Provision of healthcare support services in the period between conception and age two

Aaron Kulakiewicz; Manjit Gheera; Philip Loft

The Department of Health and Social Care in July 2020 commissioned a review into improving health outcomes in babies and young people, led by Andrea Leadsom MP, the Government’s Early Years Health Advisor. The review intends to look at reducing inequalities in young children from birth to age 2-and-a-half. An associated call for evidence on early years healthy development closed on 23 October. Building on the previous conclusions of the Inter-Ministerial Group on Early Years Family Support, debated in the House of Commons in July 2019, an initial report is expected to be submitted in January 2021.

The following provides brief background and associated UK Parliament material.

Library Material

Improved early years interventions, House of Lords Library, 13 February 2020

Early Intervention, House of Commons briefing paper, CBP 7647, 11 July 2019

Reports and resources

Royal College of Paediatrics and Child Health (RCPCH), The impact of COVID-19 on child health services, May 2020

Public Health England (PHE), Child Health Profiles 2020 (various reports and resources on child health and wellbeing for each local authority in England), March 2020

RCPCH, State of child health in the UK, March 2020

Health Foundation, Health equity in England: The Marmot review 10 years on, February 2020

Cabinet Office and Department of Health and Social Care (DHSC), Advancing our health: Prevention in the 2020s- consultation document, 22 July 2019

PHE, Healthy beginnings: applying all our health, 17 June 2019

DHSC and PHE, Early years high impact area 1: Transition to parenthood. Health visitors leading the Healthy child programme, November 2018

PHE, Health matters: giving every child the best start in life, 12 May 2016

Andrea Leadsom, Frank Field, Paul Burstow and Caroline Lucas MPs, 1,001 critical days: The importance of the conception to age two period, 16 June 2014

UK Parliament Material

Committee reports

Health and Social Care Committee, First 1,000 days of life, HC 1496, February 2019, and Government response, CP 112, June 2019

Science and Technology Committee, Evidence-based early years intervention, HC 506, November 2018, and Government response, HC 1898, January 2019

Parliamentary Questions

Mental Health Services: Fathers

01 Dec 2020 | 117967

Asked by: Jeremy Hunt

To ask the Secretary of State for Health and Social Care, what steps he is taking to improve mental health services for new fathers experiencing mental health difficulties during the perinatal period.

Answering member: Ms Nadine Dorries | Department: Department of Health and Social Care (DHSC)

The NHS Long Term Plan commits the National Health Service to expanding access to evidence-based psychological therapies within specialist perinatal mental health services so that they also include parent-infant, couple, co-parenting and family interventions.

Fathers and partners of women accessing specialist perinatal mental health services and maternity outreach clinics will be offered evidence-based assessments for their mental health and signposting to support as required. This will help the five to 10% of fathers who experience mental health difficulties during the perinatal period and increase access to evidence-based psychological support and therapy, including digital options, in maternity settings.

Children: Coronavirus

18 Nov 2020 | 112121

Asked by: Fleur Anderson

To ask the Secretary of State for Health and Social Care, what steps he is taking to support parents to mitigate the detrimental effects of covid-19 lockdown on the social development of (a) new born babies and (b) toddlers.

Answering member: Jo Churchill | Department: DHSC

Community health services have continued to provide support during the pandemic with greater use of digital and remote technologies providing support and prioritising higher needs families. Health visitors, as the lead for the Healthy Child Programme, and maternity settings will continue to be key contacts between the health system and families. NHS England and NHS Improvement’s community health services prioritisation/restoration document and standard operating procedure make clear that these services will continue to perform vital functions, virtually or face to face if there is a clinical or safeguarding concern.

The Early Years Health Adviser (Rt hon. Andrea Leadsom MP) is carrying out a review focusing on the period from birth to age two and a half. The review will look at the lessons learned from COVID-19, including minimising the risks from the pandemic to very young children.

Maternity Services

09 Oct 2020 | 97643

Asked by: Rachael Maskell

To ask the Secretary of State for Health and Social Care, what recent steps he has taken to ensure that a woman can be accompanied to (a) maternity appointments, (b) antenatal classes and (c) the birth of their child.

Answering member: Ms Nadine Dorries | Department: DHSC

Throughout the COVID-19 pandemic, women have been able to have one birth partner of their choice with them during labour and childbirth as long as their birth partner is well and does not have COVID-19 symptoms. The National Health Service is making arrangements to ensure that women are supported and cared for safely through pregnancy, birth and the period afterwards during this pandemic.

A new ‘Framework to assist NHS trusts to reintroduce access for partners, visitors and other supporters of pregnant women in English maternity services’ was published on 8 September 2020.

Pregnancy: Mental Health Services

06 Oct 2020 | 94485

Asked by: Vicky Foxcroft

To ask the Secretary of State for Health and Social Care, what progress he has made on the NHS Long Term Plan commitment to provide an additional 24,000 women with access to specialist perinatal mental health support.

Answering member: Ms Nadine Dorries | Department: DHSC

The NHS Long Term Plan commits to increasing access to evidence-based care for women experiencing moderate, severe and complex mental health issues. This will benefit an additional 24,000 women per year by 2023/24, in addition to the extra 30,000 women getting specialist help by 2020/21.

NHS England continues to expand capacity of inpatient mother and baby units, which support women with serious mental health issues, keeping them together with their babies.

From 2020/21 there will be a requirement for general practitioners to offer a six-eight week maternal postnatal health check for new mothers as an additional appointment to that for the baby. This should include a review of the mother’s mental health and wellbeing, in line with the National Institute for Health and Care Excellence’s guidance. Five years ago, 40% of the country had no access to specialist perinatal mental health care. Now, there is full geographical coverage for the first time, with specialist community perinatal mental health services in every one of the 44 local National Health Service areas.

Mothers: Coronavirus

25 Sep 2020 | 91783

Asked by: Sarah Olney

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to support the (a) mental and (b) physical health of new mothers during covid-19 restrictions on the number of people allowed to meet in a group from 14 September 2020.

Answering member: Ms Nadine Dorries | Department: DHSC

Health visitors as leaders of the Healthy Child Programme work closely with children and families and are well placed to address issues relating to mental and physical health. Throughout the COVID-19 pandemic, Health visiting services remained in contact with families either through face to face visits (with personal protective equipment) where clinically indicated, or virtually. Priority contacts included vulnerable families, providing support to perinatal mental health and physical health and wellbeing of mother and baby. Other key priority contacts were the antenatal and new baby scheduled contacts.

Public Health England worked with NHS England on guidance to reinstate the six to eight weeks contact and prioritised caseload contacts at the earliest opportunity. This can be viewed at the following link:

https://www.england.nhs.uk/coronavirus/publication/covid-19-prioritisation-within-community-health-services-with-annex_19-march-2020/

Support for parents is also available through Start4Life and the Information Service for Parents at the following link:

https://www.nhs.uk/start4life/pregnancy/

Support for professionals can be found through the Early Years High Impact Areas at the following link:

https://www.gov.uk/government/publications/commissioning-of-public-health-services-for-children

Health Visitors: Coronavirus

25 Jun 2020 | 58040

Asked by: Catherine West

To ask the Secretary of State for Health and Social Care, whether he plans to make an assessment of the effect of the redeployment of health visitors on the wellbeing of babies and families during the covid-19 outbreak.

Answering member: Jo Churchill | Department: DHSC

With the onset of COVID-19 some public health nurses were redeployed into hospitals where their expertise was most needed to care for acutely ill patients. It is important that these nurses return to help mitigate the negative impacts of the pandemic on families with young children.

The ‘Restoration of community health services for children and young people: second phase of NHS response’ is available at the following link:

https://www.england.nhs.uk/coronavirus/publication/covid-19-prioritisation-within-community-health-services-with-annex_19-march-2020/

Public Health England will also work with local authority commissioners and service providers to support the return of health visiting teams.

Infant Mental Health Awareness

23 Jun 2020 | 677 c1153

Asked by: Tim Loughton

I am grateful to the Secretary of State for that short answer. We have heard much about the impact of lockdown on school-age children away from school, but little on the impact on babies and new parents facing particular challenges on their emotional wellbeing. Has the Secretary of State or the Minister, if she has got her voice back, seen the research published during Infant Mental Health Awareness Week by the First 1001 Days Movement last week, suggesting that three quarters of parents with children under two are feeling the detrimental impact of the lockdown, particularly BAME parents? What are the Government doing to put this crucial cohort on the radar and provide support before they grow up and take the problems to school and beyond?

Answering member: Matt Hancock | Department: DHSC

My hon. Friend is absolutely right on this. I applaud the work of the First 1001 Days Movement. It is incredibly important. I strongly support the work that it has done to highlight the importance of the early days of life and the time before the birth of children. I have seen that report. I have discussed it with the Minister and we are working very hard to put that into effect.

Maternity Services: Coronavirus

17 Jun 2020 | 59268

Asked by: Olivia Blake

To ask the Secretary of State for Health and Social Care, what post-natal care procedures he has put in place for people who gave birth during the covid-19 lockdown; and what assessment he has made of the effect of the covid-19 outbreak on the provision of post-natal care.

Answering member: Ms Nadine Dorries | Department: DHSC

During the COVID-19 pandemic, maternity services have been facing significant staff shortages with many staff either ill, shielded or self-isolating.

The National Health Service is making arrangements to ensure that women are supported and cared for safely through pregnancy, birth and the period afterwards during this pandemic when there will be extra pressures on healthcare services.

Community health services should continue to provide support during the current pandemic, supported by greater use of digital and remote technologies, and priority given to families in greatest need or who are vulnerable. Antenatal contact and new baby visits should continue.

NHS mental health services have remained open for business throughout this time, including delivering support digitally and over the phone where possible.