Giving children the best start in life

Public Health England is working with councils and other partners to modernise the Healthy Child Programme.

The importance of early years, and their impact on the physical and emotional health of a child, is well evidenced. 

What happens before conception, during pregnancy and in early childhood shapes children’s health, happiness and life chances, so getting the Best Start in Life (BSiL) really matters. Our ambition is for all mothers to experience good health before, during and after pregnancy, and for all children to have a happy, secure and healthy childhood – but inequalities remain, and we need to take action to make this ambition a reality.

“We need to work together on an evidence-based programme that helps create healthy communities for families”

Public Health England has identified BSiL as one of its 10 strategic priorities for 2020-25. Based on discussions with a range of partners, including the LGA, we are designing a programme of work that aims to reduce inequalities and improve health outcomes for children and families across England. In particular, we will work with partners to reduce inequalities in children being ready to learn at age two and ready for school by age five.

A significant focus of this work will be the modernisation of the Healthy Child Programme (HCP). Initially published in 2009, the evidence-based HCP remains the public health programme for children and young people. Clearly, the commissioning landscape and workforce surrounding the programme have changed since then, and more new evidence is available to inform its content and delivery.

The HCP encompasses individual interventions, both universal and targeted (including screening and immunisation programmes, parenting support, health and development reviews, and health promotion) and developing healthy places for children and families. The age range of the programme is being expanded – from the current pregnancy to 19 years – to pre-conception to 24 years. The BSiL programme and the modernisation of the HCP will be developed through the two themes of the individual intervention offer and place-based approaches to reducing inequalities. This will be in alignment with the NHS Long Term Plan and its potential to improve outcomes for children.

The HCP will be framed around the provision of a public health offer that is “universal in reach and personalised in response”. For many families, a personalised response will be a high-quality universal service; for others, early or specialist extra help and interventions may be needed.

PHE is working with partners in other government departments and non-governmental organisations to align national programmes and priorities for children, young people and families, and with partners such as the LGA and Solace to enable strong, joined-up national and local collaborations.

Health visitors and school nurses are the local ‘public health field force’, responsible for leading and delivering much of the HCP, and local councils have the commissioning responsibility for these services. This has given opportunities for closer working across children and families services. The rollout of integrated care systems offers further ways to work with NHS services, bringing together local systems around prevention and support for families.

We need to work together to develop and deliver an evidence-based programme that contributes to the creation of healthy communities for families, brings together local providers and commissioners, and offers services that are responsive to families’ needs. We all share the ambition to enable all children to have positive health and wellbeing, and to achieve their full potential – and, by working together, we can move towards achieving it.

This discussion will continue at a dedicated panel session at the LGA/ADPH’s annual public health conference in Brighton on 24 March. Healthy Child Programme | More information.


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