18th March 2025
In January, the iHV provided a written submission to The Education Committee’s major inquiry focused on finding solutions to the special educational needs and disabilities (SEND) crisis. Following its review, the Committee has accepted our submission which is now publicly available and published on the UK Parliament website.
Faced with years of increasing demand for SEND support, the cross-party Committee launched their call for evidence on 20 December 2024, focused on ways to stabilise the SEND system in the short term and achieve long term sustainability with improved outcomes for children and young people. The inquiry aims to examine every phase of education and development, from the early years through to the age of 25.
Our evidence submission focussed on providing an effective, collaborative approach to SEND provision which keeps the needs of babies, children and families at the centre – improving outcomes and reducing inequalities. Whilst recognising that this requires a whole system response, due to word count limits, our submission focused on the vital contribution that health visitors bring to solving the SEND crisis.
When adequately resourced, health visitors provide an important part of the solution in ensuring that families get good, joined up support. The benefits of an effective health visiting service accrue to numerous government departments, contributing to a whole system response to improve SEND provision. Based on key messages from research and evidence-based practice, we provided the following recommendations to:
- Prioritise the critical earliest years of life – solving the SEND crisis needs to start long before children start school. The earliest years of life, including the preconception period, pregnancy, infancy and early childhood represent a critical window to shape a child’s outcomes.
- Maximise the role of health visitors across multiple points in an integrated pathway of SEND provision, including:
– Primary prevention – to reduce risk factors to prevent disease or injury.
– Secondary prevention/early identification/needs assessment – reducing the impact of a condition and the likelihood of more severe issues developing over time
– Tertiary prevention – supporting families to manage long-term, often complex conditions to improve their quality of life.
– Reaching all babies and children with SEND, improving access and providing a safety-net – the very best SEND interventions will only be effective if our services reach those who need them.
– Engaging and supporting parents – including the importance of continuity of care.
– Enabling diagnosis – connecting to support. Support for babies and young children with SEND and their families should be in place as soon as the early signs are detected; and this includes the period when they are waiting for specialist support and diagnosis.
– Providing increased targeted support for high-risk groups. - Improve integrated SEND pathways which maximise the contributions of all agencies supporting children with SEND (including health visitors).
- Strengthen the Healthy Child Programme and the health visiting model for England. To improve SEND provision, we made the following recommendations:
– Increase health visitor workforce capacity (train, retain and reform – including recommendations for Specialist Health Visitors for SEND to support high-quality service delivery, training and education, supervision, quality assurance, service improvement and research).
– Ensure that all babies and young children receive the mandated universal Healthy Child Programme reviews.
– Strengthen the health visiting commissioning guidance.
– Increase the number of universal health visiting contacts to eight.
– Non-face-to-face contacts should not count as mandated universal health visitor reviews in service delivery metrics.
– Provide relationship-based care – parents want continuity of carer.
– Replace the Ages and Stages Questionnaires with a validated, UK-specific child development assessment tool and population measure – parents want assessment to be personalised and not a “tick box” exercise.
– Strengths-based, child and family centred services. A shift from “What can we do for your child?” to “What does your child need?”
– Family Hubs and health visitors should work together to coordinate care, involving other professionals as needed for tailored support.
– Quality Improvement.
We also provided some additional evidence on:
- Current and future SEND need and provision – with stark evidence on soaring numbers of children waiting more than two years for community paediatric services.
- Finance, funding and capacity of SEND provision.
- Accountability and inspection of SEND provision.
To cite this document, please use https://bit.ly/4c5tgz9
We would like to say a heartfelt thank you to our expert advisors for SEND, Nikki Freeman and Kirsty Jacques for supporting the iHV with our evidence submission, alongside our SEND Special Interest Group (SIG) members. We really value their time, commitment, expertise and knowledge.
If you are passionate about improving the lives of babies and children with SEND and want to strengthen this area of health visiting practice and support our work to influence policy – join our growing community of SEND SIG members – click here for more information.
