Hello Elizabeth. Thanks for posting on the Fellows Forum. Christmas and new Year have come and gone with no reply, for which apologies!! I don’t have an answer to your direct question, but the issue of how Early Help is implemented is one over which I have noted some concern in our membership survey, conducted late last year. The intensity of need around (rising) thresholds for taking action to safeguard children, combined with falling numbers of HV posts have made it increasingly difficult to reconcile the concern to protect vulnerable children while also delivering a universal primary preventative programme – the Healthy Child Programme. Without doubt, local authorities are under huge pressure to meet their statutory responsibilities, but a ‘targeted’ HV service will not be informed by comprehensive assessment of need amongst the unseen. Arguably, EH is essentially Universal Partnership Plus work, except that the latter includes health needs that require help not limited to that provided by local authority services. Working Together effectively defines EH assessments in terms of capacity to benefit from local authority services. An added complication is that in some areas, EH assessments are functioning as barriers to access for help e.g. a parenting programme, if the family does not consent to the EH assessment itself. Because each local authority in England commissions in its own way, it is hard to generalise about how best to respond. For a principled approach, I suggest you look at the public health briefings on this website on the Contribution of health visiting to Prevention and the one on Safeguarding and Child protection. (The section on working with local authorities)
I made some of these points in our recent response to the consultation on the revised version of Working Together (due for publication fairly soon). I recently discussed this issue with the Network of designated Health Professional for Safeguarding and Child Protection. They were very clear about how essential it is for HVs to be searching for health needs with ALL families, and not just focussing on those who are most needy by becoming a substitute for social care.
If you have some more specific queries, then do share them either in the forum or email me on [email protected]. Also, try the Fellows Facebook page. It’s rather more active than this Forum!
Robert Nettleton
Education Advisor, iHV
