28th June 2023
Yesterday, the Office for Health Improvement and Disparities published their interactive Schedule of Interventions Guide for the Healthy Child Programme (HCP). This sits alongside the other two policy components for the HCP that were refreshed in previous publications.
The three policy components for the HCP now comprise:
We understand that the Schedule of interventions for the Healthy Child Programme in England is an iterative resource – and the Office for Health Improvement and Disparities (OHID) are keen to have your feedback on any areas that are missing or need to be strengthened.
Our first impressions are that it provides a very impressive digital and interactive platform that acts as a helpful repository of high-level information on a range of interventions, across a breadth of needs for babies, children, young people and families (across different life course stages – and also different levels of intervention for universal, targeted, specialist and community). The ambition is to improve the identification of health needs and the quality of support provided to all babies, children, young people and families – in particular, those who are the most vulnerable and at risk of poor health outcomes. This is an ambition that we wholeheartedly support at the iHV. The Schedule contains a wealth of useful information and will undoubtedly be a helpful ‘one stop shop’ for practitioners, providers and commissioners.
Compared to the 2009 Healthy Child Programme, some additional topic areas have been included to reflect the growing evidence base for investment in the earliest years of life– these are all welcomed. For example, preconception care, speech and language development and the importance of infant’s social and emotional development (infant mental health).
It is clear that this is a document driven by the current government’s policy priorities. For example, children’s speech language and communication are featured strongly in every section – including the antenatal contact which is always the best place to start! In contrast, other priorities like transition to parenthood, and maternal physical and reproductive health needs have not been included in the details on the health visitor antenatal, new birth and postnatal contacts in the schedule when they should form an essential part of the Healthy Child Programme. Similarly, the health visitor’s role in managing minor illnesses and physical health problems in childhood, are other vital components of the health visitor’s role that could be utilised more fully as we look to improve seamless support for families and reduce inequalities across Integrated Care Systems.
The resources are presented as a series of ‘tiles’ of interventions which may risk fragmenting people and services into single issues. To avoid this, it will be important to view this Schedule as a ‘collective whole’ that represents a vital infrastructure of support that needs to be centred on families and delivered in partnership with them. Health visiting is much more than an intervention. It was recognised by UNICEF-UK as a ‘vital infrastructure of support… the backbone of the early years and a safety-net for all families’.
Alongside this repository of ‘what’ interventions are needed in the Schedule, we urge policymakers to also include the wealth of evidence on ‘how’ outcomes are created, including the common elements of effective programmes and the wealth of evidence on what makes health visiting successful (namely, trusted relationships, continuity and coordination of care, services that are accessible/ visible in communities and responsive to changing needs within families, and workforce skills to elicit need, broker engagement and support change which is often difficult).
To embed this Schedule in practice, we now need a national strategy and vision for child health, with ambitious goals that all local areas can get behind to ensure that the health and wellbeing of our nation’s children is on a par with the best in the world. This will require implementation and workforce plans, with sufficient resource and clear lines of accountability, to ensure all babies, children and families receive the high-quality support that is laid out in this important schedule, regardless of where they live – our children’s health is too important to be left to chance.