Guidance

Introduction to delivery of the healthy child programme

Published 6 February 2026

Applies to England

© Crown copyright 2026

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This publication is available at https://www.gov.uk/government/publications/delivery-of-the-healthy-child-programme/introduction-to-delivery-of-the-healthy-child-programme

About the healthy child programme

The healthy child programme is the national delivery model for public health nursing services for those aged 0 to 19 (or up to the age of 25 for care leavers and those with special educational needs and/or disabilities (SEND)) in England. The programme is led by qualified specialist community public health nurses (SCPHNs) and is structured around 2 age-based phases:

  • pregnancy and the early years (ages 0 to 5) delivered by health visiting teams
  • the school years (ages 5 to 19) delivered by school nursing teams

Each phase reflects the specific developmental priorities of that age group and draws on the professional expertise of qualified SCPHNs to ensure a continuous, preventative public health offer from pregnancy through to young adulthood.

The core principle of the healthy child programme is that all babies, children and young people - no matter where they live or their circumstances - should have the opportunity to achieve the best possible health outcomes. This is enabled through high-quality evidence-based 0 to 19 public health nursing services, which are delivered by suitably qualified and competent staff in ways that are proportionate to individual needs, culturally sensitive, and responsive to family context and lived experience. 

Delivery is collaborative, involving the following:

  • general practice teams
  • midwives
  • early years practitioners
  • housing services
  • voluntary or community organisations, particularly within integrated models like Best Start Family Hubs

Allied health professionals - such as speech and language therapists, orthoptists, occupational therapist and dieticians - support delivery of the healthy child programme by providing specialist expertise and interventions that complement the services delivered by health visitors and school nurses.

Starting in the antenatal period, the healthy child programme comprises 4 core elements:

  • screening
  • child health surveillance
  • health protection
  • health promotion

It applies the principle of proportionate universalism, offering a universal service for all with additional targeted and specialist support and interventions based on assessed levels of need.

The healthy child programme is a powerful tool for tackling health inequalities. It is delivered through 4 levels of service:

  • community
  • universal
  • targeted
  • specialist

These levels reflect the principle of proportionate universalism described in Fair Society, Healthy Lives: the Marmot Review - a strategic review of health inequalities in England post-2010 and further developed in Hall’s model of progressive universalism in child health services (as outlined in Emond’s Health for all Children).

These 4 levels of service form the foundation of the healthy child programme and are embedded within the updated Healthy child programme: high-impact area framework.  The high-impact areas:

  • help services identify population needs and align resources
  • ensure that support is tailored, equitable and responsive to local context
  • enable practitioners to focus delivery where it can have the greatest impact
  • ensure that babies, children, young people and families receive the right support at the right time

This approach provides a foundation for predicting risk and preventing problems, including:

  • the early identification of safeguarding concerns
  • timely responses to protect babies, children and young people

This refreshed delivery guidance builds on the evidence set out in the fifth edition of ‘Health for All Children’, a widely recognised reference text that underpins professional practice across the early years.

The healthy child programme is funded through the public health grant. As part of public health grant assurance, commissioners and providers are expected to monitor performance and use data to drive improvements in health outcomes. While some areas may need time to build capacity, it is important to recognise that the healthy child programme can only be as strong as the priority attached to it by local authorities in their public health grant funding allocations.

This refreshed guidance is committed to complementing the quality improvement journey that local authorities are embarking upon in partnership with the Department of Health and Social Care. 

Why we are refreshing this delivery guidance

This delivery guidance refresh has 4 aims - to:

  • replace the schedule of interventions, in response to stakeholder feedback and usage analytics. This will help ensure that the delivery guidance available to practitioners and providers is as useful as possible
  • increase the accessibility and utility of the guidance, supporting confident implementation and consistent understanding of expectations. This will help increase the efficiency with which practitioners and providers can navigate the delivery guidance
  • strengthen assurance of service delivery and alignment with national priorities, giving practitioners and providers confidence in the impact of their work
  • support quality improvement and collaboration to achieve greater consistency in the quality and equity of services offered to babies, children, young people and families across the country. This will help practitioners and providers to spread best practice and co-ordinate most effectively with other parts of the child health system

Terminology

Note: the definitions given in this section also apply to the following publications, which have been updated alongside this guidance:

Health visitors or school nurses

The terms ‘health visitors’ or ‘school nurses’ refer exclusively to holders of the SCPHN qualification.

Health visiting or school nursing teams

The terms ‘health visiting teams’ or ‘school nursing teams’ refer to the larger set of practitioners who deliver health visiting and school nursing services, which may include:

  • nursery nurses
  • early years practitioners
  • school nurse assistants
  • registered nurses
  • registered nursing associates

0 to 19 or 5 to 19 pathways

Where we refer to ages ‘0 to 19’ and ‘5 to 19’, this should be understood to mean ages ‘0 to 25’ or ages ‘5 to 25’ when the person receiving support:

  • is disabled
  • lives with special educational needs (SEN)
  • has experience of leaving the care system

For this point to apply, extended public health nursing services (up to the age of 25) should be appropriate in the circumstances of the specific person.

Special educational needs and disabilities (SEND)

‘SEND’ is the term used where the same clinical approach, support or considerations apply to both those who are disabled and those with SEN.

Family

‘Family’ refers to any configuration of adults caring for children, including but not limited to the following:

  • single parents
  • same sex couples
  • kinship carers
  • other non-traditional structures

All references to ‘parents’ or ‘caregivers’ should be understood inclusively.

Wider healthy child programme publications

The ‘Delivery of the healthy child programme’ guidance and the ‘Healthy child programme: commissioning public health nursing services’ guidance are related, but distinct.

Commissioners and provider organisations should read both publications as well as the updated ‘Healthy child programme: high-impact area framework’. 

This delivery guidance outlines the expected delivery expectations for public health nursing teams for ages 0 to 19 and their provider organisations.

The commissioning guidance sets standards for commissioners to establish, monitor and assure the quality of public health nursing services for ages 0 to 19 delivered by provider organisations.

The high-impact area framework complements this by translating principles into nationally recognised, actionable priorities across ages 0 to 19.

All practitioners, providers and commissioners must comply with relevant legal frameworks and organisational policies on information governance, including:

  • data protection legislation
  • confidentiality requirements
  • agreed data-sharing protocols

Data should only be shared in line with statutory duties, safeguarding responsibilities, and formal data sharing agreements to ensure the privacy and security of individuals and families.

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