Sector Led Improvement review of local authority responsibilities for Health Visiting and School Nursing services

The commissioning of Health Visiting came under the responsibility of local authorities in 2015, aligning to the existing responsibility for School Nursing services. London Directors of Public Health have agreed to a thematic review of local authority responsibilities for these services as part of their Sector Led Improvement programme. There are three overarching aims to the review:

• Inform future standards for SN, HV and interfaces with other Children & Young People services.

• Aid improved public health provision for children and young people across London.

• Develop and strengthen partnership working with the Association of London Directors of Child Services (ALDCS) and support the development of a shared Children & Young People agenda.

The objectives of the review are:

• To develop a self assessment tool in collaboration with Public Health and Children Services professionals, to review HV and SN practice in London.

• To engage all (33) London boroughs in the Health Visiting & School Nursing SLI thematic review.

• To conduct a peer review process in line with the principles of SLI.

• Identify and develop areas for improvement locally and across London for CYP.

• To utilise the opportunity to strengthen collaboration between the London Directors of Public Health (DsPH) and Directors of Children’s Services (DsCS).

The hypothesis of this piece of work is that an improvement in Health Visiting & School Nursing services will lead to an improvement in health outcomes for children and young people.

Progress to date:

These services play a crucial role in giving every child the best start in life. As no self-assessment and peer review tool currently exists for Health Visiting and School Nursing services, a bespoke tool has been developed by ADPH London, working with London Councils and the Institute of Health Visiting and IPIP (Improving Performance in Practice). The tool itself was launch at the Public Health Children & Young People Network meeting in October 2019.

The Self Assessment documents:

In developing the tool, the Institute of Health Visiting and iPiP undertook a rapid evidence review, surveying and capturing the evidence and best practice that underpins all aspects of the statements included in the tool. In addition, additional documents were created to assist boroughs to deliver an effective and inclusive process locally. All the PDF documents are included below.

  1.  Briefing Document
  2. Local Workshop Presentation  
  3. Local Workshop Agenda & Objectives
  4. Self-Assessment Tool (please email Laurence Knott directly)
  5. Self-Assessment Tool (Word Template)
  6. Self-Assessment Tool (Example)
  7. Evidence Review
  8. A ‘How To Guide’, including tips for delivering the process locally


The indicative timetable for this process is as follows:

Evaluating the Impact of the SLI Review :

It should be noted that the detailed approach to peer review and evaluating the impact of the review will not be finalised until early January 2020 and that the process will generate learning available in Spring 2020 that can inform regional or national roll out or adoption.

Sharing good practice :

As the tool has been developed based on national guidelines and evidence of best practice it is recognised that it may also be of value of local authorities outside of London.

To this end ADPH London would welcome contact from any borough interesting in learning from the rolling out of the self assessment process in London. A separate guidance note has been produced which is available upon request. Please get in touch to arrange a briefing call and to obtain more information on this review:

Laurence Knott, Child Health SLI Manager

020 8489 8281