Health Visitor Pathways
Health Visiting Pathways
• DH developed 3 pathways in collaboration with DfE, RCN, CPHVA, Unite, SAPHNA,
1. Health Visiting and Midwifery Partnership (antenatal)
2. School Nursing and Health Visiting Partnership (transition to school)
3. Maternal Mental Health
• Current audience is health, partnership working referred to mainly in terms of
• How can these be developed further to ensure integration within Early Years
Health Visiting and Midwifery Partnership
• Guidance and tool that identifies the impact on the different levels of support from
community, universal, universal plus through to universal partnership plus.
Vulnerable and those with complex needs
• Structure of pathway document:
• Rationale, challenges and expected outcomes
• Pathway
• What needs to be addressed to enable the pathway to develop in terms of
partnership working, role definition, communication and information
• Pathway sets out the roles of MW and HV over the antenatal period and first birth
visit. It identifies when other services should be involved eg identifying vulnerable
families and making referrals, signposting the CC during 16-28 weeks period in key
messages and actions. Refers to relevant NICE guidance and pathways
School Nursing and Health Visiting Partnership
• Supporting children and families from age 2 to 10. Specific attention to transition
and recognising its importance and that of school readiness
• 2 -2 ½ year review – identifying additional health needs and provision of early
• Potential areas to explore integrated approach
• Community – CC, community groups
• Universal – supports family, facilitates access to other support resources/services or
refers to GP
• Universal Plus – specific help such as parental MH, attachment, toileting , DV,
behaviour management
• Universal Partnership Plus – brining together a range of services such as CC,
community services, FNP, referral to specialist services or social care
Maternal Mental Health
• Pathway focuses on HV, midwives and third sector, but recognises wider partners
(identifies midwifery, MH and GP but not LA)
• Recognised the rationale of importance of maternal MH during pregnancy and the
skills PH nurses have to identify issues and able to promote skills for parenting
• For ante-natal and postnatal period Integrated working is identified at universal
partnership plus, including CC, third sector, specialist MH, GP, housing, welfare and
social care. Are there opportunities at lower end of input, universal plus does
mention baby massage and group support but not how or who provides this?
Work Session
Task: Developing integrated pathways
• Can the HV pathways be developed further?
• How can we embed evidence based licensed programmes?
• There are a number of different examples provided for discussion
• What format looks promising
• Scope current known pathway work
• Main discussion group
• Action planning

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