Quality standard
Quality statement 3: Healthy Start scheme
Quality statement 3: Healthy Start scheme
Quality statement
Pregnant women and the parents and carers of children under 4 years who may be eligible for the Healthy Start scheme are given information and support to apply.
Rationale
Pregnant women and the parents and carers of children under 4 years who are eligible for the Healthy Start scheme can apply to receive a prepaid card, topped up every 4 weeks, for healthy food, milk and vitamins. It aims to improve health and access to a healthy diet for families on low incomes across the UK.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that pregnant women and the parents and carers of children under 4 years who may be eligible for the Healthy Start scheme receive information and support to apply.
Data source: Local data collection.
Process
a) Proportion of pregnant women who may be eligible for the Healthy Start scheme who receive information and support to apply when they attend their antenatal booking appointment.
Numerator – the number in the denominator who receive information and support to apply.
Denominator – the number of pregnant women who may be eligible for the Healthy Start scheme attending their antenatal booking appointment.
Data source: Local data collection. The Maternity Services Data Set collects data on booking appointments.
b) Proportion of 6‑ to 8‑week health visitor appointments where parents and carers who may be eligible for the Healthy Start scheme receive information and support to apply.
Numerator – the number in the denominator where information and support to apply is given.
Denominator – the number of 6‑ to 8‑week health visitor appointments where parents and carers may be eligible for the Healthy Start scheme.
Data source: Local data collection.
c) Proportion of 8‑ to 12‑month development reviews where parents and carers who may be eligible for the Healthy Start scheme receive information and support to apply.
Numerator – the number in the denominator where information and support to apply is given.
Denominator – the number of 8‑ to 12‑month developmental reviews where parents and carers may be eligible for the Healthy Start scheme.
Data source: Local data collection.
d) Proportion of 2‑ to 2‑and‑a‑half‑year health reviews where parents and carers who may be eligible for the Healthy Start scheme receive information and support to apply.
Numerator – the number in the denominator where information and support to apply is given.
Denominator – the number of 2‑ to 2-and-a-half-year health reviews where parents and carers may be eligible for the Healthy Start scheme.
Data source: Local data collection.
e) Proportion of vaccination appointments at age 3 years 5 months to 4 years where parents and carers who may be eligible for the Healthy Start scheme receive information and support to apply.
Numerator – the number in the denominator where information and support to apply is given.
Denominator – the number of vaccination appointments at age 3 years 5 months to 4 years where parents and carers may be eligible for the Healthy Start scheme.
Data source: Local data collection.
What the quality statement means for different audiences
Service providers (such as primary, secondary, community care and public health providers) ensure that systems are in place to ensure that pregnant women and the parents and carers of children under 4 years who may be eligible are given information about the Healthy Start scheme.
Healthcare professionals ensure that they give information to pregnant women and the parents and carers of children under 4 years who may be eligible about the Healthy Start scheme, and provide them with support to apply, such as helping them to complete the online application.
Commissioners (clinical commissioning groups or integrated care systems, NHS England and local authorities) ensure that providers give information to pregnant women and the parents and carers of children under 4 years who may be eligible about the Healthy Start scheme and provide them with support to apply.
Pregnant women and the parents and carers of children under 4 years who may be eligible for the Healthy Start scheme are given information about it and help to apply (including help to complete the online application). The Healthy Start scheme provides a free prepaid card, automatically topped up every 4 weeks, to buy healthy food, milk and vitamins to people on low incomes.
Source guidance
Maternal and child nutrition. NICE guideline PH11 (2008, updated 2014), recommendation 4 (key priority for implementation)
Definitions of terms used in this quality statement
Pregnant women and the parents and carers who may be eligible
Pregnant women and the parents and carers of children under 4 years of age, who are in receipt of certain benefits, may be eligible for the Healthy Start scheme. All pregnant women under the age of 18 years are eligible. Please see the Government's Healthy Start webpage for up‑to‑date information on eligibility criteria. [Expert opinion]
Healthy Start scheme
The Healthy Start scheme provides a prepaid card, automatically topped up every 4 weeks, to buy healthy food, milk and vitamins to pregnant women, new mothers and parents and carers with young children (under 4 years) who are on low incomes. It aims to improve health and access to a healthy diet for families on low incomes across the UK.
The card can be used to buy:
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plain liquid cow's milk
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fresh, frozen, and tinned fruit and vegetables
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fresh, dried, and tinned pulses
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infant formula milk based on cow's milk.
It can also be used to collect:
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Healthy Start vitamins – these support you during pregnancy and breastfeeding
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vitamin drops for babies and young children – these are suitable from birth to 4 years old.
[Adapted from the Government's Healthy Start webpage]
Healthy Start maternal vitamin supplements
The Healthy Start vitamin supplement for pregnant and breastfeeding women contains folic acid to help reduce the baby's risk of neural tube defects, vitamin C to maintain healthy body tissue, and vitamin D to help iron and calcium absorption to keep bones healthy and ensure that the baby's bones and teeth grow strong.
Women who are eligible for the Healthy Start scheme receive a prepaid card, which they can use to obtain these vitamin supplements. Women who are not eligible for the Healthy Start scheme may be able to buy the supplements from community pharmacies and should ask their midwife or health visitor where to access the vitamins in their local area. [Adapted from the Government's Healthy Start webpage and expert opinion]
Healthy Start children's vitamin supplements
The Healthy Start supplement for children contains vitamins A, C and D, which help to strengthen the immune system, maintain healthy skin, and help with absorbing iron and calcium; keeping their bones and teeth healthy. [Adapted from the Government's Healthy Start webpage]
Equality and diversity considerations
The risk of vitamin D deficiency can be increased in people with darker skin, for example, people who are black or of Asian family origin, or people who wear clothing that covers their entire body, and this should be considered by their healthcare professionals.
Care and support, and the information given about it, should be both age-appropriate and culturally appropriate. It should also be accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. Pregnant women, parents and carers should have access to an interpreter or advocate if needed.
For women with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.