Children's public health transfer

The Healthy Child Programme (HCP) for 0-5 year olds, which includes the commissioning of health visitors and family nurses, transferred from the NHS to local government on 1 October 2015.

The transfer marked the final part of the overall public health transfer. It joins up commissioning for 0 to 19 (and up to 25 years for young people with Special Educational Needs and Disabilities) to improve continuity for children and their families. It also presents a unique opportunity for local authorities to transform and integrate health, education, social care and wider council led services and to focus on improving outcomes for children and young people.

Scope of the transfer

While some responsibilities transferred some were retained by NHS England. The transfer included:

health visiting services (universal and targeted services)
Family Nurse Partnership services (targeted service for teenage mothers

The full scope of the transfer can be found in the Department of Health factsheet: Scope of public health services to transition

The following commissioning responsibilities have been retained by NHS England:

Child Health Information Systems (CHIS) in order to improve systems nationally. This will be reassessed in 2020.
the six to eight week GP check (also known as the Child Health Surveillance) because of its complex commissioning arrangements.

Mandated elements

In October 2015, the Department of Health mandated local authorities for 18 months to provide five universal checks. In October 2016 Public Health England carried out a review of the mandated checks. The findings from the review informed a decision to continue with the mandated checks and the mandation has been extended.

The five universal mandated checks cover:

antenatal health promoting visits
new baby review
six to eight week assessment of the baby
one year assessment
two to two and a half year review.

Review of the mandation for the universal health visiting service

Improving outcomes for children and families in the early years

PHE has published guidance on the six early years high impact areas to support local authorities decisions around the commissioning of the health visiting service and integrated children's early years services: Early Years High Impact Areas

The LGA has produced a case study publication to share local authority examples from different areas of innovative practice in commissioning the 0-5 Healthy Child Programme: LGA - Improving outcomes for children and families in the early years: a key role for health visiting services.

Information on in-sourcing health visiting services

Since responsibility for the 0-5 Healthy Child Programme transferred to local councils in October 2015, a number of councils have taken steps to improve integration of health visiting with other services. Some have considered bringing those services in-house. This process raises a number of questions and challenges for councils including regulatory, human resource, legislative and others. This section includes case studies to share learning.