New joining link for Working Together 2023 Summit

  • Date: 26 April 2024
  • Time: 11am – 1pm

NHS Safeguarding apologises for the technical problems that a number of people experienced joining this week’s Working Together Summit via their events platform.

To resolve these issues and ensure that you are able to hear our CEO Alison Morton’s presentation on the provider perspectives on Working Together changes 2023 (alongside the other panel of speakers from SAPHNA and NHS SEND team), NHS Safeguarding will be reverting to the tried and tested MS Teams platform for the next Summit which is being held on Friday 26 April (11am-1pm). This means that the previously shared link will no longer work.

This new way of interacting will improve your learning experience and mean greater engagement during the discussion session.

Please delete the previous links that you have received for this event and use this link instead:

Join the meeting

(Please note there is no booking for this event – just join the meeting link on the day)

Kenny Gibson at NHS Safeguarding says:

Dear safeguarding colleagues, many thanks for your on-going support with the implementation of Children’s Social Care reforms and Working Together 2023.

Please note that due to technical challenges, NHS Safeguarding has decided to change our Teams technology for Friday 26 April – this will improve your learning experience and mean greater engagement during the discussion session.

In the session you will be hearing from:

Alison Morton, CEO, The Institute of Health Visiting (iHV)

Sharon White, CEO, School and Public Health Nurses Association (SAPHNA)

Lorraine Mulroney, NHS England, SEND nursing team.

The event will include time for discussion and Q&A with the speakers and NHS Safeguarding Team.

In case you missed it – last week, the Child Safeguarding Practice Review (CSPR) Panel released its fourth annual report which is described as a barometer of the health of the national safeguarding system, highlighting both strengths and areas for improvement in multi-agency practice. The report provides important insights into patterns in English safeguarding practice, examining learning from incidents where children have died or suffered serious harm due to abuse or neglect.

In the Foreword to the report, Annie Hudson, the Chair of the Child Safeguarding Practice Review Panel, reminds us that, “The children at the heart of this report endured shocking, almost indescribable, violence and maltreatment. We must never become inured or habituated to this. What happened to these children cannot be undone, but what we must do is assess how well agencies responded to their needs.”

The findings presented in the 2022/23 annual report are based on:

  • serious incident notifications (SINs) during the 15-month period of January 2022 to March 2023 with a focus on the 12-month period of April 2022 to March 2023
  • rapid reviews with incidents that occurred during the 12-month period from April 2022 to March 2023
  • a sample of Local child safeguarding practice reviews (LCSPRs) produced during the 15-month period of January 2022 to March 2023
  • letters to safeguarding partnerships from the Panel used to assess the quality of rapid reviews during the 12-month period of April 2022 to March 2023.

The review also draws on evidence in the 2 national reviews and 2 thematic reviews the CSPR published in 2022 and 2023.

The Panel received 393 serious incident notifications during this period, with 37% (146) related to child deaths and 58% (227) involving incidents of serious harm to children.

Review highlights vulnerability of babies

  • Babies under the age of 12 months old comprised the single largest age group within the sample of rapid reviews (36%, n=142).
  • Over a fifth (26%, n=25) of serious incidents involving children under one year old occurred in the 10% most deprived areas compared to 15% (n=7) of children aged 1 to 5 years old.

Parental and family stressors were the most significant factor in escalating risk when it comes to safeguarding children under 12 months old. Previous reports like the Myth of Invisible Men and Bruising in Non-Mobile Infants emphasised challenges in responding to this vulnerable group. The review builds on the key learning from the inquiry into the murders of Star Hobson and Arthur Labinjo-Hughes in highlighting the importance of professionals having the time to understand the context in which babies and young children are living:

“Knowing what life is like for children, highlighting the centrality of children’s voices and experience, and those of their parents, carers, and wider family members, but also the knowledge, skill and confidence required to build a full picture of children’s lives to enable the best safeguarding, support and protection.”

Understanding the roles and risks of all adults around very young children is crucial, given their dependence on caregivers and the potential for rapid escalation. The analysis also highlighted ongoing problems in effectively assessing and managing risks involving babies, with connections to domestic abuse, where pregnancy is a recognised risk factor in such relationships, posing challenges for professionals.

Parents’ and carers’ needs

Among the 393 cases reported to the Panel, 13% (n=51) involved parents under 25 years old, and 3% (n=13) had a history of being in the care system, although identification was sometimes challenging. This indicates a potential need for additional support from services like GPs and health visitors for these parents.

Conditions in practice

One of the main messages from the review is the importance of providing practitioners with the best opportunity to identify, assist and protect children. Specifically for health visiting, the following factors were found to hinder optimal practice and safeguarding decision making:

  • Major challenges in workforce recruitment and retention, most obviously in children’s social care and health visiting, which impact on the quality of practice. The review raises concerns about the year-on-year decline in the number of health visitors.
  • Increases in population numbers and levels of vulnerability – this includes evidence from the iHV Annual State of Health Visiting survey. Alongside the decline in workforce numbers, these place significant pressures on health visiting services in meeting the scale of need.
  • Limited GP input and incomplete health records in multi-agency meetings posed a common problem in recognising vulnerabilities affecting families. Inadequate information sharing between agencies, like neonatal units, midwives, health visitors, and GPs, especially in families with young children, significantly impacts the protection of children at risk of harm.
  • There was also evidence that questions about domestic abuse were not being asked during checks with mothers if fathers were present (this learning point applies regardless of sex and gender of both parents or main carers). While including fathers in checks and appointments is essential to avoid them becoming invisible to services, this finding emphasises the need to ensure that mothers can speak to health visitors alone in case the presence of the other parent inhibits disclosure.
  • The report emphasises the importance of working upstream to prevent situations reaching crisis point.

The report concludes with a series of reflective questions for safeguarding leaders to support them in promoting the very high standards of safeguarding practice and makings sure that learning reviews drive longer term change to help children and families. These questions are organised around 6 key strategic themes:

  • Culture: creating an inclusive culture where professional challenge is promoted.
  • Clear partnership intent: ensuring clear and balanced partnership working.
  • Strategy to delivery: ensuring strategy is carried through to frontline practice.
  • Assessing effectiveness: evaluating impact of the safeguarding system.
  • Getting upstream: ensuring learning feeds into prevention, early intervention and the commissioning of services.
  • Workforce: working together effectively across agencies and promoting development.

On Friday 15 December, the Department for Education (DfE) published its updated version of “Working Together to Safeguard Children 2023”. The Department consulted with key stakeholders on proposed changes through an open consultation process between June and September this year.

To support the consultation, the Institute of Health Visiting engaged in meetings with DfE officials and submitted a written submission to the consultation in September 2023. Our considered position was developed in partnership with frontline practitioners, service leads, safeguarding representatives and our iHV Expert Advisers for Safeguarding, and through an iHV Roundtable event in August 2023 – you can read our written response to the consultation here.

“Working Together to Safeguard Children 2023” focuses on strengthening multi-agency working. It brings together new and existing guidance to emphasise that successful outcomes for children depend on strong multi-agency partnership working across the whole system of help, support and protection including effective work from all agencies with parents, carers, and families. We support this position – safeguarding is everyone’s business. There is a clear imperative to strengthen services to ensure that the most vulnerable babies, children and young people in our society are supported to achieve their full potential and are protected from harm.

This statutory guidance sets out key roles for individuals, organisations and agencies to deliver effective arrangements. It covers the legislative requirements, a framework for the three local safeguarding partners (local authorities, Integrated Care Boards and police), and a framework for child death reviews.  This revision has a renewed focus on how organisations and agencies provide:

  • Early help
  • Safeguarding and promoting the welfare of children
  • Child protection.

Of relevance to health visiting, the guidance introduces changes to the lead practitioner role. It clarifies that a broader range of practitioner can be the lead practitioner for children and families receiving support and services under section 17 of the Children Act 1989 (Child in Need), and the requirements on local authorities and their partners to agree and set out local governance arrangements.
The guidance states:

“Once the referral has been accepted by local authority children’s social care, a social work qualified practice supervisor or manager should decide, with partners where appropriate, who the most appropriate lead practitioner will be and, with the lead practitioner’s agreement, allocate them in line with the local protocol.

The lead practitioner role can be held by a range of people, including social workers. When allocating the lead practitioner, local authorities and their partners should consider the needs of the child and their family to ensure the lead practitioner has the time required to undertake the role. The lead practitioner should have the skills, knowledge, competence, and experience to work effectively with the child and their family. The lead practitioner should always be a social worker for child protection enquiries.”

Our response to the Working Together consultation sets out our position on this. To ensure that the key preventative public health role of health visitors is not compromised, we strongly recommend that implementation and prioritisation decisions take account of the full breadth of the Health Visiting Model for England, and support delivery of the Healthy Child Programme in full. Health visitors deliver important ‘health’ functions within a whole system approach that cannot be overlooked. These support clinical pathways across the NHS (urgent, primary and secondary care) and education (child development, school readiness and Special Education Needs and Disabilities (SEND)), alongside child safeguarding. For example, supporting parents to manage minor illnesses (read our latest evidence review on the crisis in urgent care for children 0-4years), providing interventions for families affected by perinatal mental illness and a range of physical needs in the postnatal care pathway, reducing risk factors for preventable disease (addressing smoking, poor nutrition, alcohol risks and physical inactivity) and early identification and support for children with developmental delay and SEND.

We recognise that there may be occasions when having a health visitor as the lead practitioner might be in the best interest of the child and we set these out in our consultation response – in summary:

  • We do not support the case that health visitors should be the default lead practitioner for all babies and young children categorised as “Child in Need”.
  • Designation of the lead practitioner needs to be agreed on a case-by-case basis, in the best interests of the child, and only when the health visiting service is sufficiently resourced (not as a sticking plaster for an under-resourced children’s social care department). For example, when a family is being supported through a preventative public health, health visitor-led, intensive home visiting programme like the Family Nurse Partnership Programme or the Maternal Early Childhood Sustained Home-visiting (MECSH) programme, or through a targeted programme of health visiting support for a child with Special Education Needs and Disabilities (SEND).
  • However, care needs to be taken as there is a significant risk that, without sufficient resource, focusing health visitors’ efforts on statutory Child in Need cases will further accelerate their role drift away from preventative public health and earlier intervention (this was flagged as a national risk in our “State of Health Visiting” survey, published in 2023). Health visitors’ important “upstream” role is focused primarily on preventing, identifying and working with families to address problems before they reach crisis point. This takes pressure off children’s social care and is less costly in the long run. Health visiting is the only agency that proactively and systematically reaches out to all families with babies and young children from pregnancy and through the earliest years of life – this is a safety-critical function that needs to be protected at all costs. Without sufficient resource, eroding this “safety-net” further strips out the mechanism to identify vulnerable babies and young children.

The “Working Together to Safeguard Children 2023” guidance also includes:

  • New national multi-agency child protection standards which set out actions, considerations and behaviours for improved child protection practice and outcomes for children.
  • Clarification of roles and responsibilities of health practitioners, with specific duties for child safeguarding.
  • Domestic Abuse Act 2021 legislation and the National Framework statutory guidance that supports a child-centred approach.
  • Updated guidance and terminology on the management of child deaths and the language around the responsibility of professionals where relevant, to inform relevant safeguarding partners and the Child Safeguarding Practice Review Panel.
  • Guidance on Improving practice with children, young people and families which provides advice for local areas to embed working together to safeguard children and the children’s social care national framework in practice.


The Department for Education (DfE) has announced that it is investing more than £7 million, over the next 2 years to support local areas. This consists of £6.48 million grant funding in January 2024, for safeguarding partners to:

  • Make changes to multi-agency safeguarding arrangements in light of the revised Working Together to Safeguard Children statutory guidance.
  • Build a shared understanding between agencies of what the national framework means for multi-agency working.

This funding does not cover the costs of service delivery and sustainability. The guidance sets out an expectation that “leaders are ambitious about helping, supporting, and protecting children in their area and jointly prioritise and share resources accordingly”. If fully implemented, it is clear that these changes will place additional burdens on the health visiting workforce, shifting responsibilities from children’s social care to other services.

We are concerned that, as the costs of child protection continue to soar, budgets will not be redistributed to offset the additional burdens that this guidance places on organisations taking on the lead practitioner responsibilities. Prioritisation is likely to favour statutory responsibilities. Without addressing funding and health visiting workforce issues, services will be pressurised to prioritise “Child in Need” cases at the expense of preventative public health, leaving more families without the support that they need in other areas and proving much more costly in the long run.

This guidance presents an important opportunity to improve the care, support and safety of babies, children and young people. Its success will depend on its implementation as part of a whole system approach that also includes prevention and early intervention. As this directive represents a new national policy, we strongly recommend that its implementation is subject to the scrutiny of the Office for Budget Responsibility to ensure that it is fully costed and any additional burdens placed on services are managed with a commensurate budget uplift, workforce planning and action to address the current postcode lottery of health visiting service provision.

Next steps:

NHS Safeguarding is developing a safeguarding workplan to support the implementation of this guidance (we understand that the draft plan is due in mid-January 2024). At the iHV, we will be working closely with officials in the Office for Health Improvement and Disparities, NHS Safeguarding, and partners in other professional bodies and organisations including the School and Public Health Nurses Association, Association of Directors of Public Health and Local Government Association, to consider the specific implications of the Working Together 2023 guidance for health visiting and to support its implementation in practice.

The full suite of Working Together 2023 documents is available here:

Earlier this month, the iHV submitted a written response to the Department for Education’s Working Together to Safeguard Children: changes to statutory guidance consultation.

Working Together to Safeguard Children is the multi-agency statutory guidance that sets out expectations for the system that provides help, support and protection for children and their families. It applies at every level from senior leaders to those in direct practice with families, and across all agencies and organisations that come into contact with children. It gives practitioners clarity about what is required of them individually and how they need to work in partnership with each other to deliver effective services.

Updating ‘Working Together’ forms a central part of the Government’s plans to transform Children’s Social Care, set out in Stable Homes, Built on Love. The plans aim to strengthen multi-agency working across the whole system of help, support and protection for children and their families, with greater emphasis on earlier help and strong, effective and consistent child protection practice.

The Working Together consultation ran from 21 June 2023 to 6 September 2023 and views were sought from children and young people, parents and carers, and others who are ‘essential to children’s safety and welfare’. Officials at the Department for Education contacted the iHV with a direct request for a response to the proposal that health visitors might become lead professionals for children subject to Child in Need – section 17 arrangements. Our submission is therefore focused on the questions that relate to this proposal.

Our response was formulated with support from members of the iHV Working Together Safeguarding Roundtable Event that was held on 21 August 2023. The group met specifically to consider the impact of the proposed changes to the statutory guidance on health visiting practice. Further practitioner intelligence, and views on the proposed changes, were also collated from direct emails that the iHV received from members and discussions with partners during the consultation period.

What happens next?

The results of the consultation and the department’s response will be published on GOV.UK in Autumn 2023.

With special thanks to Trish Stewart, iHV Expert Advisor for Safeguarding and Associate Director for Safeguarding and Children’s Public Health Nursing at Central London Community Healthcare NHS Trust; Georgina Mayes, iHV Policy and Quality Lead; and members of the iHV roundtable event for their valuable input and support with this submission.

iHV has a committed and highly regarded team, with professional expertise in numerous public health priority topics for babies, young children, and families. We also engage with practitioners and parents/ carers to support the co-production of our work and outputs through our Health Visitor Advisory Forum, regular networking events, surveys, and bespoke project and training co-production groups.

To strengthen the iHV team, we also have a growing number of Expert Adviser roles. These voluntary roles are a critical part of ensuring that the perspectives of our members are represented and that the iHV’s decisions and policy positions are rooted in current practice and evidence.

Following an open recruitment process, we have recently appointed two new iHV Expert Advisers to join our existing advisers, for the specialist  topics of infant feeding and safeguarding. Our new expert advisers are health visitors and leading experts in their field and their role is to offer expert subject guidance, to support the work of the iHV.

We are absolutely delighted to announce our new iHV Expert Advisers:

Pippa Atkinson – iHV Expert Adviser for Infant Feeding

Pippa is an experienced health visitor and an International Board-Certified Lactation Consultant. She has worked as a specialist health visitor in infant nutrition. Pippa has experience of leading on the implementation of the Baby Friendly Initiative (BFI) standards for health visiting and was the clinical lead for a breastfeeding peer support service, providing specialist support to families.

Currently, Pippa is a lecturer in Health Visiting and is the BFI health visiting lead at the University of Central Lancaster (UCLan). Pippa is also a National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) for the North West Coast (NWC) doctoral fellow, exploring how the BFI standards influence the infant feeding experiences of women from different socio-economic backgrounds.

Trish Stewart – iHV Expert Adviser for Safeguarding

Trish Stewart is the Associate Director of Safeguarding at Central London Community Healthcare NHS Trust (CLCH), managing a team of safeguarding children and adult specialist practitioners, working across 11 London boroughs and Hertfordshire.

Trish has experience in complex case management, partnership working, strategic planning and quality assurance in healthcare, including public health nursing and general practice. Trish’s interest in leadership in safeguarding led her to undertake the Elizabeth Garrett Anderson Programme with the NHS Leadership Academy, gaining a Master’s in Healthcare Leadership (MSc) and a Senior Healthcare Leadership Award in 2017.

Trish’s passion for safeguarding and supporting frontline practitioners is something she hopes to further champion with the iHV.

Calling all iHV members – if you missed our iHV Insights Special webinar on “Safeguarding Learning” held on Wednesday, then don’t worry as the resources from this iHV Insights, as well as the previous ones, are available to iHV members to access as a free member benefit afterwards.

On Wednesday 9 November, we were joined by a great panel of experts including:

  • Annie Hudson, Chair of the Safeguarding Practice Review Panel, and Sally Shearer, Panel Member – Nursing representative: Learning from the deaths of Arthur Labinjo-Hughes and Star Hobson, and the implications for health visiting practice
  • Trish Stewart, Associate Director of Safeguarding, Central London Community Healthcare NHS: Courage and compassion in safeguarding

Click here to catch up on iHV Insights Special: Safeguarding Learning, as well as previous iHV Insights sessions:

If you were unable to join this week’s live event, iHV members can access the following after each iHV Insights event:

  • Recording of the live iHV Insights webinar
  • Pdf of webinar slides
  • Record of Attendance/ Reflection template for you to download and complete for each iHV Insights attended

Next iHV Insights

Come along, learn from National experts, and have an opportunity to ask questions.

We are delighted to announce our agenda for this event as follows:

  • The Domestic Abuse Bill – Implications for Health Visiting practice: Dr Tanya Dennis, Domestic Abuse Expert Adviser, iHV
  • Updates from The For Baby’s Sake Trust: Judith Rees and Amanda McIntyre
  • Introducing the iHV Domestic Abuse Toolkit: Vicky Gilroy and Philippa Bishop, iHV

The webinar will be recorded and will be available to iHV Members who are unable to join the live webinar on our website after the event.

Please join us. Spaces are limited so please do book early to avoid disappointment. Please use your iHV membership number to book your place.

About iHV Insights

iHV Insights are webinars run just for our members.

These live online sessions are of interest to frontline health visitors and student health visitors, as well as service leads, commissioners and wider members of the health visiting team, both in the UK and with lots of transferable learning for our international members too.

If you are not an iHV member, join us today to access these resources and many other member benefits.

Following requests from our members, we are pleased to be able to provide a special Safeguarding Learning Insight event providing learning to support our members in their practice.

This event is open to all members to attend.

This Insights webinar is on Wednesday 9 November 10:00 to 11:00 (join from 09:45 to allow a prompt start).

Come along, learn from National experts, and have an opportunity to ask questions.

We are delighted to announce our speakers for this event are as follows:

  • Annie Hudson, Chair of the Safeguarding Practice Review Panel, and Sally Shearer, Panel Member – Nursing representative: Learning from the deaths of Arthur Labinjo-Hughes and Star Hobson, and the implications for health visiting practice.
  • Trish Stewart, Associate Director of Safeguarding, Central London Community Healthcare NHS: Courage and compassion in safeguarding

The webinar will be recorded and will be available to iHV Members who are unable to join the live webinar on our website after the event.

Please join us – we anticipate high demand for this special Insights webinar, spaces are limited so please do book early to avoid disappointment.

How to book for iHV members

Go to our Eventbrite booking page and please use your iHV membership number as your access code. If you have any problems or enquiries please email [email protected] and we will be happy to help.

Once you have submitted your details, you will be able to select your ticket and proceed to checkout – please note that this webinar is free to iHV members.

Not an iHV member?

Previous iHV Insights

The great news is that all iHV Insights webinars are available for iHV members to access as a free member benefit after the event, as well as joining the live session. As a member, you can access all of our previous iHV Insights webinars.

Click here and log in to catch up on our previous iHV Insights.

The publication of yesterday’s hard hitting national review, “The Myth of Invisible Men”, by the independent Child Safeguarding Practice Review Panel, provides a stark reminder that babies are being let down in this country and, for some, the consequences are catastrophic and life-changing.

Alison Morton, Executive Director iHV, said:

“This hard hitting report highlights yet again that babies pay the ultimate price for the failings in the systems designed to safeguard and protect them. Babies cannot speak – they rely on the adults around them to protect them and, when this is not possible or their parents need additional help and support, they need to live in a world where there are skilled professionals who can spot their distress and step in to help. This is why we are calling on the Government to invest in health visiting as a vital safety net for babies and young children.”

The report highlights that 35% of all serious incident notifications involve serious harm to babies, the vast majority involving physical injury or death. This is the biggest category of all notifications that the Panel sees. In the majority of cases where babies have been injured or killed, men are the perpetrators – research suggests that men are between 2 and 15 times more likely than women to cause this type of harm in under 1s. The greater prevalence of male abusers sits alongside a description of men as too often being ‘hidden’ or ‘invisible’ to safeguarding agencies.

The review focuses on non-accidental injury (NAI) in infants under the age of 1 and seeks to answer the following questions:

  • ‘How well does the safeguarding system understand the role of the father/male carer?’
  • ‘How can the safeguarding system be more effective at engaging, assessing and planning for and with men in the protection of children (or those for whom they have a parenting responsibility)?’

The review concludes that there is an urgent need to improve how the system sees, responds to and intervenes with men who may represent a risk to the babies they are caring for. For this group of men, the role that they play in a child’s life, their history of parenting and their own experiences as children and how this effects them as adults, are too frequently overlooked by the services with responsibilities for safeguarding children and for supporting parents.”

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.




Today, over 40 leading mental health, family and children’s charities and professional bodies are calling on national and local decision makers to give urgent attention to the wellbeing of babies, toddlers and their parents during the COVID-19 crisis.

While recognising the incredible work done over recent weeks by politicians, policy makers and dedicated front-line professionals, the charities are highlighting the need to protect unborn and very young children and their parents from the serious harm as a result of the response to the COVID-19 outbreak.

The statement comes in response to decisions from some local areas to redeploy significant numbers of staff from vital services such a health visiting, perinatal mental health and parent-infant teams that would normally support parents and safeguard babies. In some areas of England at least 50% of these highly skilled staff are being redeployed into other health services.

The organisations, which form part of the First 1001 Days Movement, describe the huge risks faced by some babies and toddlers as a result of increased pressure on already vulnerable parents, and the scaling back of services that would normally support them. They argue that babies, both born and unborn, and their parents should be given particular attention as this is a critical period with serious immediate and long-term consequences.

In a joint statement, the charities state that:

“It has already been widely recognised that for some people, home is not a safe haven. Across the UK, there are babies and children in lockdown in poor quality and overcrowded housing, with shortages of basic supplies, cared for by parents under immense pressure. Babies, born and unborn, are particularly vulnerable to physical and emotional harm because they are at a critical stage in their development, are fragile, totally dependent on adults for their care, and unable to speak out or seek help. Therefore, it is essential that Government is keeping their needs in mind.”

Research shows that, prior to the crisis, between 10-20% of women experienced mental health problems in the perinatal period[1] and 25,000 babies in England live in households where their parent or parents are already struggling with at least two significant issues – parental mental illness, domestic abuse and/or substance misuse.[2] These problems are escalating during the COVID-19 crisis as a result of the range of stresses facing families.

The charities write that families will be struggling behind closed doors, unknown to services.

“We can’t expect that families in trouble will ask for help: we know that parents often hide their struggles for fear of stigma and judgement. Babies can’t speak out.”

The statement calls on local services to work together to ensure that there is sufficient support for parents, and protection for children, not only for families known to be at risk before the crisis, but also those families who may be experiencing new or heightened problems as a result of the crisis.

While many services are working hard to deliver services in different ways – such as phone calls, video consultations and online forums – the charities argue that these may not be enough to reach families suffering from multiple disadvantage, and to understand what is really happening to babies in those households.

The organisations are calling on the UK Government to:

  • Ensure that the physical and emotional needs of the youngest children are considered more explicitly and transparently by those making decisions about the response to COVID-19. Provide clarity on who in high-level decision making forums, such as COBRA, is representing the needs of babies and their parents.
  • Provide clear guidance for health and social services on maintaining vital support for families. This must encourage an informed and coordinated local approach in each area that draws on partnerships between statutory agencies and charities (utilising any local volunteers effectively and appropriately) to ensure all families get the support they need. This guidance should minimise the re-deployment of staff from community services, in particular health visiting, parent-infant and perinatal mental health teams, recognising that these services provide essential support to families at highest risk and are needed more than ever. Decision makers must balance action to tackle COVID-19 with action to reduce its immediate and long-term negative impact on parents and the next generation.
  • Ensure that the strategy to end the lockdown considers the needs of babies and their families, and the services that work with them. Government must consider how services can swiftly and safely return to offering high-quality face to face support to families and how additional support can be put in place to mitigate the impacts of social distancing, particularly on the most vulnerable families.

The charities are calling for national leadership to champion the needs of the youngest children and their families, not only during the outbreak but also beyond it.

Sally Hogg, Head of Policy and Campaigning at the Parent-Infant Foundation and Coordinator of the First 1001 Days Movement, said:

“For a long time, charities, professionals and parliamentarians have called for there to be a senior Minister in Government with clear responsibility for the wellbeing of children – beginning in pregnancy. Perhaps if such a person had been in place, we would have seen more attention paid to the needs of the youngest children in response to COVID-19. Babies don’t have a voice. This is a time when they need someone to be speaking up for them, and championing their needs at the highest levels in Westminster and Whitehall.”

Anne Longfield, the Children’s Commissioner for England said:

“I support this statement from the 1001 Days Movement. While thankfully babies and toddlers seem to be at lower risk of COVID-19 illness, we know that many are vulnerable to a host of secondary risks. Lockdown places additional pressures on parental mental health, family finances and relationships, and leaves families without their support networks. Families with vulnerable young children need help in caring for, bonding with and supporting the development of their babies and toddlers.”

Notes to Editors:

  • The First 1001 Days Movement is a group of organisations and professionals that drive change together by inspiring, supporting and challenging national and local decision makers to value and invest in babies’ emotional wellbeing and development in the first 1001 days.
  • Organisations that signed the statement are listed below.
  • There is clear, compelling evidence from decades of research that the first 1001 days, from pregnancy to age 2, are a significant and influential phase in development. What happens during this period lays the foundation for every child’s lifelong health, well-being, learning and earnings potential. (For more information we suggest you look at previous publications and infographics by the First 1001 Days Movement )
  • Babies, before and after birth are vulnerable because they are small and fragile and completely dependent on parents for their care. Babies are over-represented in Serious Case Reviews which occur when a child dies or suffers serious harm. Reviews for DfE in 2012 and 2014 both found that at least 40% of Serious Case Reviews related to a child under one.
  • Evidence from China and Italy shows the increased prevalence of domestic abuse and safeguarding issues during lock down. In the UK, domestic abuse charities have reported a 25% increase in contacts in recent weeks and childline has also seen an increase in calls.
  • Vulnerable families are facing a huge number of pressures: economic hardship, job insecurity, isolation, anxiety about the virus and the stresses of lockdown. Babies will be affected by the lockdown – by the changes in routine and environment and the impact on their families. And the stress of the crisis will make it harder for some parents to provide babies with the safe, nurturing, responsive care that they need, and in a small but important number of cases may push families over the edge towards abuse.
  • The Royal College of Paediatrics and Child Health reported that senior paediatricians have contacted the RCPCH with reports of children arriving at hospitals with illnesses at a far more advanced stage than they would normally see. For babies, who are less physically resilient than older children, this may result in babies becoming seriously unwell.
  • Initial scoping information collated by the Institute of Health Visiting from health visitors in practice suggests that redeployment is being led locally and implemented differently by different areas. Health visiting workforce numbers in some parts of the UK  have been cut by 50-70%. In contrast, some areas have not redeployed any health visitors and a few have actually increased their health visiting establishment through redeployment of health visitors currently working in other roles, back to frontline health visiting practice.
  • Other organisations in the First 1001 Days Movement have heard from perinatal mental health and parent-infant teams where staff have been redeployed into other services.

Organisations that have signed the statement:

  • Action on Postpartum Psychosis
  • APEC
  • Approachable Parenting
  • Association of Breastfeeding Mothers
  • Best Beginnings
  • Birth Companions
  • Borne
  • Brazelton Centre UK
  • Breastfeeding Network
  • Building Bonds
  • Cattanach
  • Cocoon Family Support
  • Dad Matters
  • Easy Peasy
  • Ectopic Pregnancy Trust
  • Family Action
  • Family Links: The Centre for Emotional Health
  • First Steps Nutrition
  • GBSS
  • Home-start UK
  • ICP Support
  • Institute of Health Visiting
  • Make Birth Better
  • Mama Academy
  • Maternal Mental Health Alliance
  • Maternity Action
  • Mothers at Home Matter
  • NCB
  • NCT
  • One Plus One
  • Parent-Infant Foundation
  • Parents 1st
  • Petals
  • Sands
  • Solihull Approach
  • Stefanou Foundation (For Baby’s Sake)
  • Swansea University
  • The Association of Child Psychotherapists
  • Twins Trust

A number of member organisations provide online support for families during this crisis. Some examples that you might want to highlight for parents include:

  • Information from the iHV:
  • Baby Buddy is an NHS approved pregnancy and parenting app created by the charity Best Beginnings. It provides empowering and informing daily information, has over 300 practical films including films on maternal mental health, understanding your baby, supporting the couple relationship, breastfeeding and more. It sign-posts to scores of other charities, has a direct route to the 24/7 Baby Buddy Crisis Messenger and actively supports families whose children are at higher risk of poorer outcomes.  To find out more and download Baby Buddy go to:
  • Best Beginnings are also collating information from other charities about the support available for families during the crisis. This information will be available here from Thursday 9th April :
  • The Breastfeeding Network and other charities are providing infant feeding support for families: …
  • FamilyLine is a free service available to support adult family members on all aspects of family life issues via telephone, text message and email. Whether it’s emotional support or practical advice on any aspect of parenting or broader family issues, call: 0808 802 6666, text: 07537 404282 or email: [email protected]
    Monday to Friday: 9am – 9pm. The helplines will be covered by SHOUT our text crisis line outside these hours including weekends and bank holidays.
  • EasyPeasy is an award winning digital home learning service proven to support children’s early development (ages 0-5) through inspiring playful interactions. The app has been made FREE until May 31st and offers access to hundreds of activities, game ideas, tips and advice for parents of young children.
  • For Baby’s Sake supports both parents over the 1001 first days, starting in pregnancy, to bring an end to domestic abuse and support their baby’s early development.  This programme is continuing to work with mothers and fathers remotely, particularly using video technology, using techniques to reduce the risks of domestic abuse and increase physical and emotional safety.  The Stefanou Foundation, which created the programme, is sharing their learning, including guidance for professionals on reducing trauma risks and building resilience during COVID‑19, which may be downloaded from
  • Birth Companions specialises in working with women facing multiple disadvantage during pregnancy and early motherhood. The charity has adapted its face-to-face services in light of COVID-19 to focus on providing ongoing phone and email support, practical mother and baby essentials such as clothing, nappies and baby slings, and tailored antenatal information packs delivered electronically and through the post.  More information is available at

[1] Bauer, A., Parsonage, M., Knapp, M., Iemmi, V., & Adelaja, B. (2014). Costs of perinatal mental health problems.

[2] Miles, A. (2018). A Crying Shame A report by the Office of the Children’s Commissioner into vulnerable babies in England