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

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

Any community experiences?

Brighton used to have an excellent model but sadly it was a casualty of a the cuts but it did work brilliantly. Lancashire also used to have a good model but again unsure if it has survived. Karen Whittaker Lecturer and researcher at UCLAN may be able to help you with the Lancashire model

Excellent news great for Scotland

Hi Colleen what Maame quotes about breast milk is correct but for formula fed babies the answer if different. If a formula fed baby is constipated it is recommended to give cooled boiled water and also in hot weather.

For formula fed babies it depends very much on the baby. A small baby may need all their energy to suck the milk and so you wouldn’t want to give anything else. Most full term, healthy babies, who feed well will be able to take some water without affecting their feeding. This should always be given after a feed. I am struggling to find evidence on this for formula fed babies and wonder if the iHV should produce a Good Practice Point on this. Thank you for raising the issue.

If anyone has evidence on this please can they share it?

Thanks for sharing Hazel

Hi Leah thanks for posting we are trying to engage more students in the forums. If you have any suggestions as to how we might do this we would love to har your ideas.

Hi Leah thanks for posting we are trying to engage more students in the forums. If you have any suggestions as to how we might do this we would love to har your ideas.

Hi Melita I can’t see the infographic but we had an excellent session on developing compassionate resilience yesterday from the iHV. As professionals my experience is that we are not very good at recognising when we need to care for ourselves and if we do we are unsure what to do, we need to practice the self care techniques we encourage mums to do!