Healthy Child Programme Schedule of Interventions Guide
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Lifecourse stage
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3 to 5 years
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Screening
Immunisation
Mental and emotional health and wellbeing
Healthy weight, nutrition and physical activity
Maintaining healthy relationships including sexual health
Alcohol, drugs and tobacco
Oral health and dental care
Improving self-care and health literacy
Inequalities and disparities
Safeguarding
Children with additional health and development needs including SEND
Intensive parenting support
Follow universal guidance
Screening
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Review the immunisation status of children and other family members eligible to be vaccinated according to the national routine and selective immunisation programmes (hepatitis B and tuberculosis).
Provide assessment to highlight any specific needs related to vaccination.
Ensure that eligible children including children with long-term health needs or additional needs have been offered vaccination.
UKHSA Immunisation against infectious disease (Green Book)
UKHSA Routine childhood immunisation schedule
Vaccination of individuals with uncertain or incomplete immunisation status
UKHSA Hepatitis b: the green book, chapter 18
NICE Hepatitis B quality standard (QS65)
NHS.UK BCG tuberculosis (TB) vaccine overview
Hepatitis B: antenatal screening and selective neonatal immunisation pathway
NICE Tuberculosis
NHS.UK Tuberculosis
Where children have not received recommended immunisations, refer to the guide for uncertain or incomplete vaccinations.
UKHSA Routine childhood immunisation schedule
Vaccination of individuals with uncertain or incomplete immunisation status
Provide personalised evidence-based information, advice and guidance to support parents and carers, including for those with children with long term health or additional needs. Discuss parents’ and carers’ concerns to help them make an informed decision.
UKHSA Routine childhood immunisation schedule
Vaccination of individuals with uncertain or incomplete immunisation status
Early years high impact area 5: Improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 5: Supporting additional and complex health needs
NHS.UK Hepatitis B vaccine overview
NHS.UK BCG tuberculosis (TB) vaccine overview
NHS.UK Tuberculosis
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Metrics and outcomes indicators
Use evidence and data to monitor immunisations. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Child and maternal vaccines and immunisations
OHID Fingertips TB Strategy monitoring indicators
OHID Fingertips Health Protection indicators
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips user guidance
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Child mental health and wellbeing
Where there are concerns about child mental health and wellbeing, provide an assessment to identify needs, strengths and vulnerability, for example relating to separation anxiety, school readiness and behavioural concerns.
Based on need, provide personalised clinical interventions, for example, provide parents and carers with support, information and advice about the importance of child wellbeing including how to meet their children’s emotional needs (emotional regulation and attunement). Give strengths-based feedback on positive parent-child interactions and model attuned interactions with the child.
Support sensitive, responsive relationships, identifying and acting on risk factors for relationships.
Wellbeing and mental health: applying all our health
Solihull Approach
Healthy beginnings: applying all our health
No child left behind: a public health informed approach to improving outcomes for vulnerable children
Early years high impact area 2: supporting maternal and family mental health
School-aged years high impact area 1: Supporting resilience and wellbeing
There is an association between parental mental health and children’s social and emotional development. Where there are concerns about the maternal, paternal or family-child relationship and attachment, carry out a holistic assessment to identify need and vulnerability.
Offer personalised clinical interventions and evidence-based information in response to need. Use strengths-based approaches to empower parents and carers to meet the needs of their child, and access targeted services appropriately.
To ensure support where children, parents and carers have been identified as requiring other targeted or specialist services, follow local pathways to complete appropriate and timely referral. Targeted services may include those delivered by health visiting and school nursing teams such as listening visits or offered in the wider community such as parenting programmes.
E-Learning for Healthcare Speech, language and communication 2 to 3 years targeted
E-Learning for Healthcare Speech, language and communication 3 to 5 years targeted
Early years high impact area 2: Supporting maternal and family mental health
School-aged years high impact area 1: Supporting resilience and wellbeing
Solihull Approach Understanding your child
NSPCC Parental mental health problems
NHS.UK Every mind matters
Family Nurse Partnership
NICE Social and emotional wellbeing: early years
NICE Early years: promoting health and wellbeing in under 5s
DLUCH, DfE Supporting families
Mental Health Foundation Black, Asian and minority ethnic communities
Where health or additional needs have been identified, provide an assessment to inform planning to prepare for a seamless transition to school.
Work with the multidisciplinary team including school nurses, health visitors and education settings, to support children starting nursery or school including identifying children in need of support or health care plans at school entry.
Provide information, advice and guidance to support parents to prepare their child for the transition to school.
Health visiting and school nursing delivery model
Early years high impact area 6: Ready to learn and narrowing the word gap
Early years high impact area 2: Supporting maternal and family mental health
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 5: Supporting additional and complex health needs
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Vulnerability in childhood: a public health informed approach
Safeguarding
Parental mental health and wellbeing
Where there are concerns about parental mental health and wellbeing, provide an assessment to identify needs, strengths and vulnerabilities.
Based on need, offer personalised clinical interventions to support positive parental and family mental health. Use strengths-based approaches to empower parents and carers to meet the needs of their child, and access targeted services appropriately.
Early years high impact area 2: supporting maternal and family mental health
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
NHS.UK Every mind matters
Follow local pathways for referral and management of parental mental health needs where appropriate.
Targeted services may include those delivered by health visiting or school nursing teams such as listening visits or offered in the wider community such as parenting programmes.
Early years high impact area 2: supporting maternal and family mental health
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
NHS.UK Every mind matters
When assessing and supporting child, parental and family mental health, use strength-based approaches to provide support or onward referral. Avoid the potential for re-traumatisation by recognising when people may have experienced trauma or adverse childhood experiences.
Scottish Government Trauma-informed practice: toolkit
South Yorkshire Violence Reduction Unit Trauma-informed practice
Gloucestershire County Council Frameworks for being trauma-informed
Early Intervention Foundation Trauma-informed care: Understanding the use of trauma-informed approaches within children’s social care
Adverse Childhood Experience Support Hub Cymru and Wrexham University ‘Trauma-informed’: Identifying key language and terminology through a review of the literature
Working definition of trauma-informed practice
Ensure there is recognition and awareness of mental ill health and its signs and symptoms and raise awareness of the possible impact of adult mental ill health on children.
Early years high impact area 2: supporting maternal and family mental health
NHS.UK Every mind matters
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Vulnerability in childhood: a public health informed approach
Safeguarding
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Metrics and outcomes indicators
Use evidence and data to monitor mental health and wellbeing. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Children and young people's mental health and wellbeing
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips user guidance
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Where diet and nutrition or physical activity have been identified as requiring targeted intervention, carry out an assessment to identify need.
Offer personalised clinical interventions and evidence-based information in response to identified need. Use strengths-based approaches to empower parents and carers to meet the needs of their child, and access targeted services appropriately.
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
School-aged years high impact area 3: Supporting healthy lifestyles
The Eatwell Guide
NHS.UK The eatwell guide
NICE Obesity in children and young people: prevention and lifestyle weight management programmes
NICE Obesity: identification, assessment and management
NICE Maternal and child nutrition
Family weight management: changing behaviour techniques
Promoting a healthier weight for children, young people and families: consistent messaging
Childhood obesity: applying all our health
E-Learning for Healthcare All our health: childhood obesity
Where there are concerns about a child’s weight, carry out an assessment to identify need, measuring and recording the child’s height, weight and body mass index (BMI).
Where children, parents and carers have been identified as requiring additional services, follow local pathways to provide targeted support and complete appropriate and timely referral. This may include children identified as being outside a healthy weight range at reception through the National Child Measurement Programme.
RCPCH Growth charts
RCPCH BMI charts
National child measurement programme: operational guidance
National child measurement programme: conversation framework
School-aged years high impact area 3: Supporting healthy lifestyles
The Eatwell Guide
NHS.UK The eatwell guide
NICE Obesity in children and young people: prevention and lifestyle weight management programmes
NICE Obesity: identification, assessment and management
NICE Maternal and child nutrition
Family weight management: changing behaviour techniques
Promoting a healthier weight for children, young people and families: consistent messaging
Childhood obesity: applying all our health
E-Learning for Healthcare All our health: childhood obesity
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Ensure staff are aware of local support services and referral guidance relating to healthy weight, nutrition and physical activity.
Metrics and outcomes indicators
Use evidence and data to monitor healthy weight, nutrition and physical activity. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Obesity profile
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips Physical activity
OHID Fingertips user guidance
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Where parents and carers have been identified as requiring targeted intervention for family relationship issues, provide an assessment to identify health needs and vulnerability.
Offer personalised clinical interventions and evidence-based information in response to need, for example intensive parenting support to reduce parental conflict. Use strengths-based approaches to empower parents and carers to meet the needs of their child, and access targeted services appropriately.
Provide information about local services, such as family hubs or children’s centres and GPs, where parents and carers can seek additional support and advice, where appropriate.
Early years high impact area 2: Supporting maternal and family mental health
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
DWP Reducing Parental Conflict programme and resources
Race Equality Foundation Reducing Parental Conflict
Home Office Tackling violence against women and girls strategy
DfE Working together to safeguard children
Vulnerability in childhood: a public health informed approach
NICE Domestic violence and abuse
NHS.UK Domestic violence and abuse
DLUCH, DfE Supporting families
Home Office Domestic abuse how to get help
NHS.UK Sexual health
NICE Domestic violence and abuse: multi-agency working
Safeguarding
Safeguarding including domestic violence and abuse
Intensive parenting support
Where there are emotional health and wellbeing concerns, provide an assessment to identify needs and inform planning to support parents and carers to develop positive and appropriate relationships and build emotional resilience to support school readiness.
Health visiting and school nursing delivery model
Early years high impact area 6: Ready to learn and narrowing the word gap
Early years high impact area 2: Supporting maternal and family mental health
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 5: Supporting additional and complex health needs
Use strength-based approaches to assess and support family relationships to avoid the potential for re-traumatisation by recognising when people may have experienced trauma or adverse childhood experiences.
Scottish Government Trauma-informed practice: toolkit
South Yorkshire Violence Reduction Unit Trauma-informed practice
Gloucestershire County Council Frameworks for being trauma-informed
Early Intervention Foundation Trauma-informed care: Understanding the use of trauma-informed approaches within children’s social care
Adverse Childhood Experience Support Hub Cymru and Wrexham University ‘Trauma-informed’: Identifying key language and terminology through a review of the literature
Working definition of trauma-informed practice
Where parents and carers have been identified as requiring targeted intervention for sexual health, such as repeated sexually transmitted infections, offer an assessment to identify health needs and vulnerability.
Based on need, provide personalised clinical interventions, for example targeted advice and support for parents regarding sexual health concerns such as safer sex.
Provide parents and carers with information about sexual health services where parents and carers can seek additional support and advice, where appropriate.
Early years high impact area 2: Supporting maternal and family mental health
NHS.UK Sexual health
NHS.UK Guide to sexual health services
OHID Sexual and reproductive health and HIV: applying All Our Health
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Safeguarding
Safeguarding including domestic violence and abuse
Metrics and outcomes indicators
Use evidence and data to monitor sexual and reproductive health. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Child and maternal health pregnancy and birth
OHID Fingertips Teenage pregnancy and young parents reports
OHID Fingertips Sexual and reproductive health profiles
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips user guidance
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Alcohol
Where there are concerns about parental alcohol use, provide an assessment to identify needs and vulnerabilities.
Based on need, provide personalised clinical interventions, for example support parents and carers to understand the risks and impact of alcohol use on their ability to provide safe, consistent care for their child’s safety and development.
Alcohol use should be reviewed at each contact. The Alcohol, Smoking and Substance Involvement Screening Tool - Lite (ASSIST-Lite) is a short screening tool for use with adults (aged 18 or over) covering alcohol, tobacco, cannabis, stimulants, sedatives, opioids, and other psychoactive substances including use of medicines not as prescribed.
Parents with alcohol and drug problems: support resources
ASSIST-Lite alcohol and drug use, and tobacco smoking screening tool
Early years high impact area 2: Supporting maternal and family mental health
Early years high impact area 5: Improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 2: Improving health behaviours and reducing risk
School-aged years high impact area 3: Supporting healthy lifestyles
School aged years high impact area 6: Supporting self-care and improving health literacy
E-Learning for Healthcare Alcohol Identification and Brief Advice
UK Chief Medical Officers’ low risk drinking guidelines
Talk to Frank Honest information about drugs
Talk to Frank Find support near you
Alcohol: applying all our health
E-Learning for Healthcare All our health: alcohol
Keeping safe and accident prevention
Inequalities and disparities including parents in contact with the criminal justice system
Safeguarding
Children with foetal alcohol syndrome with residual issues will receive specialist care. Provide support for children and their parents or carers, following local pathways to provide information about additional support or refer to specialist services as necessary.
NHS.UK Foetal alcohol spectrum disorder
NICE Fetal alcohol spectrum disorder
NICE Drug misuse prevention: targeted interventions
Parents with alcohol and drug problems: support resources
RCOG Alcohol and pregnancy
National Organisation for FASD
Provide information to parents and carers about local community delivered support groups such as Alcoholics Anonymous (AA) where appropriate.
Alcoholics Anonymous (AA)
E-Learning for Healthcare Alcohol Identification and Brief Advice
UK Chief Medical Officers’ low risk drinking guidelines
Talk to Frank Honest information about drugs
Talk to Frank Find support near you
Alcohol: applying all our health
E-Learning for Healthcare All our health: alcohol
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Use strength-based approaches to assess and support parent and carers to avoid the potential for re-traumatisation by recognising when people may have experienced trauma or adverse childhood experiences.
Scottish Government Trauma-informed practice: toolkit
South Yorkshire Violence Reduction Unit Trauma-informed practice
Gloucestershire County Council Frameworks for being trauma-informed
Early Intervention Foundation Trauma-informed care: Understanding the use of trauma-informed approaches within children’s social care
Adverse Childhood Experience Support Hub Cymru and Wrexham University ‘Trauma-informed’: Identifying key language and terminology through a review of the literature
Working definition of trauma-informed practice
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Targeted)
Where there are safeguarding concerns follow local guidance and protocols from the Local Children’s Safeguarding Partnership.
Health visiting and school nursing delivery model
Universal
Community
Drugs
Where there are concerns about parental or carer illicit drug and medicine misuse, provide an assessment to identify needs and vulnerabilities.
Based on need, provide personalised clinical interventions, for example support parents to understand the risks and impact of illicit drug and medicine misuse on their ability to provide safe, consistent care for their child’s safety and development.
Parental or carer drug use should be reviewed at each contact. The Alcohol, Smoking and Substance Involvement Screening Tool - Lite (ASSIST-Lite) is a short screening tool for use with adults (aged 18 or over) covering alcohol, tobacco, cannabis, stimulants, sedatives, opioids, and other psychoactive substances including use of medicines not as prescribed.
Early years high impact area 2: Supporting maternal and family mental health
Early years high impact area 5: Improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 2: Improving health behaviours and reducing risk
School-aged years high impact area 3: Supporting healthy lifestyles
School aged years high impact area 6: Supporting self-care and improving health literacy
Alcohol and drug prevention, treatment and recovery: why invest?
Misuse of illicit drugs and medicine: applying all our health
ASSIST-Lite alcohol and drug use, and tobacco smoking screening tool
DHSC Drug misuse and dependence: UK guidelines on clinical management
Talk to Frank Honest information about drugs
NICE Drug misuse prevention: targeted interventions
Parents with alcohol and drug problems: support resources
Talk to Frank Find support near you
Drugs commissioning support: principles and indicators
NICE Drug misuse prevention: targeted interventions
E-Learning for Healthcare Alcohol identification and brief advice
Developing pathways for referring patients from secondary care to specialist alcohol treatment
Cocaine Anonymous (CA)
Narcotics Anonymous (NA)
Safeguarding
Children born with drug withdrawal and experiencing residual symptoms will receive specialist care. In addition, provide support for children and their parents or carers, following local pathways to provide information about additional support or refer to specialist services as necessary.
Parents with alcohol and drug problems: support resources
NICE Drug misuse prevention: targeted interventions
NICE Substance dependence
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Use strength-based approaches to assess and support parents and carers to avoid the potential for re-traumatisation by recognising when people may have experienced trauma or adverse childhood experiences.
Scottish Government Trauma-informed practice: toolkit
South Yorkshire Violence Reduction Unit Trauma-informed practice
Gloucestershire County Council Frameworks for being trauma-informed
Early Intervention Foundation Trauma-informed care: Understanding the use of trauma-informed approaches within children’s social care
Adverse Childhood Experience Support Hub Cymru and Wrexham University ‘Trauma-informed’: Identifying key language and terminology through a review of the literature
Working definition of trauma-informed practice
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Where there are safeguarding concerns, referrals to children’s social care should be made. Follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Targeted)
Tobacco and vaping
Where there are concerns about parental tobacco use or vaping, provide an assessment to identify needs and vulnerabilities.
Based on need, provide personalised clinical interventions, for example brief interventions to support individuals to stop and help them understand the impact of smoke free homes, second-hand smoke and vaping on their child’s health including respiratory wheeze or asthma, development and safety.
Smoking should be reviewed at each contact. The Alcohol, Smoking and Substance Involvement Screening Tool - Lite (ASSIST-Lite) is a short screening tool for use with adults (aged 18 or over) covering alcohol, tobacco, cannabis, stimulants, sedatives, opioids, and other psychoactive substances including use of medicines not as prescribed.
ASSIST-Lite alcohol and drug use, and tobacco smoking screening tool
E-Learning for Healthcare Supporting a smokefree pregnancy and smokefree families (SCP)
Early years high impact area 2: Supporting maternal and family mental health
Early years high impact area 5: Improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 2: Improving health behaviours and reducing risk
School-aged years high impact area 3: Supporting healthy lifestyles
School aged years high impact area 6: Supporting self-care and improving health literacy
Smoking and tobacco: applying All Our Health
NHS.UK Local stop smoking services
NICE Smoking: stopping in pregnancy and after childbirth
NICE Tobacco: preventing uptake, promoting quitting and treating dependence
Health matters: Stopping smoking - what works?
NHS.UK Live well quit smoking
NHS.UK Passive smoking
Provide information about local smoking cessation services.
E-Learning for Healthcare Supporting a smokefree pregnancy and smokefree families (SCP)
NHS.UK Local stop smoking services
NICE Smoking: stopping in pregnancy and after childbirth
NICE Tobacco: preventing uptake, promoting quitting and treating dependence
Health matters: Stopping smoking - what works?
NHS.UK Live well quit smoking
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Targeted)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Metrics and outcomes indicators
Use evidence and data to monitor alcohol, drug and tobacco use. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Local alcohol profiles for England
OHID Fingertips Local tobacco control profiles
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips user guidance
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Where children including those most at risk of poor dental health such as children in care, or those with special educational needs or disabilities (SEND) or refugees, asylum seekers or migrants, have been identified as requiring targeted intervention for oral health or dental care, provide an assessment to identify health needs and vulnerability.
Based on need, provide personalised clinical interventions, for example targeted advice and support such as supervised tooth brushing where there are oral health and dental care concerns such as dental caries or poor diet.
Early years high impact area 5: improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School-aged years high impact area 5: Supporting additional and complex health needs
School aged years high impact area 6: Supporting self-care and improving health literacy
Children with special educational needs and disabilities (SEND)
DHSC Delivering better oral health
All Our Health: Child oral health
Interactive townscape on child oral health
NICE Dental checks: intervals between oral health reviews
Oral health and dental care
Specialist
Provide information about dental services where parents and carers can seek additional support and advice, where appropriate.
Oral health and dental care
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Metrics and outcomes indicators
Use evidence and data to monitor oral health and dental care. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Child and maternal health oral health
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips user guidance
Close pop-up
Where children have been identified as requiring targeted intervention for allergies or anaphylaxis, provide an assessment to identify health needs and potential vulnerability.
Based on need, work with parents to provide personalised clinical interventions, for example targeted advice and support to help individuals to manage symptoms, access specialist services appropriately and develop a healthcare plan for managing allergies or anaphylaxis in education settings.
Early years high impact area 5: improving health literacy, managing minor illnesses and reducing accidents
School aged years high impact area 6: Supporting self-care and improving health literacy
Anaphylaxis Campaign
NICE Allergies
RCPCH Allergy care pathways – education resources for healthcare professionals (2011)
NHS.UK Allergies
Healthier Together I’m worried about…
Specialist
Where children, including those with special educational needs or disabilities (SEND), have been identified as requiring targeted intervention for long-term conditions, provide an assessment to identify health needs and vulnerability.
Based on need, work with parents and the multidisciplinary team including health visitors, school nurses and education settings to provide personalised clinical interventions. Examples include targeted advice and support to help individuals to manage symptoms, access specialist services appropriately and develop a healthcare plan or education healthcare plan (EHCP) for managing medial conditions in education settings.
Early years high impact area 5: improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School-aged years high impact area 5: Supporting additional and complex health needs
School aged years high impact area 6: Supporting self-care and improving health literacy
DfE, DHSC SEND code of practice: 0 to 25 years
NICE Epilepsy
BMJ Epilepsy: putting NICE guidelines into practice
NHS.UK Epilepsy
Epilepsy Action
Epilepsy Society
NHS England National bundle of care for children and young people with asthma
NHS.UK Asthma
NICE Asthma
RCPCH Allergy care pathway for asthma and/or rhinitis
Beat Asthma
Asthma UK
NHS.UK Diabetes
NICE Diabetes (type 1 and type 2) in children and young people: diagnosis and management
Diabetes UK
NHS.UK Sickle Cell Disease
Sickle Cell Society
NICE Sickle Cell Disease
NHS.UK Cystic Fibrosis
Cystic Fibrosis Trust
Healthier Together I’m worried about…
Specialist
Where children including those with special educational needs or disabilities (SEND) have been identified as requiring targeted intervention for complex needs and disabilities, provide an assessment to identify health needs and vulnerability.
Based on need, work with parents and the multidisciplinary team including health visitors, school nurses and education settings to provide personalised clinical interventions. Examples include targeted advice and support to help individuals to manage symptoms, access specialist services appropriately and develop a healthcare plan or education healthcare plan (EHCP) for managing medial conditions in education settings.
Early years high impact area 5: improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School-aged years high impact area 5: Supporting additional and complex health needs
School aged years high impact area 6: Supporting self-care and improving health literacy
Downs Syndrome Association
SCOPE Support groups for parents with disabled children
DfE, DHSC SEND code of practice: 0 to 25 years
Specialist
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Acting as advocates for parents and children, provide information to families about additional targeted and specialist services and voluntary sector agencies. Where appropriate, work in partnership with these services.
Early years high impact area 5: improving health literacy, managing minor illnesses and reducing accidents
School aged years high impact area 6: Supporting self-care and improving health literacy
GOV.UK Find a local support group for children, young people and families
SCOPE Support groups for parents with disabled children
Metrics and outcomes indicators
Use evidence and data to monitor self-care and health literacy. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Child and maternal health
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips user guidance
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Minority groups
Where children, parents or carers from minority groups have been identified as requiring a targeted intervention, provide an assessment to identify health needs and vulnerability to reduce disparities and improve health outcomes. This may include Gypsy, Traveller and Roma (GRT) and Boater communities who may have difficulty understanding and navigating the system to access health and care services appropriately.
Based on need, provide personalised clinical interventions, for example targeted advice and support to help individuals to overcome any barriers to accessing services.
Early years high impact area 2: Supporting maternal and family mental health
School-aged years high impact area 1: Supporting resilience and wellbeing
No child left behind: a public health informed approach to improving outcomes for vulnerable children
NHS.UK Children and young people’s services
Inclusion health: applying All Our Health
Healthy equity
Voluntary, Community and Social Enterprise (VCSE) Inclusion Health Audit Tool
Friends, Families and Travellers
Where children, parents or carers have been identified as requiring a targeted intervention because their ethnicity represents an increased risk of specific health conditions, provide an assessment to identify health needs and vulnerability.
Based on need, provide personalised clinical interventions, for example targeted advice and support to help individuals to access services appropriately.
Consider cultural practices, particularly when working with families from ethnic minority groups and provide a sensitive and supportive response to their implications for health, including female genital mutilation (FGM), and where parents are blood relations (consanguinity).
Early years high impact area 2: Supporting maternal and family mental health
School-aged years high impact area 1: Supporting resilience and wellbeing
Inclusion health: applying All Our Health
Mental and emotional health and wellbeing
NICE Diabetes (type 1 and type 2) in children and young people: diagnosis and management
NHS.UK Sickle Cell Disease
Sickle Cell Society
NICE Sickle Cell Disease
NHS.UK Thalassaemia
Home Office Female genital mutilation
NHS.UK Female genital mutilation
Children with additional health and development needs including complex needs and disability
E-Learning for Healthcare Cultural competence
Where children, parents or carers who are asylum seekers, refugees or vulnerable migrants are identified as requiring a targeted intervention, provide an assessment to identify health needs and vulnerability to reduce disparities and improve health outcomes. This may include those who may have difficulty understanding and navigating the system to access health and care services appropriately.
Based on need, provide personalised clinical interventions, for example targeted advice and support to help individuals to overcome any barriers to accessing services.
Consider referring families whose first language is not English to English as a second language services.
No child left behind: a public health informed approach to improving outcomes for vulnerable children
Early years high impact area 2: Supporting maternal and family mental health
School-aged years high impact area 1: Supporting resilience and wellbeing
Inclusion health: applying All Our Health
Modern slavery and public health
Home Office Modern slavery collection
Voluntary, Community and Social Enterprise (VCSE) Inclusion Health Audit Tool
DfE Safeguarding unaccompanied asylum seeking and refugee children
NHS entitlements: migrant health guide
Safeguarding
Children and families with family members in the armed forces or who are veterans may need additional support to manage stress around deployment, separation, isolation, caring responsibilities, moving between locations and access to health services.
Mental and emotional health and wellbeing
Inequalities and disparities including housing and living conditions
NHS service families: welfare and support
Ministry of Defence what the covenant means to you: leaflets
Inclusion health: applying All Our Health
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Young carers
Children who have caring responsibilities can be more vulnerable to poorer health and wellbeing outcomes. Where children have been identified as young carers and require targeted intervention, provide an assessment to identify health needs, strengths and vulnerability.
Based on need, provide personalised clinical interventions, for example, build a trusted relationship with young carers to enhance their skills, confidence and aspirations and avoid poorer outcomes.
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
No child left behind: a public health informed approach to improving outcomes for vulnerable children
Care Act 2014
Children’s Commissioner The support provided to young carers in England
ADCS No wrong doors working together to support young carers and their families
Barnardo’s Young carers
Carers’ Trust Help and information
Children’s Society Young carer services
NHS England Today on Young Carers Awareness Day – How can you help a young carer in just 5 minutes?
DHSC You’re Welcome: Quality criteria for young people friendly health services
RCPCH State of child health young carers
Young Minds Young carers
Children’s Society Advice and support for young carers
Carers Trust Young carers in schools toolkit (PDF)
Youth Access
NHS.UK Mental health and self-care for young people
AYPH Helping parents and carers of young people with mental health problems: What can we do?
Mental and emotional health and wellbeing
Safeguarding (Universal)
Safeguarding (Targeted)
Safeguarding (Community)
Provide information about local services, such as family hubs or children’s centres and GPs, where children, parents and carers can seek additional support and advice.
Children’s Commissioner The support provided to young carers in England
ADCS No wrong doors working together to support young carers and their families
Barnardo’s Young carers
Carers’ Trust Help and information
Children’s Society Young carer services
NHS England Today on Young Carers Awareness Day – How can you help a young carer in just 5 minutes?
DHSC You’re Welcome: Quality criteria for young people friendly health services
Young Minds Young carers
Children’s Society Advice and support for young carers
Carers Trust Young carers in schools toolkit (PDF)
Youth Access
NHS.UK Mental health and self-care for young people
AYPH Helping parents and carers of young people with mental health problems: What can we do?
Mental and emotional health and wellbeing
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
Safeguarding (Universal)
Safeguarding (Targeted)
Safeguarding (Community)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Local authorities are required to consider the needs of young carers if, during the assessment of an adult with care needs, or of an adult carer, it appears that a child is providing, or intends to provide, care.
Ensure young carers and their family are aware of their right to a young carer’s needs assessment.
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
No child left behind: a public health informed approach to improving outcomes for vulnerable children
Care Act 2014
Children’s Commissioner The support provided to young carers in England
ADCS No wrong doors working together to support young carers and their families
Work together across partner organisations including adults’ and children’s services to offer young carers and their families an effective service and respond to the needs of a young carer, the person cared for, and others in the family.
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
No child left behind: a public health informed approach to improving outcomes for vulnerable children
Care Act 2014
Children’s Commissioner The support provided to young carers in England
ADCS No wrong doors working together to support young carers and their families
Acting as advocates for young carers, provide information to families about additional targeted and specialist services and voluntary sector agencies. Where appropriate, work in partnership with these services.
Barnardo’s Young carers
Carers’ Trust Help and information
Children’s Society Young carer resources
Children’s Society Young carer services
Community cohesion, social networks and cultural activities
Parents in contact with the criminal justice system
Where parents or other close family members are involved with the criminal justice system, children can be more vulnerable to poorer health and wellbeing outcomes.
Where parents and carers in contact with the criminal justice system have been identified as requiring targeted intervention, provide an assessment to identify health needs, strengths and vulnerability of parents, carers and children.
Based on need such as issues related to stigma, housing, finance or mental health, provide personalised clinical interventions including targeted advice and support.
Early years high impact area 2: Supporting maternal and family mental health
Early years high impact area 5: Improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 2: Improving health behaviours and reducing risk
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School aged years high impact area 6: Supporting self-care and improving health literacy
No child left behind: a public health informed approach to improving outcomes for vulnerable children
HMPPS Support for professionals working with offenders
Barnardo’s, HMPPS National Information Centre on Children of Offenders (NICCO)
Inclusion health: applying All Our Health
Prisoners’ Families Helpline
Mental and emotional health and wellbeing
Safeguarding
Intensive parenting support including nurturing parenting
Provide information about local services, such as family hubs or children’s centres and GPs, where parents and carers can seek additional support and advice.
HMPPS Support for professionals working with offenders
Barnardo’s, HMPPS National Information Centre on Children of Offenders (NICCO)
Prisoners’ Families Helpline
Mental and emotional health and wellbeing
Intensive parenting support including nurturing parenting
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
Safeguarding (Universal)
Safeguarding (Targeted)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Workless and low income households
Where children and families have been identified as needing targeted intervention due to being workless households or having low income, work in partnership with other agencies and parents and carers to carry out assessment to identify needs, strengths and vulnerabilities, and develop appropriate plans.
Offer targeted interventions in response to need, which may include joint visits or consultations with other professionals or advocacy. Use strengths-based approaches to empower parents and carers to meet the needs of their child, and access services appropriately.
GOV.UK Find your local council
Citizens Advice
UK Government Benefits and financial support for families
GOV.UK Disability living allowance for children
GOV.UK Financial help if you have children
GOV.UK Healthy Start
NHS.UK Healthy Start
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
Vulnerability in childhood: a public health informed approach
DLUHC, DfE Supporting families
Safeguarding
Work with partners to respond to identified needs requiring a multi-agency approach such as accident prevention, frequent attendance at A&E, housing needs or domestic abuse.
DLUHC, DfE Supporting families
Improving self-care and health literacy
Safeguarding
Where additional targeted or specialist services are required, work in partnership to follow local pathways and to complete referral.
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
Safeguarding (Universal)
Safeguarding (Targeted)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Housing and living conditions including tenure
Where children and families have been identified as needing targeted intervention due to unhealthy, overcrowded precarious housing, work in partnership with other agencies and parents and carers to carry out assessment to identify needs, strengths and vulnerabilities, and develop appropriate plans.
Offer targeted interventions in response to need, which may include joint visits or consultations with other professionals or advocacy. Use strengths-based approaches to empower parents and carers to meet the needs of their child, and access services appropriately.
Where additional targeted or specialist services are required, work in partnership to follow local pathways and to complete referral.
Early years high impact area 5: improving health literacy, managing illnesses and reducing accidents
School aged years high impact area 6: Supporting self-care and improving health literacy
Reducing unintentional injuries among children and young people
Inclusion health: applying All Our Health
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
Vulnerability in childhood: a public health informed approach
DLUHC, DfE Supporting families
Safeguarding (Universal)
Safeguarding (Targeted)
Safeguarding (Community)
Healthy and inclusive neighbourhoods including housing and living conditions including tenure
Keeping safe and accident prevention
Inequalities and disparities
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
Safeguarding (Universal)
Safeguarding (Targeted)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Metrics and outcomes indicators
Use evidence and data to monitor inequalities and disparities. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Child and maternal health
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips Wider determinants of health
OHID Fingertips user guidance
Close pop-up
Vulnerability and early help
Where children and families have been identified as vulnerable and require targeted interventions, for example families in poverty, poor housing or at risk of hidden harms, work in partnership with other agencies and parents and carers to carry out an assessment including family relationships and dynamics, and chronology of events to identify needs, strengths and vulnerabilities, and develop appropriate plans.
Offer personalised clinical interventions in response to need, which may include joint visits or consultations with other professionals. Use strengths-based approaches to empower parents and carers to meet the needs of their child, and access services appropriately.
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
Vulnerability in childhood: a public health informed approach
DLUHC, DfE Supporting families
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Community)
Use strength-based approaches to assess and support parents and carers to avoid the potential for re-traumatisation by recognising when people may have experienced trauma or adverse childhood experiences.
Scottish Government Trauma-informed practice: toolkit
South Yorkshire Violence Reduction Unit Trauma-informed practice
Gloucestershire County Council Frameworks for being trauma-informed
Early Intervention Foundation Trauma-informed care: Understanding the use of trauma-informed approaches within children’s social care
Adverse Childhood Experience Support Hub Cymru and Wrexham University ‘Trauma-informed’: Identifying key language and terminology through a review of the literature
Working definition of trauma-informed practice
Where additional targeted or specialist services are required, work in partnership to follow local pathways.
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Community)
Where a child transfers in or out-of-area, ensure that the child’s health records are transferred to the receiving service with particular reference to GPs, health visiting, school nursing and social care services. Local guidance and best practice should be adhered to, and include information regarding specialist services in the handover to ensure continuity of care.
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Community)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Children in need
A child in need is defined under the Children Act 1989 and 2004 as a child who is unlikely to reach or maintain a satisfactory level of health or development, or their health or development will be significantly impaired without the provision of children's social care services, or the child is disabled.
Work in partnership with other agencies and parents and carers to carry out holistic assessment including family relationships and dynamics, and chronology of events to identify needs, strengths and vulnerabilities, and develop appropriate care plans.
Offer personalised clinical interventions in response to need, which may include joint visits or consultations with other professionals in response to need. Use strengths-based approaches to empower parents and carers to meet the needs of their child, and access targeted services appropriately.
Safeguarding (Universal)
E-Learning for Healthcare Safeguarding children and young people programme
DfE Working together to safeguard children
Vulnerability in childhood: a public health informed approach
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
Children Act 1989
Children Act 2004
Safeguarding (Community)
Use strength-based approaches to assess and support parents and carers to avoid the potential for re-traumatisation by recognising when people may have experienced trauma or adverse childhood experiences.
Scottish Government Trauma-informed practice: toolkit
South Yorkshire Violence Reduction Unit Trauma-informed practice
Gloucestershire County Council Frameworks for being trauma-informed
Early Intervention Foundation Trauma-informed care: Understanding the use of trauma-informed approaches within children’s social care
Adverse Childhood Experience Support Hub Cymru and Wrexham University ‘Trauma-informed’: Identifying key language and terminology through a review of the literature
Working definition of trauma-informed practice
Where additional targeted or specialist services are required, work in partnership to follow local pathways and to complete referral.
Where a child transfers in or out-of-area, ensure that the health records are transferred to the receiving service, with particular reference to GP, health visiting, school nursing and social care services. Local guidance and best practice should be adhered to, and include information regarding specialist services in the handover to ensure continuity of care.
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Community)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Where safeguarding concerns escalate, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
E-Learning for Healthcare Safeguarding children and young people programme
Safeguarding (Universal)
Safeguarding (Community)
Children with child protection plans
A child has a child protection plan if they are assessed as being at risk of significant harm at an initial child protection conference.
Work in partnership with other agencies and parents and carers to review assessment including family relationships and dynamics, and chronology of events to identify needs, strengths and vulnerabilities, and develop appropriate care plans.
Offer personalised clinical interventions in response to need, which may include joint visits or consultations with other professionals in response to need. Use strengths-based approaches to empower parents and carers to meet the needs of their child, and access targeted services appropriately.
DfE, DHSC Promoting the health and wellbeing of looked-after children
DfE Working together to safeguard children
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
Safeguarding
E-Learning for Healthcare Safeguarding children and young people programme
Use strength-based approaches to assess and support parents and carers to avoid the potential for re-traumatisation by recognising when people may have experienced trauma or adverse childhood experiences.
Scottish Government Trauma-informed practice: toolkit
South Yorkshire Violence Reduction Unit Trauma-informed practice
Gloucestershire County Council Frameworks for being trauma-informed
Early Intervention Foundation Trauma-informed care: Understanding the use of trauma-informed approaches within children’s social care
Adverse Childhood Experience Support Hub Cymru and Wrexham University ‘Trauma-informed’: Identifying key language and terminology through a review of the literature
Working definition of trauma-informed practice
Where additional targeted or specialist services are required, work in partnership to follow local pathways to complete referral.
Where a child transfers in or out-of-area, ensure that the child’s health records are transferred to the receiving service with particular reference to GP, health visiting, school nursing and social care services. Local guidance and best practice should be adhered to, and include information regarding specialist services in the handover to ensure continuity of care.
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Community)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Looked-after children
Follow statutory guidance including health assessments that consider family relationships and dynamics, and chronology of events to inform the health plan and ensure looked-after children have access to any physical, developmental, emotional or mental health care they may need, including support for foster carers regarding health issues and emotional support for children not living with their parents.
Offer personalised clinical interventions in response to need, which may include joint visits or consultations with other professionals in response to need. Use strengths-based approaches to empower parents and carers to meet the needs of their child, and access targeted services appropriately.
For example, looked after children can be at a higher risk of missing childhood vaccinations or development reviews. For missed immunisations, refer to the guide for uncertain or incomplete vaccinations.
DfE, DHSC Promoting the health and wellbeing of looked-after children
DfE Working together to safeguard children
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
Intensive parenting support including young parents
Children’s Commissioner Help at hand
Immunisation
Vaccination of individuals with uncertain or incomplete immunisation status
Safeguarding
E-Learning for Healthcare Safeguarding children and young people programme
Work with foster carers and social workers to ensure full delivery of the local child public health offer.
Health visiting and school nursing delivery model
Universal
Targeted
Specialist
Community
Use strength-based approaches to assess and support parents and carers to avoid the potential for re-traumatisation by recognising when people may have experienced trauma or adverse childhood experiences.
Scottish Government Trauma-informed practice: toolkit
South Yorkshire Violence Reduction Unit Trauma-informed practice
Gloucestershire County Council Frameworks for being trauma-informed
Early Intervention Foundation Trauma-informed care: Understanding the use of trauma-informed approaches within children’s social care
Adverse Childhood Experience Support Hub Cymru and Wrexham University ‘Trauma-informed’: Identifying key language and terminology through a review of the literature
Working definition of trauma-informed practice
Where additional targeted or specialist services are required, work in partnership to follow local pathways to complete referral.
Where a child transfers in or out-of-area or has a change of placement, ensure that the child’s health records are transferred to the receiving service with particular reference to GP health visiting, school nursing and children’s social care services. Local guidance and best practice should be adhered to, and include information regarding specialist services in the handover to ensure continuity of care.
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Community)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Domestic violence and abuse
Where domestic violence or abuse is suspected, discuss concerns safely, when the individual is away from the abuser and there is no risk of being overheard. This will usually be when a client is alone except where they wish to have a friend or family member present for support.
No child left behind: a public health informed approach to improving outcomes for vulnerable children
DfE Working together to safeguard children
Barnardo’s Families affected by domestic abuse
NICE Domestic violence and abuse
NHS.UK Domestic violence and abuse
DLUHC, DfE Supporting families
Home office Domestic abuse how to get help
NHS.UK Sexual health
Early years high impact area 1: supporting the transition to parenthood
NICE Domestic violence and abuse: multi-agency working
Safeguarding
Where domestic violence and abuse (including controlling relationships between parents) is identified, follow statutory guidance and local safeguarding procedures. Consider the child as a victim and determine further safeguarding actions and support are required.
Undertake holistic assessment according to local guidance to identify needs, strengths and vulnerabilities including family relationships and dynamics, and chronology of events.
NICE Domestic violence and abuse
NHS.UK Domestic violence and abuse
Home office Domestic abuse how to get help
NHS.UK Sexual health
NICE Domestic violence and abuse: multi-agency working
Mental and emotional health and wellbeing
Alcohol, drugs and tobacco
Safeguarding
NSPCC Learning Early help (or early intervention)
Home Office and Ministry of Justice Domestic Abuse Bill
Where children, parents and carers have been identified as requiring targeted intervention, based on need provide personalised clinical interventions.
Where additional targeted or specialist services are required, work in partnership to follow local pathways to complete appropriate and timely referral.
NICE Domestic violence and abuse
NHS.UK Domestic violence and abuse
Home office Domestic abuse how to get help
NHS.UK Sexual health
NICE Domestic violence and abuse: multi-agency working
Mental and emotional health and wellbeing
Alcohol, drugs and tobacco
Safeguarding
NSPCC Learning Early help (or early intervention)
Home Office and Ministry of Justice Domestic Abuse Bill
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Community)
Metrics and outcomes indicators
Use evidence and data to monitor the health and wellbeing of vulnerable children and those with safeguarding needs. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Child and maternal health vulnerable children and young people
OHID Fingertips Improving health outcomes for vulnerable children and young people reports
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips Wider determinants of health
OHID Fingertips user guidance
Close pop-up
Special educational needs and disabilities (SEND)
Where appropriate, contribute to education, health and care (EHC) plan needs assessments for the local authority to decide whether it is necessary for it to make provision in accordance with an EHC plan. Ensure these are completed to the national standards and within the statutory timeframe.
DfE, DHSC Promoting the health and wellbeing of looked-after children
DfE, DHSC SEND code of practice: 0 to 25 years
Early years high impact area 6: Ready to learn and narrowing the word gap
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School-aged years high impact area 5: Supporting additional and complex health needs
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
Vulnerability in childhood: a public health informed approach
Safeguarding
Where children have been identified as in need of an education, health and care plan (EHCP) assessment, for example children with neurodisability, work in partnership with parents and carers, early years and education settings including SEN coordinators (SENCOs), and other agencies to identify the child’s needs, strengths and vulnerabilities.
Offer personalised clinical interventions in response to the identified EHCP. This may include joint visits or consultations with other professionals in response to need.
Use strengths-based approaches to empower parents and carers to meet the needs of their child, access services appropriately and prepare for transition to other education settings where appropriate.
DfE, DHSC Promoting the health and wellbeing of looked-after children
DfE, DHSC SEND code of practice: 0 to 25 years
GOV.UK Children with special educational needs and disabilities (SEND)
Early years high impact area 6: Ready to learn and narrowing the word gap
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School-aged years high impact area 5: Supporting additional and complex health needs
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
Vulnerability in childhood: a public health informed approach
Safeguarding
Use strength-based approaches to assess and support children, parents and carers to avoid the potential for re-traumatisation by recognising when people may have experienced trauma or adverse childhood experiences.
Scottish Government Trauma-informed practice: toolkit
South Yorkshire Violence Reduction Unit Trauma-informed practice
Gloucestershire County Council Frameworks for being trauma-informed
Early Intervention Foundation Trauma-informed care: Understanding the use of trauma-informed approaches within children’s social care
Adverse Childhood Experience Support Hub Cymru and Wrexham University ‘Trauma-informed’: Identifying key language and terminology through a review of the literature
Working definition of trauma-informed practice
Where additional targeted or specialist services are required, work in partnership to follow local pathways.
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Community)
Where a child transfers in or out-of-area, ensure that the child’s health records are transferred to the receiving service with particular reference to GPs, health visiting, school nursing and social care services. Local guidance and best practice should be adhered to, and include information regarding specialist services in the handover to ensure continuity of care.
Guidance to support commissioning of the healthy child programme 0 to 19 Commissioning guide 2: model specification
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Community)
Continue to provide children, parents and carers with the universal and community offer and work in partnership with other agencies while providing targeted support.
NHS.UK How to care for children with complex needs
E-Learning for Healthcare: Early developmental support programme
Health visiting and school nursing delivery model
Universal
Community
Complex needs and disability
Work in partnership with other agencies and parents and carers to review assessment identifying needs, strengths and vulnerabilities, and develop appropriate care plans to meet the needs of children with complex needs, for example prior to hospital discharge or to support starting nursery or school.
Offer personalised clinical interventions in response to need, which may include joint visits or consultations with other professionals in response to need. Use strengths-based approaches to empower parents and carers to meet the needs of their child, support school readiness and access targeted services appropriately.
Early years high impact area 2: Supporting maternal and family mental health
Early years high impact area 5: Improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School-aged years high impact area 5: Supporting additional and complex health needs
School aged years high impact area 6: Supporting self-care and improving health literacy
NHS.UK How to care for children with complex needs
E-Learning for Healthcare: Early developmental support programme
Where children with complex needs and disabilities have been identified as requiring targeted interventions for special educational needs or disabilities (SEND), support the multidisciplinary assessment and review process to identify health needs and vulnerability.
Based on need, work with parents and the multidisciplinary team including school nurses, health visitors and education settings including SEN coordinators (SENCOs) to develop the education healthcare plan (EHCP).
Provide personalised clinical interventions in response to health needs, for example, targeted advice and support for parents and carers to help their children engage in learning opportunities, access specialist services appropriately and for managing medical conditions in early years settings.
DfE, DHSC SEND code of practice: 0 to 25 years
GOV.UK Children with special educational needs and disabilities (SEND)
Early years high impact area 5: improving health literacy, managing minor illnesses and reducing accidents
Early years high impact area 6: Ready to learn and narrowing the word gap
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School-aged years high impact area 5: Supporting additional and complex health needs
School aged years high impact area 6: Supporting self-care and improving health literacy
SCOPE Support groups for parents with disabled children
Specialist
Children with additional and complex needs may also have speech, language and communication needs. This may include those with autism spectrum disorder; developmental coordination disorder (dyspraxia); social, emotional and mental health issues; selective mutism; hearing impairment; and motor disorders such as cerebral palsy and muscular dystrophy.
Based on need, provide personalised clinical interventions, for example information, advice and support for early speech and language development following guidance in the speech, language and communication pathway.
E-Learning for Healthcare Speech, language and communication 2 to 3 years targeted
E-Learning for Healthcare Speech, language and communication 3 to 5 years targeted
Best start in speech, language and communication (SLC)
NHS.UK How to care for children with complex needs
DHSC Supporting children with special educational needs and disabilities
E-Learning for Healthcare: Early developmental support programme
Communication Trust
I CAN
BookTrust
National Literacy Trust
Speech, language and communication needs
Healthy development including speech, language and communication needs
Mental and emotional health and wellbeing
Where additional targeted or specialist services are required, work in partnership to follow local pathways and to complete timely referral.
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
NHS.UK How to care for children with complex needs
E-Learning for Healthcare: Early developmental support programme
Health visiting and school nursing delivery model
Universal
Community
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Targeted)
Safeguarding (Community)
Where parents or carers are caring for a terminally ill child or have experienced the death of a child, support them in their bereavement.
Advocate for the child to ensure that their voice is heard, they are involved in decision-making, understand consent and that their needs are met.
Refer to specialist child palliative and end of life care where appropriate. In addition, provide information about relevant support groups and programmes.
Listen to parental concerns about caring for future children and provide support, information and advice to help alleviate anxiety.
Palliative and end of life care
NICE End of life care for infants, children and young people with life-limiting conditions: planning and
management
GOV.UK Find a local support group for children, young people and families
Hospice UK
Child Bereavement UK
Long-term health and wellbeing needs
Work in partnership with other agencies and parents and carers to review assessment identifying needs, strengths and vulnerabilities, and develop appropriate care plans to meet the needs of children with long term health needs, for example, children who have spina bifida, congenital heart disease or cancer.
Offer personalised clinical interventions in response to need, which may include joint visits or consultations with other professionals in response to need. Use strengths-based approaches to empower parents and carers to meet the needs of their child, manage symptoms and access targeted services appropriately.
Where additional targeted or specialist services are required, work in partnership to follow local pathways to complete referral.
NHS England House of care: a framework for long-term condition care
Early years high impact area 5: improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School aged years high impact area 6: Supporting self-care and improving health literacy
Healthier Together I’m worried about…
NICE Epilepsy
BMJ Epilepsy: putting NICE guidelines into practice
NHS.UK Epilepsy
NHS.UK Sickle Cell Disease
Sickle Cell Society
NICE Sickle Cell Disease
NHS.UK Cystic Fibrosis
Cystic Fibrosis Trust
NHS England NHS Commissioning children and young people’s cancer
Young Lives vs Cancer
NHS.UK Congenital heart disease
NHS.UK Spina bifida
RCPCH State of child health long-term conditions
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Targeted)
Safeguarding (Community)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
NHS England House of care: a framework for long-term condition care
Health visiting and school nursing delivery model
Universal
Community
Support children and families with allergies and anaphylaxis, offering personalised clinical interventions in response to need, which may include joint visits or consultations with other professionals in response to need. Use strengths-based approaches to empower parents and carers to meet the needs of their child, manage symptoms and access targeted services appropriately.
Early years high impact area 5: improving health literacy, managing minor illnesses and reducing accidents
School aged years high impact area 6: Supporting self-care and improving health literacy
NICE Allergies
RCPCH Allergy care pathways – education resources for healthcare professionals (2011)
NHS.UK Allergies
NHS England National bundle of care for children and young people with asthma
NHS.UK Asthma
NICE Asthma
RCPCH Allergy care pathway for asthma and/or rhinitis
Beat Asthma
Asthma UK
Healthier Together I’m worried about…
Speech, language and communication needs
Where children have been identified as requiring targeted intervention for speech and language development, provide an assessment to identify health needs and vulnerability.
Based on need, provide personalised clinical interventions, for example information, advice and support for early speech and language development following guidance in the speech, language and communication pathway.
Where there are concerns about a child’s speech and language development as a result of maternal, paternal or family-child relationship and attachment, follow local protocols for assessment of child mental health and parent or carer attachment.
Best start in speech, language and communication (SLC)
E-Learning for Healthcare Speech, language and communication 2 to 3 years targeted
E-Learning for Healthcare Speech, language and communication 3 to 5 years targeted
Early years high impact area 1: Supporting the transition to parenthood
Early years high impact area 2: Supporting maternal and family mental health
Solihull Approach Understanding your child
GOV.UK Working together to safeguard children
Where children have been identified in high risk group for delayed early speech and language development, provide an assessment to identify health needs and vulnerability. This may include children living in socioeconomic deprivation, children with cleft lip and palate or with additional needs such as autism spectrum disorder or hearing impairment.
Based on need, provide personalised clinical interventions, for example targeted advice and support for early speech and language development following guidance in the speech, language and communication pathway.
Vulnerability in childhood: a public health informed approach
Early years high impact area 6: Ready to learn and narrowing the word gap
Best start in speech, language and communication (SLC)
E-Learning for Healthcare Speech, language and communication 2 to 3 years targeted
E-Learning for Healthcare Speech, language and communication 3 to 5 years targeted
E-Learning for Healthcare: Best start in language, speech and communication
NHS.UK Cleft lip and palate
Cleft Lip and Palate Association
RCSLT Creating better lives for people with communication and swallowing needs
Solihull Approach Understanding your child
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Metrics and outcomes indicators
Use evidence and data to monitor the health and wellbeing needs of children with additional health and development needs including SEND. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Child and maternal health long-term conditions and complex needs
OHID Fingertips Child and maternal health vulnerable children and young people
OHID Fingertips Speech, language and communication reports
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips user guidance
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Young parents
The outcomes for young parents and their children are disproportionately poor, with higher rates of low birthweight, postnatal depression and negatively impact mental health for up to 3 years after birth.
Early, coordinated and sustained support for adolescent mothers and fathers can improve the life chances for them and the next generation of children.
Where young parents have been identified as requiring targeted intervention, provide an assessment to identify health needs, strengths and vulnerability.
Based on need, provide personalised clinical interventions, for example build a trusted relationship with young parents to enhance their skills, confidence and aspirations, develop their support networks and avoid poorer outcomes.
Teenage mothers and young fathers: support framework
Early years high impact area 2: Supporting maternal and family mental health
Early years high impact area 4: supporting healthy weight and nutrition
Early years high impact area 5: Improving health literacy, managing minor illnesses and reducing accidents
Early years high impact area 6: Ready to learn and narrowing the word gap
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 2: Improving health behaviours and reducing risk
School-aged years high impact area 3: Supporting healthy lifestyles
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School aged years high impact area 6: Supporting self-care and improving health literacy
Mental and emotional health and wellbeing
NHS.UK Mental health in pregnancy
Alcohol, drugs and tobacco
Healthy weight, nutrition and physical activity
Mental Health Foundation Young mums together
YoungMinds – children and young people’s mental health charity
Solihull Approach Understanding your child
Maintaining healthy relationships including sexual health
Safeguarding (Universal)
Safeguarding (Targeted)
Safeguarding (Community)
Provide information about local services, such as family hubs or children’s centres and GPs, where young parents can seek additional support and advice.
Teenage mothers and young fathers: support framework
Early years high impact area 2: Supporting maternal and family mental health
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School aged years high impact area 6: Supporting self-care and improving health literacy
Mental and emotional health and wellbeing
Mental Health Foundation Young mums together
YoungMinds – children and young people’s mental health charity
Solihull Approach Understanding your child
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
While young parents are receiving targeted support, continue to provide the universal and community offer and work in partnership with other agencies.
Health visiting and school nursing delivery model
Universal
Community
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Universal
Targeted
Community
Nurturing parenting
Where parents and carers have been identified as requiring targeted intervention due to concerns about inconsistent parenting, provide an assessment to identify health needs, strengths and vulnerability within the family.
Based on need, provide personalised clinical interventions, for example targeted advice and support on healthy coping strategies, reducing parental conflict, or intensive parenting support to enhance their skills and confidence.
Early years high impact area 2: Supporting maternal and family mental health
Early years high impact area 5: Improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 2: Improving health behaviours and reducing risk
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
Alcohol, drugs and tobacco
DWP Reducing parental conflict: tools for commissioners, managers and leaders
Solihull Approach Understanding your child
NSPCC How childhood trauma affects child brain development
Safeguarding (Universal)
Safeguarding (Targeted)
Safeguarding (Community)
Where parents and carers have learning disabilities, provide an assessment to identify health needs, strengths and potential vulnerability.
Based on need, provide personalised clinical interventions, for example targeted advice and support on healthy coping strategies or intensive parenting support to enhance their skills and confidence.
Early years high impact area 2: Supporting maternal and family mental health
Early years high impact area 5: Improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 2: Improving health behaviours and reducing risk
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School aged years high impact area 6: Supporting self-care and improving health literacy
Safeguarding (Universal)
Safeguarding (Targeted)
Safeguarding (Community)
Provide accessible information about local services, such as family hubs or children’s centres and GPs, where parents and carers can seek additional support and advice. Where required, give assistance with interpreting information and accessing other sources of support.
Early years high impact area 2: Supporting maternal and family mental health
Early years high impact area 5: Improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 1: Supporting resilience and wellbeing
School-aged years high impact area 2: Improving health behaviours and reducing risk
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School aged years high impact area 6: Supporting self-care and improving health literacy
Solihull Approach Understanding your child
GOV.UK Understanding accessibility requirements for public sector bodies
NHS England Accessible information standard
Where additional targeted or specialist services are required, follow local pathways to complete appropriate and timely referral.
Where there are safeguarding concerns, follow statutory guidance and local safeguarding procedures.
DfE Working together to safeguard children
Safeguarding (Universal)
Safeguarding (Targeted)
Safeguarding (Community)
Continue to provide parents, carers and the child with the universal and community offer and work in partnership with other agencies while providing targeted support.
Health visiting and school nursing delivery model
Universal
Community
Children who frequently miss health appointments, are not brought to appointments or attend health services inappropriately are at risk of poor outcomes. Follow up non-attendance of health appointments or frequent use of A&E and provide support, information and advice to parents or carers as appropriate.
Non-attendance at appointments can be a sign of neglect. Where there are safeguarding concerns, referrals to children’s social care should be made.
Safeguarding
Early years high impact area 5: improving health literacy, managing minor illnesses and reducing accidents
School-aged years high impact area 2: Improving health behaviours and reducing risk
School-aged years high impact area 4: Reducing vulnerabilities and improving life chances
School aged years high impact area 6: Supporting self-care and improving health literacy
No child left behind: a public health informed approach to improving outcomes for vulnerable children
Metrics and outcomes indicators
Use evidence and data to monitor factors which may benefit from intensive parenting support. Compare local data with similar areas, within a region and nationally, to identify opportunities for improvement. Use evidence and data to evaluate and demonstrate improvements in population health and other outcomes resulting from targeted intervention.
OHID Fingertips Child and maternal health
OHID Fingertips Teenage pregnancy and young parents reports
OHID Fingertips Public Health Outcomes Framework
OHID Fingertips user guidance
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