Guidance

Annexes

Published 6 February 2026

Applies to England

Annex A: specific populations

The following examples are not exclusive, but highlight how practitioners can apply proportionate, trauma-informed responses within the healthy child programme.

Care leavers

Under part III of the Children Act 1989, local authorities have a duty to support young people who were looked-after at ages 16 or 17 (known as a ‘former relevant child’) and are now under the age of 25.

Health visitors and school nurses should recognise that young people with experience of the care system - whether or not they meet the statutory definition of a care leaver - may require extended or specialist support as they navigate parenthood, relationships or independent living.

Their experiences may affect how they engage with services, requiring sensitive, proactive and non-judgemental outreach to ensure they are not underserved by universal offers.

Examples of relevant support may include:

• joint antenatal visits or parenting support for young care-experienced parents
• liaison with personal advisers or local authority leaving care teams
• additional emotional wellbeing reviews and advocacy for timely mental health support
• help to access services such as sexual health, housing, benefits or education

Young carers

Section 17ZA of the Children Act 1989 defines a young carer as a person under 18 who provides or intends to provide care for another person. A person is not a young carer if the person provides or intends to provide care:

• under or by virtue of a contract
• as voluntary work

According to Barnardo’s, as many as 1 in 5 children and young people may be young carers, yet it can take years for their needs to be identified and met.

Health visitors are uniquely placed to notice early patterns of caregiving during home visits, while school nurses may be the first to detect indicators during health or wellbeing conversations. Both professions have an essential role in:

• recognising young carers early
• triggering local carer assessments
• supporting them with targeted input or referral

In some cases, safeguarding considerations may also need to be explored.

Local authorities and provider organisations should ensure there are robust mechanisms for early identification and assessment of young carers, in line with statutory duties under sections 63 and 64 of the Care Act 2014. 

The Children’s social care: national framework sets out guidelines to identify and assess young carers who may need support and to assess their needs. Carers Trust’s No wrong doors for young carers memorandum of understanding should be adopted to promote joint working across:

• children’s and adults’ services
• health
• education
• the voluntary sector

All schools, colleges, and universities should appoint a young carers lead and implement whole-school approaches to identification and support.

Commissioners should:

• address the needs of hidden and seldom-heard young carers
• ensure access to financial and mental health support
• plan for their needs in emergency situations

Young carers and their families should be actively involved in service design and evaluation.

The Schools, pupils and their characteristics - academic year 2024 to 2025 census identified 64,500 pupils as young carers - this is an increase of 10,500 from the previous year. This data source provides valuable demographic insight into the young carer population.

Examples of relevant support may include the following:

• facilitation of access to young carers support groups or co-ordination of respite
• liaison with education to promote school attendance and engagement
• provision of emotional wellbeing assessments and advice during drop-ins, home visits and other contacts
• referral to early help services or mental health support
• flagging of safeguarding concerns where caring responsibilities impair child wellbeing or safety

Young parents

Young parents - typically those under the age of 25, according to the government’s Teenage mothers and young fathers: support framework - may benefit from targeted or specialist support due to their age, life stage and potential vulnerability.

Their experiences may intersect with other factors such as:

• poverty
• housing insecurity
• mental health needs
• limited support networks

The healthy child programme provides a vital opportunity to engage young parents early, build trust and offer co-ordinated care that promotes both infant and parental wellbeing.

Health visitors, school nurses and family nurses play a central role in supporting young parents by:

• delivering relationship-based care
• enabling access to wider services
• offering guidance on topics such as infant development, emotional wellbeing and sexual health

This includes signposting or facilitating access to services such as the following:

• housing and benefits
• education, training and employment
• sexual health and contraception
• mental health and perinatal support
• early help and safeguarding services

Establishing a trusting relationship between practitioner and parent is essential. Many young parents may have experienced trauma, stigma or fractured relationships with services. A trauma-informed, strengths-based approach:

• helps young parents feel supported rather than judged
• promotes confidence in their caregiving role

Relational working, grounded in empathy, consistency and respect, creates the conditions for engagement and enables practitioners to offer guidance, identify needs and co-create solutions.

Practitioners should also be mindful of the impact of child poverty and use healthy child programme health and development reviews, health needs assessments, visits and contacts to help families access financial support, benefits advice and other relevant services. This aligns with the wider role of health visiting in mitigating the effects of poverty and promoting equity in early childhood.

Examples of relevant support may include:

• help to navigate infant feeding and sleep routines
• emotional wellbeing support, including screening for perinatal mental health needs
• facilitation of peer support networks to reduce social isolation
• empowerment to re-engage with education, training or employment
• advice on safe and appropriate family planning, including spacing of pregnancies
• support to access housing, benefits or safeguarding services where appropriate

Annex B: references

Part 1: principles of delivery

1. Knapman J and Morrison T. Making the most of supervision in health and social care: a self-development manual for supervisees. 1998. Pavilion Publishing and Media Ltd.

Part 2: health visiting (ages 0 to 5)

2. Woodman J, Simon A, Hauari H and Gilbert R. A scoping review of ‘think-family’ approaches in healthcare settings. Journal of Public Health 2019: volume 42, issue 1, pages 21 to 37.

3. Jenner B, Jenner W, Chattopadhyay R and Bhagra C. Maternal cardiac disease in pregnancy. Obstetrics, Gynaecology and Reproductive Medicine 2025: volume 35, issue 4, pages 101 to 110.

4. Sacker A and Kelly YJ. Ethnic differences in growth in early childhood: an investigation of two potential mechanisms. European Journal of Public Health 2011: volume 22, issue 2, pages 197 to 203.