In March 2022, The National Institute for Health and Care Excellence (NICE) published a new comprehensive quality standard designed to improve the diagnosis and assessment of foetal alcohol spectrum disorder (FASD). The NICE guidance says midwives and other healthcare professionals (including health visitors) should give clear and consistent advice on avoiding alcohol throughout pregnancy, and explain the benefits of this, including preventing FASD and reducing the risks of low birth weight, preterm birth and the baby being small for gestational age.

The NICE quality standard highlights five key areas for improvement:

  • Pregnant women are given advice throughout pregnancy not to drink alcohol.
  • Pregnant women are asked about their alcohol use throughout their pregnancy, and this is recorded.
  • Children and young people with probable prenatal alcohol exposure and significant physical, developmental, or behavioural difficulties are referred for assessment.
  • Children and young people with confirmed prenatal alcohol exposure or all 3 facial features associated with prenatal alcohol exposure have a neurodevelopmental assessment if there are clinical concerns.
  • Children and young people with a diagnosis of FASD have a management plan to address their needs.

Updated GPPs

As a result, we have updated two Good Practice Points (GPPs) which now include links to the recently published NICE guidance:

Please note that GPPs are available to iHV members only.

If you’re not a member, please join us to get access to all of our resources.

The iHV is a self-funding charity – we can only be successful in our mission to strengthen health visiting practice if the health visiting profession and its supporters join us on our journey. We rely on our membership to develop new resources for our members.

So do join us now!

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iHV welcomes yesterday’s publication of PHE guidance on Care continuity between midwifery and health visiting services: principles for practice.

The PHE guidance document is designed to act as a tool to support local practice implementation and improvements in the care continuity between midwifery and health visiting services. It was developed based on a literature search of current research, an examination of current UK guidance and policy and interviewing midwives and health visitors working in Local Maternity Systems. The document provides evidence and practice examples to consider when improving quality of care through effective transition of information and collaborative practice between midwifery and health visiting services.

Alison Morton, Executive Director at the Institute of Health Visiting, commented:

“We support and welcome this new guidance from Public Health England on the care continuity between midwifery and health visiting.

“We know from our iHV annual surveys that continuity of care and building trusting relationships with parents is critical for delivering good support in the first 1001 days. Improving the quality of care for parents and their babies throughout their maternity journey, through the effective sharing of information and collaborative practice between midwifery and health visiting services, will help ensure that consistent and evidence-based information is given. Continuity of care, as well as continuity of carer (they are not the same thing), between midwifery and health visiting is crucial to ensure that health visitors provide safe and personalised care – tailored to each family’s individual needs.”

Clare Livingstone, Professional Policy Advisor at the Royal College of Midwives, said:

“This will be a valuable resource for midwives and health visitors in facilitating women to have the smoothest possible journey throughout and beyond their pregnancy. The point at which women’s care is transferred from midwives to health visitors, at around 10-14 days after the birth, is a critical point in that journey. This toolkit will support a better and more efficient handover of care, joining up the two services and ensuring care continuity for women and their babies.”

Following the Prime Minister’s announcement last night of more stringent guidance to “Stay at Home”, we know that many of you will be asking questions about how this impacts your families and the important services that you provide. This is also a worrying time for families who may be wanting to access helpful parenting information. The Institute is doing all we can to support the government-led decisions (nationally and locally) by disseminating any guidance as soon as it is published to avoid confusion and mixed messages at this time when clarity is needed.

We have a dedicated COVID-19 section of our website which we are using to provide updates as and when they are received.

Our colleagues at Public Health England and local government are moving at extraordinary pace and scale at this time – we thank and applaud them for all their efforts during the unfolding events of this pandemic.

Following the PM’s announcement last night, the latest advice has been received:

Outline details of priority work is set out in the NHS COVID-19 Prioritisation within Community Health Services published last Friday.  The NHS are currently developing a more detailed Standard Operating Procedure (SOP) that will be published soon – the NHS are custodians of the SOP as this avoids confusion, retaining a single line of communication.  It is high level covering all community services (under NHS standard contract). PHE expect that common approach will be applied across all services.

PHE are aware that families understandably do not want home visits so it makes sense to prepare advice ahead of the SOP being published.

Viv Bennett, the Chief Nurse at PHE, has given us the following holding advice: “I think that what is clear is that the presumption should be that contacts will be virtual – skype, facetime and failing that phone call.  There will need to be individual assessment of compelling need for face to face contacts and then decisions re PPE”.

The iHV will be supporting this work by developing guidance for health visitors to address questions like, “What makes an effective virtual visit especially for AN breastfeeding support and NBV”.

We share some of the latest Government guidance on our website – both for families and healthcare professionals:

This information is being regularly reviewed and updated.  We will be adding more content regarding supportive resources for parents and carers in the coming days and weeks make this a repository of best advice for families during these difficult times – so bookmark these pages for any further updates. We have waivered our usual restrictions on resources for members and the COVID-19 sections of our website are “free access” to all to support the national response to this pandemic.

We suggest that you also keep a look out on the government COVID-19 update web pages and contact your local commissioner and Director of Public Health who will be coordinating the response to the NHS guidance in your area.

We have received numerous enquiries from health visitors asking for greater clarity for the health visiting service during the COVID-19 pandemic.  The Institute is doing all we can to expedite this information for the profession and have a dedicated COVID-19 section of our website which we are using to provide updates as and when they are received. However, at the moment the content still lacks this much needed detail for health visitors’ roles.

We have contacted Public Health England, the Local Government Association and the Association of Directors of Public Health to highlight the need for advice to manage the numerous queries that we are receiving from health visitors, including service leads around emergency planning and escalation for the health visiting service – things like, “should we carry on with universal contacts?” “Will I be redeployed? And if so, when?” “What about families who have safeguarding concerns or high levels of vulnerability?” “Am I in a priority key-worker group?” etc…

The latest update that we have received from Public Health England is that the NHS is leading on drafting guidance on community services including health visiting. PHE and local government have provided advice and we are awaiting publication.  We will alert our members and followers when we receive advice that it has been published – hopefully very soon. As there is considerable pressure and pace within the healthcare system due to the pandemic, we suggest that you also keep a look out on the government COVID-19 update web pages and contact your local commissioner and Director of Public Health who will be coordinating the response to the NHS guidance in your area.

Our position at the iHV is that we need to support the government-led decisions (nationally and locally) rather than issuing our own guidance which may cause confusion and mixed messages at this time when clarity is needed.

We will continue to do all that we can to help.

A big thank you to everyone working in health visiting at this time. You are all doing an amazing job during the uncertainties of the COVID-19 situation – it is comforting to know that we have great teams of people who care so much about the communities they work in, and the health and wellbeing of families.

Many parents are very concerned about how to feed their babies during the COVID-19 outbreak.  Here, we share the latest statement on best practice from Unicef UK Baby Friendly Initiative – who also suggest that all practitioners follow latest updates from the UK governments and the World Health Organization (WHO) as these could change as more information becomes available.

The Unicef statement (on the link below) includes:

  • Public Health England (PHE) guidance – If you are breastfeeding while infected
  • Accessing infant formula – information from First Steps Nutrition Trust


In addition, the Royal College of Obstetricians and Gynaecologists (RCOG) has updated their guidance on Coronavirus (COVID-19) infection and pregnancy (published today 18 March) to reflect the announcement on Monday evening (16 March) that pregnant women have been placed in a ‘vulnerable group’. Check the summary of updates on pages 3-5 to see all the changes.

As a result RCOG Information for pregnant women is updated:

The Royal College of Nursing (RCN), alongside over 20 health organisations including the Institute of Health Visiting, has published new safeguarding guidance for healthcare staff responsible for the care and protection of children and young people.

Safeguarding guide

Called ‘Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff’, the document provides clear guidance to healthcare professionals on how to protect children and young people in their care and what to do in the event they come to harm.

All staff who come into contact with children and young people have a responsibility to safeguard and promote their welfare and should know what to do if they have concerns about safeguarding and child protection issues.

The latest document has been updated to include changes to legislation and statutory guidance in England and now includes education and learning logs to enable individuals to record their learning and form a ‘passport’ for those who move on to new jobs or other organisations.

A resource focusing on reproductive choice and ensuring that pregnancy, if desired, occurs at the right time and when health is optimised.

This resource for professionals working with women and men that may have children in the future focuses on reproductive choice and ensuring that pregnancy, if desired, occurs at the right time and when health is optimised. Effective contraception and planning for pregnancy mean that women and men stay healthy throughout life and take steps to improve the health of the baby.

Significant changes to local multi-agency arrangements have recently been established through the Children and Social Work 2017. The Act creates new duties for police, health and the local authority to make arrangements locally to safeguard and promote the welfare of children in their area. Following the passage of the Act in April 2017, the Government has worked to revise the statutory guidance Working Together to Safeguard Children, and draft the regulations required to commence the legislation. The public consultation on these draft documents ran from 25 October 2017 to 31 December 2017.

During this period, the Government also held a series of nine regional consultation events across England. The consultation sought sector input on the proposed changes to Working Together to
Safeguard Children, as well as the draft regulations. It attracted 703 responses from a wide variety of interested stakeholders, including representatives from local authorities, health sector bodies, police, youth justice, voluntary and community organisations, social care professionals, safeguarding boards and educational establishments. Nearly 450 delegates attended the regional events and shared their views in person.

This document summarises the results of the consultation, and sets out the Government’s response.