child eating imageGood 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.

A new model for health visiting services is currently being introduced which will strengthen the provision of the healthy child programme across England. The model will bring improved access and time with families, providing services where it best suits the family – at home, in health settings including GP surgeries, in Sure Start Children’s Centre as well as other non-traditional settings.

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 support for 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.

The rollout of this new health visiting service will be helped by the addition of 4,200 more health visitors by 2015.

From October 2015, certain universal elements of the Healthy Child Programme will be 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.

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.

Reflective questions:
  • How is health information shared and used in your situation?
  • Where you work – how often do health and education professionals meet to learn from each other?

Eat Better, Start Better project

The Eat Better, Start Better project is all about helping young children to eat well by working with families and everyone involved in early years health and education.

Children start learning about food at a very early age and the messages they receive during this time lay the foundations for the choices they make about food as they move up to school and beyond. With more than one in five children overweight or obese as they start their reception year, it’s never been more important to help them get a healthy start in life.

That’s why the Children’s Food Trust is leading work to help early years professionals meet children’s nutritional needs more consistently, and to help families with young children to develop the cooking skills and confidence they need to cook and eat more healthily. Read how Eat Better, Start Better is already helping childcare providers and local authorities around the country.

The project has published Voluntary Food and Drink Guidelines for Early Years Settings in England – A Practical Guide and seasonal menus and recipes for early years settings.

Physical activity guidelines

In July 2011, the UK governments published new physical activity guidelines and for the first time these included guidelines specifically for the under 5s. The British Heart Foundation National Centre for Physical Activity and Health (BHFNC) has produced two information booklets which are designed to give early years practitioners and health professionals help with using these guidelines effectively and to provide practical tips.

In recognition of the emerging evidence supporting the promotion of physical activity in the early years, the BHFNC has also produced an evidence briefing, which is designed for professionals who require a detailed review of the evidence base available for physical activity and the early years.

Find out more… (click to open)

Mind Ed

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Thousands of children with a mental health condition could be prevented from slipping through the net as a free pioneering e-learning and advice resource launches – MindEd.

Any adult who works with children can now access the 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.

MindEd can be accessed quickly and easily anywhere, at any time, by anyone, on tablets and computers. It already contains over 100 sessions of e-learning and with a further 170 in production; the chance to improve children and young people’s mental health and well-being is now in your hands.

National Nursery Toothbrushing Programme

NHS Scotland and the University of Glasgow have published a cost analysis of national nursery toothbrushing programme in Scotland showing that the programme started to pay for itself in terms of avoidable costs of treatment in about 3 years and by year 8 it was saving the equivalent of approximately 3 times the cost of the programme.


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 lifecourse approach to public health targets specific health challenges at different times in a person’s life, such as maternal and newborn, child and adolescent, working age adult and older age. The framework encompasses the Six Early Years High Impact Areas that the Department of Health recently 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 ‘Ten Steps’ is a programme from the Infant & Toddler Forum (ITF). Following the initial development of the ‘Ten Steps’ materials in 2010, the campaign moved to encouraging wider adoption of the ‘Ten Steps’ via strategic partnerships. The ITF works with the Pre-school Learning Alliance, Busy Bees and the London Early Years Foundation to encourage uptake of the ‘Ten Steps’ in childcare settings.

These partnerships give the ITF tangible feedback on how the ‘Ten Steps’ is received and how easily it is implemented, demonstrating how the programme influences and changes behaviours around mealtimes in childcare settings.

Adopting the Ten Steps for Healthy Toddlers in your setting is easy! For more information on how to initiate the ‘Ten Steps’ programme in your setting, please visit

Toilet Training Tips

Toilet training is one of those child developmental stages parents can find frustrating and complex. Making the transition from nappy to toilet can certainly be a challenge, particularly if you feel pressurised to start the process before your child is ready.

The Institute of Health Visiting have put together some tips and advice to help you overcome common toilet training troubles. They cover areas such as deciding whether your child is ready for toilet training and how to support your little one 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