Health visiting services use a 4 tiered progressive model. This involves:
- Building community capacity to support parents of young children by contributing to the understanding of local need and targeting work appropriately with our key partners.
- The provision of 5 universal contacts focusing on prevention, early identification and early intervention.
- The provision of targeted packages of care to meet identified need for example on early attachment, maternal mental health issues, breastfeeding, behavioural issues.
- Contributing and/or leading packages of integrated care for those identified as having complex needs or being at risk, including troubled families and safeguarding.
This is the first contact to explain the Health Visiting service and Bright Start offer and to complete the initial holistic family health needs assessment, which will include: discussion on attachment and the transition to parenthood; emotional and practical support available to individuals and families; infant development, feeding, and the Healthy Start programme .
The New Birth Visit
This occurs in the home by the Health Visitor 10 to 14 days following the birth. This visit forms an important part of the ongoing holistic assessment of family risk and resilience factors started by the Health Visitor with the parents during the antenatal period. Some examples of issues that parents may wish to discuss include: interacting with baby (e.g. songs and music, books); feeding; diet and nutrition; colic; sleep; crying; establishing a routine; safety; car seats; and the immunisation programme as well as their own emotional and physical well being as they continue their own transition to parenthood. Engagement in the local Bright Start services such as child health clinics, first time parent groups, feeding workshops and stay and play sessions will be encouraged.
6-8 week Health Visitor Contact
When the baby is 6 to 8 weeks old the Health Visitor will offer contact to review and assess the emotional well being of both mother and child and provide the opportunity to discuss topics such as feeding, immunisations, managing minor ailments, sleep and colic as well as encouraging engagement in the local services such as child health clinics, first time parent groups, feeding workshops and stay and play sessions.
9-12 Month Developmental Review
This is a review of the child’s growth and development at 9 to12 months by a member of the Health Visiting team. This contact may take place in the home, or in a local clinic or children’s centre and focuses on the assessment of the child’s emotional and physical development as well as providing an opportunity to discuss how to respond to the child’s changing developmental needs. Safety and health promotion messages linked to the next stages of development will be discussed and this may include sleep, oral care, diet and nutrition, play and safety, speech and language development. The offer of free 2 year nursery placements will also be explained.
2-2 1/2 year Developmental Review
This is a review of the child’s growth, development and emotional well being at 2 to 2½ years by a member of the Health Visiting team with the parents using the ASQ assessment tool. Topics covered may include hearing and vision, language development, behaviour, sleeping and toilet training and it ensures that families are linked in with the right services and support where additional help is needed or if there are any concerns. Where a child already attends an early years setting, the two year health review may be integrated with the progress check undertaken at age two by early years providers.
In addition to the 5 contacts descibed above the Health Visiting team provide leadership and support in six high impact areas alongside Early Years providers and health partners including midwifery, speech and language therapy and CAMHS.
The transition to parenthood and supporting early attachment
Activities include the ‘Journey to parenthood’ programme’; first time parent groups, listening visits and access to specific courses facilitated by CAMHS such as ‘Growing Together’.
Maternal mental health
Activities include early identification of post natal depression, listening visits, outreach work to support engagement with available groups and resources.
Breast-feeding; healthy weight
Activities include UNICEF baby friendly accreditation; access to peer support and breast feeding drop in services; family kitchen events.
Preventing accidents and managing minor illness
Activities include follow up A&E attendances: support the asthma pathway; safety in the home initiatives; ‘managing minor illnesses’ awareness sessions.
Development at age two, underpinning school readiness
Integrated developmental reviews; support and encourage take up of the 2 year free nursery offer; stay and play sessions, early identification of developmental and behavioural issues for support and referral.