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Foreword

The Government wants all children to have the best possible start in life. Every child deserves the opportunity to achieve the good outcomes that some children may take for granted, including being healthy. In many ways children are healthier than ever before but inequalities persist from conception and continue throughout life. For children and young people living in poverty and difficult circumstances the picture is particularly worrying. It is here that nurses, midwives and health visitors can make a real difference.

This report reviews the nursing, midwifery and health visiting contribution to supporting vulnerable children and young people. It sets out the changes that are needed to improve their health and wellbeing. Arising out of the Government's Green Paper, Every Child Matters, the review outlines a clear strategy for achieving improvements in all services for children and young people.

Nurses, midwives and health visitors play a key role in children and young people's services and their contribution is highly valued. However Lord Laming's inquiry into the death of Victoria Climbié, and subsequently Every Child Matters, identified that further work was needed to strengthen the role of nurses, midwives and health visitors in caring for children and young people.

I have taken the needs and wishes of children, young people and their carers as the starting point, followed by the views of the professionals involved in their care and other stakeholder groups. While many opinions are expressed, messages about current problems and deficits in addressing the needs of vulnerable children remain constant throughout. The review shows nurses, midwives, health visitors and other stakeholders are well aware of the issues and have much that is useful to say about solutions. This review sets a strategic direction that prepares the professions for the future.

This report identifies the changes needed if nurses, midwives and health visitors are to improve the outcomes for the most vulnerable children and young people in our society. It is primarily for the professions but they work within a multiprofessional context and cannot deliver these changes alone. They will need the support of employers, workforce planners, educationalists and colleagues in other services and professions. For this reason the report includes recommendations that go beyond the individual practitioner.

I strongly encourage the professions to take account of these recommendations when developing services locally. I know change can be difficult, especially when it requires people to shed traditional practices and relationships and create new working environments. In the course of the review everyone conveyed a sense of urgency. None of us is neutral about the health and wellbeing of the nation's children. They are high on the list of everyone's priorities. Children cannot wait long for us to rise to the challenge of meeting their needs. Their future health is determined for good or ill, with every passing day.

Sarah Mullally
Chief Nursing Officer (England)
Department of Health
London, August 2004

• Download The Chief Nursing Officer's review of the nursing, midwifery and health visiting contribution to vulnerable children and young people (PDF, 2308K)