local services and how health visitors can support children from 0-5 and their families.

The Department for Health has identified six areas where health visitors have the most impact on children aged 0 to 5’s health and wellbeing.

Professional guidance for health visiting – domestic violence and abuse

In June 2013, the Department of Health published guidance for professionals when working with domestic violence and abuse helping health professionals to recognise factors that may indicate domestic violence and abuse and describes steps to ensure appropriate support and referral where necessary.

The guidance acknowledges that because of the role of midwives, health visitors and school nurses, they are often one of the first to become aware of domestic violence and abuse issues within families. They therefore have a significant part to play.

Mind Ed

Any adult who works with children can access the MindEd website which contains quality assured, bite-size information that’s tailored by profession – teachers and sports coaches, healthcare professionals, police and judiciary staff, social workers and many more.   Its aim – to give adults the skills to identify a child at risk of a mental health condition early, the confidence to act on their concern and signpost them to the services or support that can help.

Framework for Personalised Care and Population Health

This framework has been developed to underpin the Department of Health’s national programme to maximise the impact of nurses, midwives, health visitors and allied health professionals on improving health outcomes and reducing inequalities. The framework supports and shapes health promoting practice and embeds personalised care and population health across all ages.

The framework encompasses the Six Early Years High Impact Areas that the Department of Health developed that focus on the areas having the biggest impact on a child’s life.

Ten Steps for Healthy Toddlers Programme

The Ten Steps for Healthy Toddlers provides a practical, easy-to-follow guide on what food to offer, what behaviour to encourage, and how best to manage mealtimes. Aligned with public health priorities for disease prevention and early intervention, the ‘Ten Steps’ are perfectly placed to promote early years nutrition know-how amongst health and childcare professionals, parents and carers.

The Integrated Review

West Sussex County Council have produced a video about the 2-year old integrated review, with interviews with parents, early years practitioners and Health Visitors.

The experiences of two local authorities putting into practice the new Integrated Review for two-year olds have been published by the National Children’s Bureau for the Children’s Partnership, enabling others to learn from their different approaches to the new way of working.

The Experiences of Practice series is designed to help both staff working directly with young children and those managing and designing services, to learn from work being done in Islington and Warwickshire, which were among the first to trial the Integrated Review.

Based on the experiences of service leads, practitioners and parents, each document in the Experiences of Practice series can be used as a standalone guide to one aspect of the Independent Review, or can be read alongside other published material.


Working with Parents

Involving the child

Professional working relationships

Using ages and stages questionnaire

The Department for Education and Department of Health have published the findings of a study led by the National Children’s Bureau (NCB) into the pilot phase of the Integrated Review which can be accessed here.

Additional resources

This includes case study examples of approaches and materials, such as: forms, practitioner briefing materials, letters, parental engagement strategies and other resources used by pilot areas from the implementation study.

Toilet Training Tips

The Institute of Health Visiting have put together some tips and advice to help parents overcome common toilet training troubles. They cover areas such as deciding whether a child is ready for toilet training and how to support them as they learn this important new skill.

Guidance on Feeding/Weaning Toddlers

The Infant & Toddler Forum has produced Guidance & Tips for parents on complementary feeding/weaning to include:

  • when to start introducing complementary foods

  • what foods to offer and what foods to avoid/limit at the different stages

  • how to introduce foods that are most likely to cause an allergic reaction

  • how to progress between the different stages