Tags: report

iHV welcomes Petitions Committee Report – Impact of COVID-19 on new parents: one year on

The iHV welcomes today’s Petitions Committee Report which calls on the Government to publish a dedicated COVID-19 recovery strategy for new parents. 12 months on from the Petitions Committee Report last year, it is clear that the pandemic continues to impact on new and expectant parents.

The Petitions Committee Report – Impact of COVID-19 on new parents: one year on calls for:

  • extra funding and resources to allow catch-up mental health support for new parents and to boost perinatal mental health services
  • funding for local authorities to arrange in-person visits to new parents by councils, voluntary organisations or health visiting staff by the end of the year
  • a review of monitoring and enforcement activity relating to employers’ health and safety obligations to pregnant women
  • legislation on the planned extension of redundancy protections for new and expectant mothers
  • a review into the funding, affordability and provision of childcare, and the sustainability of the childcare sector

Alison Morton, iHV Executive Director, said:

“We thank the Petitions Committee for their ongoing work championing the needs of new and expectant parents which have been largely overlooked during the pandemic. This hard-hitting report adds to the growing weight of evidence that has helped raise this important issue. It recognises the vital role that parents play in raising the next generation and the devastating and far-reaching impact that the pandemic has had on babies, young children and their families.

“We share the Committee’s disappointment that despite the government’s pledges to ‘build back better’, this has not translated into any tangible action or investment to make the changes that are needed to strengthen the support that families receive during these important earliest years of life.

“We support the calls for investment into the health visiting workforce which adds weight to the groundswell of support that the profession has received from a multitude of partners in the current #TurnOffTheTaps campaign. We join with them in calling on the Government to invest in giving children the best start in life.

“It is difficult to understand what more evidence policy makers need to take this matter seriously. We are currently wasting billions of pounds of taxpayers’ money every year on ‘getting it wrong’ with spiralling costs of late intervention. Babies, young children and families need action now – this cannot wait any longer.”

Read Petitions Committtee news story

New MMHA report evidences key role of HVs in addressing the increase in mental health needs of families

The iHV is delighted to have supported the launch of the new report on maternal mental health and the services that supported women and their families during the COVID-19 pandemic. We would like to put on record our thanks to the Alliance for undertaking this work and creating a public opportunity today for us to come together, to think together about the findings and their important implications for families now – need is great and families can’t wait.

 


Today’s report brings together, for the first time, all of the available data collected during the pandemic looking at the mental health challenges that women during and after pregnancy have faced. The evidence shows a significant increase in maternal mental health problems across the UK over the last 12 months

Speaking at the launch event today, iHV Mental Health Lead, Melita Walker highlighted the important role that health visitors play in identifying and supporting families experiencing mental health challenges, saying:

“Health visitors are qualified nurses or midwives who go on to study at a specialist level in public health to become health visitors. Every family has a health visitor, and they are there to support all members of the family to enjoy good health. Health is affected by a multitude of things so health visitors may be working with families to support a very broad range of need, and those needs, left unsupported as this report shows, can actually tip families into experiencing mental health problems. Health visitors have a vital role in promoting good mental health, preventing mental health problems, identifying them early, offering evidence-based interventions and care coordination when more specialist services are needed. Family mental health and wellbeing is “the bread and butter” of health visiting.

The perinatal period is a vulnerable time for the acute onset and recurrence of mental disorders. When these vulnerabilities are combined with the impact of a pandemic, mental health problems and health inequalities are affected further. We have seen parents struggling with isolation, and sadly, we are seeing an increase in, domestic abuse, child poverty, substance misuse and child maltreatment. Rates of mental health problems are increased and inequalities are widening.  The impact of lockdown has been unevenly distributed and families with lower incomes, from Black, Asian and minority ethnic communities and young parents are experiencing the most detrimental consequences due to compounding factors like overcrowded housing with lack of outdoor space, the effects of poverty, which all have an impact on parental stress, anxiety and predisposition to mental illness. The family centred holistic role of the health visitor cuts across and can make a difference in all of these areas- thus positively and proactively supporting good family mental health alongside a range of other health outcomes.

That said, health visitors can only make a difference if we have sufficient numbers of them and this report highlights that health visitors in England went into the pandemic in a hugely depleted state due to years of cuts to the health visiting service. The first two years of a child’s life are important, and the right support and guidance for families at this time can make a big difference to their long-term outcomes. HVs can be a lifeline for families and the iHV ‘s position from very early on in this pandemic was that there was “more than one frontline” and sustaining support for families’ needed to be a priority and that health visitors should not be redeployed.

It is important to note that many local authorities in England did not redeploy their health visitors, but 65% redeployed at least one health visitor and redeployment ranged from no health visitors being redeployed in some areas, to 63%, of the HV team being redeployed. Over 11% of local authorities lost over a quarter of their HVs. So, we can see, with redeployment rates differing substantially, young children and families’ access to health visiting services was determined by their postcode.

The iHV campaigned vigorously from the outset about redeployment and we were very relieved when England’s chief nursing officer Ruth May , Public Health England & the Local Government Authority sent a letter to all the CNOs stating that HVs provide ‘frontline’ work and should not be redeployed.

The learning we have now, and the swell of collective voices, hopefully means that we can be confident going forward in this and any future pandemic, that health visitors will remain on their own frontline. We are also very optimistic that the Leadsom review will contain some significant measures to strengthen the HV offer for families.

There has been a lot of learning from and throughout this pandemic and we must pay tribute to all the health visitors who continue to work really hard in some very challenging circumstances to find ways to stay alongside families to make sure they receive the care and support they need for their mental health. We have heard of some fantastic examples of health visitors turning to new ways of working and to get all of this up and running in the speed that they have is commendable.

Health visitors are telling us that virtual and digital help has allowed them to reach parents in the absence of being able to visit, and there may well be some of the virtual offers kept after restrictions have eased. They are also telling us very firmly, as is the emerging evidence included in this report, that virtual should not replace face to face contacts.

The research is showing us that there are significant increased MH problems in parents who have experienced becoming a parent during the pandemic. If we are to meet this need then all services need to work together as a system, and all parts of that system need to be strong.

We know a robust home visiting – health visiting service works- we need to build back our health visitor numbers because as this report shows, health visitors are a critical part of the solution for achieving good family mental health and wellbeing”.

Click here to access the new report: Maternal mental health during a pandemic

Preliminary insights of the Early Years Healthy Development Review

Preliminary insights of the Early Years Healthy Development Review were outlined by Rt Hon Andrea Leadsom MP at the APPG on Conception to age two meeting, held on Tuesday 19 January 2021

At the online APPG, the First 1001 Days Movement ‘s Working for Babies: Lockdown lessons from local systems report was formally launched – read our news story on this.

Speaking at the online event, Andrea Leadsom said that the report findings ‘chime totally’ with what the Early Years Healthy Development Review has found.

The F1001D report presented hard-hitting findings about the direct and indirect harm to babies, young children and their families caused by the pandemic during the Spring 2020 lockdown. These “hidden harms” were broad and significant, and experienced unevenly depending on family circumstances and background. The report also highlighted how there are often ‘baby blind-spots’ where babies’ needs are overlooked in policy, planning and funding.

Andrea Leadsom’s Early Years Healthy Development Review, due to be published at the end of February, will look at issues around joining up services; improving the use of digital services to reach parents; data sharing and local leadership.

She told the APPG attendees that evidence is emerging that services for babies have been ‘particularly better’ since the latter part of last year, when second and third lockdowns took place, largely because staff were not moved away as much as they had been in the first lockdown.

The Early Years Healthy Development Review will give six recommendations which, by the time it is launched in February, Andrea Leadsom hopes will gain the approval of all the political parties so that this early years review will be ‘the one that sticks and endures’ for many years to come.

She talked about the possibilities of harnessing the benefits of digital technology to provide consistent and joined-up support to new parents. The use of data-sharing will enable professionals to provide ‘much more focused support on what families need’ and less time will be spent for parents retelling their story to different professionals.

Andrea Leadsom thanked early years professionals for their amazing work during the lockdowns ‘who have done so much to support new families in such difficult period’ and to reassure them that ‘these lessons would be learnt’ and reflected in the Early Years Healthy Development Review.

Watch and listen to APPG proceedings on 19 January 2021 including the launch of the F1001D report and presentation by Rt Hon Andrea Leadsom MP (starting at 29:51)

 

iHV welcomes new F1001D report – Working for Babies: Lockdown lessons from local systems

iHV welcomes a new report published today by the First 1001 Days Movement (F10001D) which provides insight into the impacts of COVID-19 and the Spring 2020 lockdown on babies.

The report, Working for Babies: Lockdown lessons from local systems, presents hard-hitting findings about the direct and indirect harm to babies, young children and their families caused by the pandemic. These “hidden harms” were broad and significant, and experienced unevenly depending on family circumstances and background.  Historically inadequate or insecure funding, and a rising tide of need, has inhibited the ability of some services and local systems to respond to the needs of babies and their families during the pandemic. There were often ‘baby blind-spots’ where babies’ needs were overlooked in policy, planning and funding.

However, the report also provides some “good news stories” of organisations and systems which reacted and adapted positively to the pandemic. The report introduces the concept of “baby-positive” local responses and provides the beginnings of a formula for what good local systems should look like. In particular, it sets out the positive difference that was made by professionals who were connected to each other, and to their communities, and were empowered to meet families’ needs.

Most importantly, the report seeks to ensure that lessons are learned for the future of service provision for this age group. It provides further evidence of the importance of many things that the iHV campaigns for, such as clear leadership, a focus on babies’ needs, and a joined-up response.

Alison Morton, Acting Executive Director of the iHV said:

“This report adds further weight to the growing body of evidence on the direct and indirect impact of the COVID-19 pandemic on families with babies and young children. The message is clear, despite the indisputable evidence that the first 1001 days are the most crucial period of human development, babies and young children have largely been forgotten in the national pandemic response. Now we know better, we must do better.

“We hope the report brings a much-needed tipping point for change. It provides a powerful impetus to the Government to focus their efforts on the things that matter most by investing in our youngest citizens, to put things right and achieve their ambition to ‘build back better’.”

Working for Babies: Lockdown lessons from local systems

Download F1001D report - Working for Babies: Lockdown lessons from local systems

The report will be officially launched today at the APPG on Conception to Age Two meeting. For those not able to secure a space on at the APPG meeting itself, F1001D will be live streaming it at 3pm this afternoon via the Parent Infant Foundation YouTube channel. It will also be available to watch back later.

Please get involved by talking about the report on your social media channels! Get involved with the conversation and the report by using the hashtags #WorkingForBabies  #BabyBlindSpots on social media.

 

 

iHV welcomes NCB Report “Whatever it takes”

iHV very much welcomes the NCB’s clear analysis and recommendations published in its report “Whatever it takes”: Government spending on children and young people – the impact of the coronavirus pandemic and the 2020 Spending Review.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“This NCB Report is a superb and clear analysis of the crises for children at the moment and, amongst other recommendations, it recommends investing in the early years and health visiting.”

“We hope that many interested parliamentarians and others will take the opportunity to attend the APPG for Children taking place this afternoon to discuss its contents.”

Parliamentarians will be debating the implications of this analysis at 4:30-6pm on Monday 14 December at a meeting of the All-Party Parliamentary Group for Children. Children, young people and parents who participated in the #GiveUsAChancellor campaign will also be presenting on the areas where they want to see future government spending.

Read NCB Report - “Whatever it takes”: Government spending on children and young people - the impact of the coronavirus pandemic and the 2020 Spending Review

 

Disappointment at Government Response to Petitions Committee report

The Government has given their response to the Petitions Committee’s landmark report on the impact of COVID-19 on maternity and parental leave.

The report was the result of an extensive inquiry following an e-petition calling for the Government to extend maternity leave by 3 months with pay in light of COVID-19 which received over 226,000 signatures, and to which Dr Cheryll Adams contributed some evidence via Zoom in May earlier this year (see iHV at Petition Select Committee).

See also iHV responds to Petitions Committee report: impact of COVID-19 on maternity and parental leave

Dr Cheryll Adams commented on today’s news on the Government Response:

“The Government Response to the report by the Petitions Committee’s recommendations on the impact of COVID-19 on parental leave is a disappointing response by government to such powerful lobbying by parents. So many new families have struggled during the past 6 months and more acknowledgement of that, in the form of positive responses to at least some of the recommendations, would have meant that they felt more valued in their essential role of bringing up the next generation.”

Read Petition Committee express disappointment at Government response to its report on impact of Covid-19 on maternity and parental leave

Read The impact of COVID-19 on maternity and parental leave: Government Response to the Committee’s First Report

 

iHV welcomes Babies in Lockdown report

Charity collective, Best Beginnings, Home-Start UK and the Parent-Infant Foundation, publish a new report sharing families’ experiences of lockdown during pregnancy or with a baby.

Babies in Lockdown: listening to parents to build back better (2020), based on a survey of over 5000 families, highlights the chronic under resourcing of services for families, the inequalities in babies’ early experiences and its worsening forecast due to the COVID-19 pandemic. The report warns that many families with lower incomes, young parents and those from Black, Asian and minority ethnic communities, will have been hit hardest by the pandemic. The Babies in Lockdown Report shines a light on UK baby inequalities as charities call on Government to act now to avoid a “Post-COVID19 lottery”.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“The iHV welcomes this excellent report which lays bare just how challenging it has been for many parents during lockdown. It was distressing to read their stories and, in particular, how the most disadvantaged have felt the hardest impact of lockdown and lack of support. It is important that we listen to the voice of these parents and ensure that we are better prepared to meet the needs of young children and their families as the pandemic continues. We support the report title, we now need to build back better for infants and their families and this will include ensuring that all families receive support from the health visiting service during this crucial stage of their parenting journey”.

The report tells us that:

  • COVID-19 has affected parents, babies and the services that support them in diverse ways.
  • Families already at risk of poor outcomes have suffered the most.
  • Without action, the pandemic could cast a long shadow on the lives of some babies.

The Babies in Lockdown: listening to parents to build back better (2020) report makes three policy calls for the UK Government:

  • A one-off Baby Boost to enable local services to support families who have had a baby during or close to lockdown.
  • A new Parent-Infant Premium providing new funding for local commissioners, targeted at improving outcomes for the most vulnerable children.
  • Significant and sustained investment in core funding to support families from conception to age two and beyond, including in statutory services, charities and community groups.
Read Babies in Lockdown: listening to parents to build back better (2020) full report

Read Babies in Lockdown Executive Summary

Go to Babies in Lockdown website for more info

iHV comments on UCL survey on impacts of COVID-19 on Health Visiting in England

According to a new survey from University College London (UCL), health visitors are concerned that the needs of children have been missed due to staff redeployment to support the COVID-19 workforce and increased caseloads.

Download The impacts of COVID-19 on Health Visiting in England - first results

The UCL survey of 663 health visitors in England, conducted between 19 June and 21 July 2020, found that 41% of respondents in teams that lost staff had between 6 and 50 team members redeployed between 19 March to 3 June 2020.

In approximately 10% of teams, which experienced a loss, this was a redeployment of at least half of their staff. Few teams (9% among those with staff redeployed) gained additional staff to fill the gaps. This meant that 253 respondents (38%) had their caseload increase, some with an increase of 50% or more, and 73% of those that experienced a change reported that their caseload had not returned to its usual size.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“The interim results of this research into the impact of redeployment of health visitors by University College London confirms all the anecdotal evidence already sent to the iHV by health visitors. Health visitors should never have been redeployed, instead their time should have been spent on reaching the most vulnerable families during lockdown and checking in on all other families. I don’t believe we yet fully know the impact of that period on children and families, but this research confirms that it was very significant for many families. Furthermore, there were significant impacts on the health visitors themselves, as those remaining strived to provide redesigned services and to reach the most vulnerable families, and those redeployed worried about the families they had left behind without opportunity for necessary handovers. I find the feedback on how the health of health visitors was impacted particularly distressing, this should not have been allowed to happen.

“Developmental reviews have now been delayed for more than four months and that too will mean that developmental delays are being missed and this could impact children for the rest of their lives. The already very diminished health visiting service in some areas of the country will be struggling to catch up whilst also juggling the challenge of maintaining their personal safety, and that of families. If we do face a second wave of COVID-19, health visitors must not be redeployed again. Instead, an urgent workforce plan is needed to rebuild numbers in the profession which are at their lowest for very many years and, alongside that, tackle the huge inequities in service delivery across England which have opened up over the past five years. It is not right that whilst children in some areas of the country continue to receive a reasonable service, children in many other areas now only receive a skeleton service, made even worse now by the challenges of service delivery during the COVID-19 pandemic.

“The first years of life lay down the foundations for our future health and wellbeing – get it right then and children will thrive and achieve at school and in the workplace; get it wrong, as we are now in England, and governments for many years to come will be paying for the consequences. The critical value of health visiting services is understood and invested in by the Scottish, Welsh and Northern Ireland governments. However, in England, it is not OK that an unwarranted variation of service quality has been allowed to open up as health visiting numbers continue to be allowed to plummet. I hope that the interim findings of this research will lead to prompt action. They have been published early as the researchers were so concerned by what they found.”

Dr Gabriella Conti, Associate Professor (UCL Economics and Institute of Fiscal Studies) who led the survey, said:

“Whilst all families are impacted by COVID-19, the most detrimental effects are felt by those who are already disadvantaged – in particular, our most vulnerable infants and children whose needs are often hidden from sight.

“Increased caseloads for a significant proportion of health visitors, along with reports of a lack of PPE for home visits, has created a lot of additional stress and anxiety, during a time of great uncertainty and difficulty.”

The researchers make a number of policy recommendations, including for:

  • Health visiting services to be reinstated (where not already happening) to provide vital support and a safety-net for children, with appropriate measures put in place, including the use of PPE, to reduce the spread of the virus.
  • An evaluation of the use of virtual, non face-to-face service delivery methods to determine their effectiveness for identification of vulnerabilities and risks, impact on child and family outcomes and reducing inequalities to inform future digital change.
  • A clear workforce plan to ensure that the health visiting service has sufficient capacity to manage the backlog of missed appointments, as well as demand for support due to the secondary impacts of the pandemic.
  • A proactive plan to ensure staff wellbeing during the restoration of services.

Research assistant Abigail Dow (UCL Economics) said:

“A cross-government strategy is needed to reduce inequalities and “level-up” our society. This will require investment to strengthen the health visiting service which plays a crucial role in the early identification and support of the most disadvantaged families.”

The survey, supported by the Institute of Health Visiting, was carried out using the online survey platform Qualtrics. Participants (98% female, 88% White British or Irish, and average age 50) were obtained with consent from the Institute of Health Visiting database. Data collection is still ongoing and a full report will be released later this year.

iHV welcomes Children’s Commissioner’s new report “Best Beginnings”

The Children’s Commissioner for England has published a report looking at the provision of early years services for children across the country, alongside a warning that many nurseries are at risk of closure, hitting the life chances of some of the most vulnerable children and holding back the economic recovery following lockdown.

The report, ‘Best Beginnings’, is an in-depth examination of early years provision in England. It describes a system that is disjointed and often failing to target those disadvantaged children with development problems who most need early help.

It comes amid a recent warning from childcare providers that one in four nurseries and pre-schools fear closure within the year, rising to one in three in the most disadvantaged areas, as a result of the coronavirus lockdown.

Dr Cheryll Adams CBE, Executive Director iHV, commented: 

“Best beginnings is a powerful and very well researched report from Anne Longfield, the Children’s Commissioner and her team. It recommends a strengthened holistic, cross-government approach to ensuring that every infant is supported to meet its full potential, whether through strengthened community services, including health visiting, or a strengthened childcare/nursery offer.

“I particularly liked the starting point: There are certain things that every baby needs as the foundations for a healthy, happy life:

  1. Loving, nurturing relationships with parents and carers
  2. A safe home free from stress and adversity
  3. The right help to develop good language and other cognitive skills
  4. Support to manage behaviour and regulate their emotions
  5. Good physical and mental health and access to healthcare”

“Helping parents achieve this for their infants is the essence of health visiting.”

The report shows the need for an overhaul of the early years system in England. It details how too many children, particularly those growing up in disadvantaged families, are already behind by the time they start formal education. Last year, 29% of five- year-olds in England were not at the expected level of development by the time they started school, including 45% of children receiving Free School Meals. In Middlesbrough, 38% of children are not achieving the expected level of development aged 5, while in Dudley and Sandwell it is 35% of children.

The report sets out how starting school behind can undermine children’s life chances. The Commissioner’s office analysed data on all children in England who had not met the expected level on half of their early learning goals at age 5 and tracked them through to the end of primary school. These children were:

  • five times as likely to end up being excluded by age 10
  • twice as likely to have had contact with children’s social care by age 11
  • three times more likely to be struggling with reading at age 11
  • four times more likely to be struggling with writing at age 11.

Recent research also shows these children are more likely to leave school with no GCSEs, more likely to suffer some form of mental ill health and more likely to be obese.

The Children’s Commissioner is calling for a new ‘Best Beginnings’ early years investment plan, ranging from Children and Family hubs to midwives and health visitors, to tackle these problems at the beginning of a child’s life rather than waiting until crises develop in later years. While some foundations of an excellent early years service are already in place, the Children’s Commissioner is urging the Government to bring together and turbocharge these services into one system which provides first class provision that works for families and ensures that all children, including the most disadvantaged, get the best possible start in life.

The Children’s Commissioner makes a number of recommendations including:

  • An emergency recovery package for the childcare providers whose finances have been worst affected by Covid-19. Government should also reconsider the design of Universal Credit which makes it hard for lower earning families to get help with childcare, as parents have to pay costs upfront and then wait to be repaid.
  • An expanded offer of 30 hours free childcare and early education for all children aged two, three and four, and 15 free hours for all one-year-olds, so that early years education is seen as part of ordinary life, in the same way that school is.
  • A cross-government ‘Best Beginnings’ strategy led by a Cabinet Minister for the Early Years. This would set out how a revitalised and extended Healthy Child Programme, the Early Years Foundation Stage, Children and Family Hubs, antenatal services and the Troubled Families Programme would work together.
  • A Family Guarantee of support for under-fives and their families delivered by health visitors, early help and Troubled Families workers, family nurses or family support workers based in Family Hubs.
  • A national infrastructure of Children and Family Hubs. These would be a centre point of support for children and families and act as a gateway to multiple services. Each hub would be a base for universal services so that every child is reached.
  • A Government review of early education and childcare funding to ensure it is working as effectively as possible to help children and families who need it most.
  • A single system for supporting families with early years education and childcare, with fees charged in relation to families’ incomes as they are in Sweden and Norway.
  • A national workforce strategy for the early years, focusing on staffing across existing health, local government and early years settings.
  • Better sharing of data between different services, so children who need help do not fall through the gaps or go unidentified. This should include more effective use of a child’s NHS number and Unique Pupil Number so it is possible to match children in different databases.
Download - Best Beginnings: A proposal for a new early years guarantee to give all children in England the best start in life

Download - Best Beginnings:
Technical report - Predicting children’s outcomes at the end of primary school based on their early years foundation stage profile results

iHV welcomes new report by the Child Safeguarding Practice Review Panel

A new report by the Child Safeguarding Practice Review Panel calls for the Government to develop new tools to help prevent the sudden unexpected death of infants (SUDI).

The independent panel of experts reviews serious child safeguarding incidents, when children have died or suffered serious harm, to learn how to improve the safeguarding system.

While the overall numbers of babies dying from SUDI are decreasing, a worrying number of deaths have been notified to the panel as serious child safeguarding incidents. Between June 2018 and August 2019, the deaths of 40 babies from SUDI were reported to the panel. Most of whom died after co-sleeping in bed or on a chair or sofa, often with parents who had consumed drugs or alcohol.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“The loss of every baby is a tragedy for their parents and the services supporting them, so it is reassuring to see the number of babies dying from SUDI continues to fall.  This suggests that the safe sleeping messages are generally getting through.  However, as this report makes clear, more of these deaths might still be prevented if all parents had the right support when they were struggling with multiple issues – information alone is not enough. Again, this makes the case for health visiting services to be strengthened so that the support needs of all parents are recognised early and that they are given timely and appropriate help.”

The review reveals families with babies at risk of dying in this way are often struggling with several issues, such as domestic violence, poor mental health or unsuitable housing. It found that these deaths often occur when families experience disruption to their normal routines and so are unable to engage effectively with safer sleeping advice. Due to coronavirus (COVID-19) and the associated anxieties about money, social isolation and mental health issues, disruptions that led to the deaths of these infants may be more prominent at present.

To address this, the panel is calling for local areas to reduce the risk of SUDI by incorporating it into wider strategies for responding to social and economic deprivation, domestic violence and parental mental health concerns. This should be backed up by new government tools and processes to support frontline practitioners and local safeguarding partners to make these changes.

Download Out of routine: A review of sudden unexpected death in infancy (SUDI) in families where the children are considered at risk of significant harm (July 2020)