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Background The health visiting service in England leads the government's Healthy Child Programme (HCP) for children under five years. Local authorities and their provider partners deliver this service differently across England. Objective To describe local authority variation in the delivery of health visiting to children under five years in England (2018-2020). Methods We used publicly available statistics on mandated health visiting contacts, and administrative data from the Community Services Dataset (CSDS) on duration, location, and medium of contacts. We mapped population coverage of mandated contacts (new birth visit, 6-8-week review, one-year review, and 2-2½ -year review) and described the frequency and characteristics of mandated and additional contacts across local authorities. Results Based on publicly available data, almost all eligible children received their new birth visit, 6-8-week review and one-year review (89%-99%), with substantial variation across local authorities in children receiving he 2-2½ -year review: median 81%, range 33%-98%. Based on CSDS, 80% of local authorities (n=46/57) delivered more additional than mandated contacts: a median of 1.6 additional contacts (range: 0.1-8.5) were delivered for each mandated contact. There was also significant variation in the duration of contacts and the percentage of contacts delivered face-to-face and at home. Conclusions Despite decreases in funding and workforce since 2015, in 2018--2020, health visiting teams reached nearly all babies and most children face-to-face via mandated contacts, and conducted over one and a half times the number of additional contacts relative to mandated contacts, with variation between local areas. This represents a significant public health infrastructure to support the health and development of babies and children and the wellbeing of their families in the critical period before school. Our study highlights the importance of taking into account additional contacts. Further work is needed to understand variation, including in the way additional contacts are used.

Background: The Healthy Child Programme is the universal public health system in England to assess and monitor child health from 0 to 19. Following a review of measures for closer monitoring at age 2 years, the Department of Health for England implemented the Ages & Stages Questionnaires®, Third Edition (ASQ‐3™; Hereon, ASQ‐3). Aim: The aim of this study was to evaluate the acceptability and understanding of the ASQ‐3 in England by health professionals and parents. Method: A mixed‐methods approach was used. This paper reports on the qualitative data drawn from interviews with 40 parents and 12 focus groups with 85 health professionals. The data were analysed using applied thematic analysis. Findings Overall, parents and health professionals found the ASQ‐3 acceptable and understandable and could use it as a measure at age 2 years. The ability to work in partnership was valued. Some limitations included potential to cause anxiety, concerns around the safety of some of the items, and use of Americanized language. Health professional's training in the use the ASQ‐3 was inconsistent. Conclusion: The ASQ‐3 is an acceptable and understandable measure to use as part of the 2‐year assessment with some adaptations to the English context and some standardized training for health professionals. [ABSTRACT FROM AUTHOR]

This paper aims to discuss the infant assessment component of the new birth review. The Healthy Child Programme (HCP) is the guidance that underpins the practice of health visiting at this contact. It should be clearly stated that this article is not referring to the Newborn and Infant Physical Examinations (NIPE) undertaken by medical practitioners and midwives at birth and by GPs at six weeks respectively. From reviewing other provider organisations' health visiting standards online, through discussions at professional health visiting forums such as The National Professional Advisory Group and from the author's small qualitative study as part of a master's dissertation there appears to be a wide variation in health visiting practice. There are health visiting (HV) services that offer a universal infant assessment, while other HV services assess the infant in other ways at the request of the parent. However, some services do not undertake an infant assessment at all. The Health Visiting Core Specification states that the health visitor should be able to assess the baby's growth and be able to conduct an ongoing review. This paper discusses the historical background that underpins the different approaches and discusses the implications for different practice at a universal healthy child programme contact. The author discusses tools that evidence current practice. [ABSTRACT FROM AUTHOR]

Background Secure attachment is associated with optimal outcomes across all domains in childhood, and both insecure and disorganised attachment are associated with a range of later psychopathologies. Insecure and disorganised attachment are common, particularly in disadvantaged populations, pointing to the need to identify effective methods of addressing such problems. Aims This paper presents the findings of a review of secondary and primary studies evaluating the effectiveness of interventions aimed at improving attachment and attachment-related outcomes on a universal, targeted or indicated basis, which was undertaken as part of an update of the evidence base for a UK-based national programme targeting children aged 0-5 years (Healthy Child Programme). Method A systematic search of key electronic databases was undertaken to identify secondary and primary sources of data that addressed the research question and that had been published between 2008 and 2014; search sources included Cochrane Collaboration, NICE, EPPI Centre, Campbell Collaboration and PubMed, PsychInfo, CINAHL databases. Findings Six systematic reviews and 11 randomised controlled trials were identified that had evaluated the effectiveness of universal, selective or indicated interventions aimed at improving attachment and attachment-related outcomes in children aged 0-5 years. Potentially effective methods of improving infant attachment include parent-infant psychotherapy, video feedback and mentalisation-based programmes. Methods that appear to be effective in improving attachment-related outcomes include home visiting and parenting programmes. Conclusions A number of methods of working to promote attachment and attachment-related outcomes in preschool children are now being recommended as part of the Healthy Child Programme. The implications in terms of the role and contribution of practitioners working in child and adolescent mental health service are discussed. [ABSTRACT FROM AUTHOR]

Abstract: A Child Health Promotion programme has developed over the last century. Its remit and content has been revised and updated over the last 50 years. The current programme, the Healthy Child Programme, enshrined in law, offers a comprehensive schedule of checks, reviews and support from pregnancy to 19 years of age. This is the first nationally agreed programme, and yet we are not clear whether it is achieving what it sets out to do. We review the aims of the HCP and ask whether it is doing too little or too much? We explore the outcomes that matter and assert that we often don't have the data to make this judgement. We call for more data and argue for the importance of getting to know your local data, in advocating for children and young people. We ask paediatricians to step up and take a role in the promotion of health and wellbeing of families in their care: child public health is everybody's business. [Copyright &y& Elsevier]

Activity demand models for delivery of the Healthy Child Programme (HCP) through the school nursing workforce are limited. This paper describes the application of a potentially new activity demand model for school nursing. The model identifies what the demand for school nursing is in Staffordshire, using estimated delivery times of universal and targeted components from the HCP, numbers of children and local information around targeted activity, eg, numbers of looked after children. The model suggests that the school nursing service would spend around 60% of time on individual face to face activity, 30% on public health leadership, management and evaluation and the 10% on travel in Staffordshire. It also suggests a shortfall in workforce capacity. The model can be used to underpin commissioning decisions and service redesign and changes in practice would be required to meet the full requirements of the HCP. [ABSTRACT FROM AUTHOR]

Increasing recognition of the importance of maternal mental health and early parenting in optimising the later mental health of the child has given rise to new ways of working during the perinatal period. The objective of this review is to identify effective health-led interventions to support parents, parenting and the parent-infant relationship during the perinatal period, and beyond. A systematic search of key electronic databases was undertaken to identify secondary and primary sources of data addressing the research question. Twenty-four reviews addressed the effectiveness of interventions delivered during the postnatal period in promoting closeness and sensitive parenting, infant sensory and perceptual capabilities, and positive parenting, and in addressing infant regulatory problems, maternal mental health problems, and parent-infant relationship problems. A number of methods of working are recommended as part of a model of progressive-universalism beginning ante-natally and continuing through the first two post-natal years, and beyond. The implications for universal, targeted and specialist healthcare services are explored, alongside the role and contribution of CAMHS practitioners. [ABSTRACT FROM AUTHOR]

The Healthy Child Programme includes an antenatal contact with the health visitor between 28 and 36 weeks gestation. In South Sedgemoor, health visitors had previously run an antenatal parenting session as part of the parentcraft education provided by the midwives. This had stopped due to a number of reasons. The decision was made to survey expectant parents to determine their views on how best this antenatal contact with the health visitor could be achieved. Sixty-six questionnaires were handed out and 73% responded. It was evident from the findings that the vast majority of parents questioned (82%) wanted individual face-to-face to contact with health visitors and midwives, with only 27% wanting to attend a small group. There was a clear request that this contact was to be done in the surgery (59%), although 36% felt that home or the children's centre would be an appropriate place. The parents mostly felt that the best time for this to happen would be during the day (48%) or at the weekend (30%). This small survey shows how important it is for individual health visiting teams to identify the antenatal needs of their clients in each locality and to listen to what they want. [ABSTRACT FROM AUTHOR]