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C U T T I N G T H T H E N O I S E R O U G H
How to ensure the right voices are heard in the new battle against dangerous parenting advice online
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REFLECTION
CONFERENCE
Sponsorship and Exhibition opportunities, please reach out to:
A look at successful integrated approaches to safeguarding and infant safety in the Derbyshire health visiting service
36 ALCOHOL – IT ’S A FAMILY ISSUE
Examining the need for health visitors to receive better training in assessing parental alcohol misuse and the dangers for children when not addressed
40 BACK TO BASICS
Psoriasis: latest updates on this much misunderstood condition, plus how to help young people
THE EVIDENCE
42 RESEARCH DIGEST
A round-up of research news from across the globe, including on children’s sleep, refugee wellbeing and strength training
PROFESSIONAL PAUSE
44 SAVING GENERATIONS
Helen Hyndman, of The Eve Appeal, discusses the positive updates on cervical cancer prevention and yet why there is still much work to be done
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WELCOME
from your editor, Aviva
With summer well under way, parents’ thoughts will soon be turning to the new school term ahead – and there is much to keep your clients abreast of. The new, time-limited MenB vaccine for young people at highest risk of catching meningococcal B disease is now being rolled out across the UK (see page 10).
The government has announced a social media ban for under-16s (with restrictions for under-18s), expected to come into force in spring 2027, and the UK’s children’s commissioners give their verdict (page 8). And a new information battle is emerging as parents turn to social media influencers and self-styled ‘experts’ for advice (page 16). While this highlights your professional value more than ever, how can you (and, vitally, the government) ensure your voices are heard, especially with workforce shortages?
Taking a broader look, a new report shows we are living fewer years in good health, with certain groups hit harder than others (page 12). As always, an early focus is key, but there is much still to be done to tackle ill health. How can CPs help?
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Contributors this issue explore topics including integrated safeguarding practices and better training for HVs on alcohol in the home (pages 33 and 36).
Discover your keynote speakers at the upcoming Unite-CPHVA conference and a call for papers/awards reminder (from page 28). Finally, reacquaint yourself with your CPHVA Executive and see how they can support you (page 24).
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Early bird ENDS SOON
Your chance to secure tickets for the UniteCPHVA Annual Professional Conference at a discount is coming to an end shortly! Here are the details you need to know...
Are you ready to attend the professional highlight of the year? Celebrating 130 years of health visiting: honouring the past and shaping the future, is the theme of this year’s conference. As before, the event will be held in Bristol, in a wonderful space in which to network and learn. There will be an extensive programme of leading speakers to advance your knowledge, skills and practice, and it will count towards your CPD.
There will also be a celebratory awards evening to recognise the outstanding work of CPs who go above and beyond in their work (see below, right). Check out the details, then click on Book here (circle – above, right) to make sure you secure your place – but hurry, so you can benefit from the early-bird offer!
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THE FACTS
UNITE-CPHVA ANNUAL PROFESSIONAL CONFERENCE
Dates: 4 and 5 November 2026
Venue: Novotel Bristol Centre, Victoria Street, Redcliffe, Bristol BS1 6HY
Cost: Varies (see table below, left)
AWARDS CELEBRATION
Date: 4 November 2026 at 7:30pm
Cost: £20 per person (additional to conference ticket)
AGM (members only)
Date: 3 November 2026 at 3pm
BOOK ACCOMMODATION
Your keynotes
Conference speakers Discover more about some of the leading professionals presenting at conference, including the two keynote speakers. See page 28
The call for papers and the opportunity to nominate for an award are both ending soon. See page 30 for details
News in numbers
135,000+
children and young people in Wales are estimated to have a diagnosable mental health condition
Around 25-30% of parentinfant relationships are likely to benefit from support in the first 1000 days, yet 2/3 are unlikely to receive that support before the age of 2
An estimated 1 in 4 girls and 1 in 2 trans or gender-questioning secondary school students experience low mental wellbeing
60%
of children aged 5-16 in England should be travelling actively to school by 2035
The government’s new national cycling and walking investment strategy also aims for people to walk, wheel or cycle for 55% of short trips in towns and cities
£4.5bn will be invested over the next 5 years into 5000 new routes and 10,000 safer crossings
36.1%
of 8 to 18-year-olds say they enjoy reading in their spare time, compared with 32.7% in 2025 (a 20-year low). It’s the 1st rise in 5 years
20.3% now read daily (vs 18.7% in 2025) = 1st rise since 2023
49% of paediatricians surveyed said they often or very often discuss online activity and social media use with children and young people during consultations
Most common concerns are self-harm and suicidality (49% of responses); bullying and peer conflict (45%); and mental health presentations (39%)
For references
Public health
UK
A look at recent programmes or campaigns launched, and reports published.
SOCIAL MEDIA TO BE BANNED FOR CHILDREN AGED UNDER 16
Guidance: Fact sheet: New rules to protect children online, Department for Science, Innovation and Technology*
What are the main points?
Young people aged under 16 will be barred from platforms including Snapchat, TikTok, YouTube, Instagram, Facebook and X. The ban is modelled on one already introduced in Australia.
Additional UK blocks will restrict functions, including livestreaming and stranger communication online, for under-18s
The protections, which were backed by 9 in 10 parents, are expected to come into force in spring 2027.
The government is also exploring overnight curfews and ‘breaks in infinite scrolling’ for all under-18s.
EXPERT THOUGHT from the UK’s children’s commissioners:
Dame Rachel de Souza, England: ‘This announcement is a positive response to what children have been telling me. However, these measures will only be as strong as their enforcement.’
Chris Quinn, Northern Ireland: ‘A blanket ban allows the root causes of harm to persist. Such measures could push under-16s into darker and more dangerous corners of the internet.’
Nicola Killean, Scotland: ‘Social media can expose children to serious risk, but it can also play an important role by supporting communication, self-expression, access to information, play and connection with support networks.’
Rocio Cifuentes, Wales: ‘The most important question is not simply whether children should be allowed on social media, but whether social media is managed in a way that is safe for children in the first place.’
UK
THE MOST SIGNIFICANT HEALTH SECURITY RISKS OVER NEXT FIVE YEARS
Report: Health security risk assessment: 2025 edition, UK Health Security Agency (UKHSA)
What are the main threats?
Respiratory infections with pandemic potential, such as influenza and novel coronavirus, represent the greatest risks to UK health security because of their high potential impact and assessed likelihood of occurring.
Environmental hazards (for example, extreme heat and extreme cold) can cause significant health and socioeconomic disruption.
Combined seasonal hazards (for example, influenza, RSV, norovirus) pose challenges for healthcare capacity and health system coordination.
Emerging infections and antimicrobial resistance are persistent and potentially increasing threats.
EXPERT THOUGHT
PROFESSOR STEVEN RILEY
UKHSA chief data officer
‘As we continue to experience risks from a wide range of complex health security threats that disproportionately impact more vulnerable groups in our society, it is vital we continue to enhance our preparedness measures and resilience planning.’
England
TRUE NUMBER OF WOMEN SLEEPING ROUGH ABSENT FROM OFFICIAL FIGURES
Report: The women’s rough sleeping census 2025: missing women, Single Homeless Project and Solace, Crisis, Change Grow Live
What are the main points?
As many as 10 times more women sleep rough in some parts of England than official government figures suggest.
65% of women surveyed said they had slept in places excluded from official homelessness counts, including buses, A&E waiting rooms and public transport, or stay awake through the night to avoid assault.
Across six local authorities, official counts recorded zero women sleeping rough, while the census identified 162 women sleeping rough in those same areas.
Now in its fourth year, the census used a gender-informed methodology across 101 local authorities for a more accurate picture. The findings also showed that women are not being helped by the very services designed to help them.
The report’s five key asks include: updating the official definition of rough sleeping (current counts are built around visible, male ‘bedding down’ patterns), rolling out the census nationally, and making services safer for women.
EXPERT THOUGHT
PAULA BARKER MP
Co-chair of the APPG for Ending Homelessness
‘Women are not absent from our streets; they are absent from the data… We cannot end homelessness while continuing to ignore the women hiding in plain sight.’
England
NEW SUNBED AGE-CHECK LAWS TO PROTECT YOUNG PEOPLE
Consultation: Strengthening the regulation of commercial sunbeds in England, Department of Health and Social Care
What is the main advice?
Children and young people will be stopped from using sunbeds through mandatory ID checks under new laws being consulted on by the government.
These new proposals would require staff to be present and to check a customer’s ID before they can use a sunbed.
The tougher rules also include the need for health warnings to be displayed clearly, and the banning of dangerous claims that sunbeds help with weight loss or prevent sunburn.
Under-18s are currently barred from using sunbeds, but teenagers can get around this by using contactless systems without any checks by staff.
The 12-week consultation on introducing the new regulations is open until 14 August 2026.
EXPERT THOUGHT
Professor Peter Johnson, national clinical director for cancer at NHS England, said: ‘Sunbeds… are a cancer risk and under-18s should not be using them at all. These proposals would help prevent unscrupulous operators from providing sunbeds to children and make sure that adults understand the risks before they use one.’
Professional update
UK
VACCINE UPDATE: ROLLOUT OF ONE-OFF
MenB VACCINE UNDER WAY
The new, time-limited MenB vaccine for young people at highest risk of catching meningococcal B disease is now being rolled out across the UK. Students will need two doses of the vaccine at least four weeks apart for maximum protection. Those eligible include:
Young people currently in school Year 13 in England and Wales (born between 1 September 2007 and 31 August 2008); in year S6 in Scotland (born between 1 March 2008 and 28 February 2009); and in Year 14 in Northern Ireland (born between 2 July 2007 and 1 July 2008)
All undergraduate freshers who turn 25 after 31 December 2026 attending university for the first time in autumn 2026
Anyone who turns 25 after 31 December 2026 and who will be living in further education accommodation or halls of residence for the first time in autumn 2026.
This includes international students who may not arrive in the UK until September.
Data on invasive meningococcal disease has shown that, after infancy, the highest number of cases are seen in 18- to 19-yearolds. Students in their first year of university have a risk about seven times higher than young people of a similar age who do not go to university. A full JCVI review is also under way.
England
Deputy chief medical officer Dr Thomas Waite said: ‘Meningococcal B disease is a rare but very serious infection, which is fatal in up to 10% of cases and can cause life-long injury. There has been an increase in clusters of the disease this year, so this one-off programme is designed to provide direct protection to those at highest immediate risk.’
NEW PLAN INCLUDES AFFORDABLE HOMES FOR HEALTHCARE WORKERS
The government has announced a 10-year capital plan to modernise NHS buildings, bring more care closer to patients’ homes and upgrade GP surgeries.
The plan details how unused NHS land can be turned into affordable homes for healthcare workers, with nurses, healthcare assistants and other NHS staff able to rent homes close to the hospitals and communities they serve, the government says.
The policy paper also confirms that the government will deliver 250 ‘Neighbourhood health centres’, which are designed to bring together GPs, diagnostic tests, community, and other services under one roof.
The long-term plan is backed by a ‘record capital budget for health’, reveals the government, rising to £15bn in 2029/30.
The Health Foundation’s deputy director of policy, Tim Gardner, described the report as ‘a long overdue step towards providing the NHS with a clear national strategy to support long-term transformation and prioritise patient care’.
But he also had these words of warning: ‘The government must ensure that capital funding is allocated transparently and targeted where need is greatest. That means prioritising safety-critical repairs, modernising digital infrastructure, and investing beyond hospitals into primary and community care and the workforce needed to deliver transformed services.’
England HEALTH AND SOCIAL CARE REGULATORS COMMIT TO TACKLING RACISM
The NMC, Care Quality Commission and General Medical Council are among the health and social care regulators that have committed and signed up to shared anti-racism principles.
The aim of the nine new principles is to help tackle longstanding racism experienced by health and social care staff. The nine headline commitments of Advancing workforce race equity in health and social care: shared principles across regulators, are:
1 Naming racism
2 Valuing lived experience
3 Showing leadership
4 Collaborative working
5 Data and insight development
6 Empowering approaches
7 Using our powers effectively
8 Influencing progress together
9 Transparency and accountability
These agreed principles build on the independent NHS Race and Health Observatory’s (NHRO) seven principles of anti-racism, and commitments made following a roundtable held last year.
The key insights from that roundtable have also been published in a separate NHRO report. Participants cited the need to raise the profile of regulators when addressing all forms of racism and discrimination, including Islamophobia and antisemitism.
Chief executive of the NHRO, Professor Habib Naqvi, welcomed the development. ‘This announcement marks a landmark step towards regulating for workforce race equality across our healthcare system,’ he said. ‘True equality requires more than words, it requires intentional action.
‘We look forward to working with the regulatory bodies as they progress on this journey.’
Scotland
STABILISATIONS AND IMPROVEMENTS IN UPTAKE FOR SOME VACCINATIONS
Childhood immunisations by 12 months have stabilised, and there have been improvements by aged five, Public Health Scotland’s (PHS’s) annual vaccination and immunisation report reveals.
Other positive examples included a significantly high number of winter vaccines given in a short period, with more than 1.8 million doses of the influenza vaccine administered throughout the programme. Uptake was highest among older care home residents (82.6%) and adults over 75 (81.0%), the report shows.
There were also increases in uptake among healthcare workers compared with winter 2024/25.
However, across Scotland, the report reveals persistent inequality in vaccine uptake linked to deprivation, ethnicity, sex and geography. Overall, vaccine uptake remains lower in the most deprived
areas – which shows the need to improve access, confidence and meaningful engagement, the report states.
Several changes made to immunisation programmes in 2025 were also highlighted, including updates to the childhood schedule and extended eligibility for RSV.
Dr Sam Ghebrehewet, PHS head of vaccination and immunisation, said: ‘Protecting the population of Scotland from vaccine-preventable diseases will continue to depend on a resilient, equitable and responsive vaccination and immunisation system, underpinned by strong partnership and shared commitment.’
He added that the report ‘celebrates the breadth of the work at local and national levels across Scotland, and provides insight into areas where further focus and sustained effort are required.’
The amount of time we can expect to live in good health has fallen rapidly. Journalist Kaye McIntosh explores the reasons why and the importance of strong foundations.
THE HEALTH DECLINE
Healthy life expectancy (HLE) has dropped dramatically in the UK, The Health Foundation has revealed (Mooney, Alarilla and Cavallaro, 2026). From 2012-14 to 2022-25, the amount of time we can expect to live before we start to battle serious health conditions fell by two years, to just more than 60 years for women and men – well below the retirement age of 66.
The findings are stark. Researchers at The Health Foundation found the UK had the second steepest decline among 21 wealthy countries. Only the United States now has a lower rating.
Deprivation and poverty reduced HLE by up to 20 years. The report called it ‘a watershed moment’.
Joint author Francesca Cavallaro says: ‘To see that the UK had the second largest decrease in HLE, and we’re now 20th out of 21 countries, should be a wake-up call for policymakers.’
The findings align with other evidence that highlights a decline in workingage health, says the report, including worsening mortality rates among 25to 49-year-olds compared with other countries, and a rise in the number of 16- to 24-year-olds not in education, employment or training (NEETs) because of work-limiting conditions.
Many argue this is driven by young people’s mental health, but Francesca says: ‘The decline in people reporting to be in good health is not just among young people; it’s throughout the working age.
‘It’s not just mental health. Previous work showed that there’s been a rise in chronic physical conditions, including diabetes, chronic pain and heart conditions.’
POVERTY LIMITS LIVES
HLE is strongly associated with deprivation, the report found. In England, HLE is highest in Richmond upon Thames, one of the least deprived areas in the country, at nearly 70 for males and just over for females in 2022–24. It is lowest in Blackpool for men (51) and Hartlepool for women (51), both among the most deprived. In these places, people on average experience the onset of ill health
‘PEOPLE LIVING IN MORE DEPRIVED AREAS ARE MORE LIKELY TO DEVELOP SERIOUS ILLNESS... AND EXPERIENCE FEWER HEALTHY YEARS’
almost 15 years before state pension age (Mooney et al, 2026).
Dr Chris Packham, population health special adviser for the Royal College of Physicians (RCP) says: ‘The finding reflects what RCP members have told us based on their own experience. Last year, 72% of UK physicians responding to our snapshot survey reported seeing more patients in the previous three months with illnesses caused or worsened by wider social determinants of health [RCP, 2025].’
Greg Fell, president of the Association of Directors of Public Health, agrees: ‘We know that health outcomes are shaped by much more than our individual choices. Instead, the environments where we live, grow, work and play, alongside the commercial influences we face every day, are continually shaping our decisions and health outcomes.’
Dr Packham adds: ‘People living in more deprived areas are more likely to develop serious illness, receive poorer care and, as a result, experience earlier decline, greater disability and fewer healthy years.’
Women are more severely affected than men, the report found. Female HLE fell more rapidly than for men, raising concerns about the worsening trend of women’s health (see page 14).
EARLY FOCUS IS KEY
Dr Packham highlights: ‘Children and adolescents are particularly vulnerable to the causes of long-term ill health because of the development of key protective systems [such as the immune system].
‘Children are significantly affected by the health inequality caused by social determinants of health more broadly.
Children from deprived groups in England are more than twice as likely to be living with obesity than their more affluent counterparts, and rates of childhood obesity are increasing significantly faster in communities with high deprivation compared with low deprivation.’
So why has the UK been so hard hit? The experts point towards health inequalities. The gap in life expectancy between the most and least deprived areas is wider than in most comparable European countries, such as the Netherlands (Cavallaro et al, 2024). Health inequalities have widened. People living in more deprived areas are more likely to wait longer for treatment, for instance.
Underinvestment in public services has played a key part. Francesca adds: ‘We know that the budgets for local authorities have been cut. We know that
Healthy life expectancy – a good measure?
There has been some recent criticism of the HLE measure, because it combines hard data – mortality – with self-reported health status. But Andrew Mooney, one of the report authors and principal data analyst at the Health Foundation, says: ‘While the latter may be shaped by expectations and lived experience, it [HLE] remains a reliable public health measure and is broadly linked to both morbidity and mortality.’
The report describes HLE as ‘a key measure of the population’s health, providing a more comprehensive picture of the UK’s health than life expectancy alone’.
The HLE report at a glance
• Over the decade 2012–14 to 2022–24, healthy life expectancy (HLE) in the UK fell by about 2 years, to 60.7 years for men and 60.9 years for women
• Of 21 high-income countries, the UK is 1 of only 5 that saw HLE fall between 2011 and 2021, and had the 2nd steepest decline
• Most local areas in Great Britain saw a decline in HLE. It has fallen below the state pension age of 66 years in more than 90% of areas. In more than 1 in 10 local areas, HLE is below 55 years
• Deep inequalities in healthy life expectancy between affluent and deprived areas have widened. The gap between the most and least deprived deciles in England is now 19 years for men and 20 for women
• In Wales, female HLE fell by 3.7 years over the decade, leaving Welsh women with lower HLE than men and the lowest HLE in the UK. For men, Scotland saw the largest decline (down 2.5 years) and now has the lowest male HLE, just below Wales.
‘ONLY BY MAKING SURE WE CREATE THE CONDITIONS WE NEED TO LIVE IN GOOD HEALTH, THROUGHOUT EACH STAGE OF OUR LIVES, CAN WE HOPE TO IMPROVE THE STATISTICS’
Mooney, Alarilla and Cavallaro, 2026
health visitors and children’s centres play a big role in not only influencing health outcomes but also in reducing inequalities. If you want to tackle poor health and inequalities, early childhood is a really important place to start.’
Reductions in local government funding led to cuts to frontline services, including preventative services funded through public health budgets, she adds.
THE CP ROLE
There’s a mountain to climb to turn this trend around, but community practitioners have an important part to play.
CPHVA Executive chair Janet Taylor says: ‘HVs and school nurses can help people to make healthy choices and be considerate of their budget. There are community programmes where people can go.
‘Signposting to the right places or showing what resources are available within the community, such as healthy eating programmes or cookery classes’ is important, she adds.
‘It starts with breastfeeding, which can lay down good pathways for brain development.’ In the long term, these babies are less likely to be overweight, too, Janet says.
‘There are various programmes across health visiting services where we can refer our clients to have some education and support, because sometimes, if you manage your budget accordingly, you can buy better choices. If you get in early, you can get good patterns in place.’
TACKLING ILL HEALTH
Turning this around ‘requires a new approach that looks beyond the NHS to focus on the drivers of poor health’, states the Health Foundation report (Mooney
‘HVs AND SCHOOL NURSES CAN HELP PEOPLE TO MAKE HEALTHY CHOICES’
et al, 2026). It continues: ‘Successive governments – including Labour and its much vaunted, but largely abandoned, “health mission” – have understood the importance of targeting improvements in healthy life expectancy, but have failed to take the necessary action.
‘These findings should mark a watershed moment that sparks a new drive to rebuild the nation’s health, putting improving health on a par with delivering economic growth as a core objective of government policy.’
A spokesperson for the Department of Health and Social Care described the figures over the past decade as ‘a disgrace’ and added: ‘We know there is much more to do, but by building an NHS fit for the future, we will help people live well for longer, whatever their background.’
Francesca says: ‘There’s no silver bullet or single intervention that will help reverse this worsening trend in healthy life expectancy. What’s going to be needed is concerted cross-government action.’
She’s calling for ‘broad investment across the building blocks of health from early childhood’ to enable people to live healthier lives for longer.
Greg adds: ‘Directors of public health are working hard with partners across the system to make sure that everyone – regardless of their background or income, or where they live – has access to safer homes, green spaces, stronger social connections, affordable, nutritious food, and opportunities to keep engaged and active in work and the wider community, from the very beginning of their lives.
‘Only by making sure that we create the conditions we need to live in good health, throughout each stage of our lives, can we hope to improve the statistics, while making sure our health and care services are there when people need them most.’ CP
RESOURCES
The Health Foundation report (2026) on healthy life expectancy (Mooney et al)
Young people with mental health conditions are more likely to be NEET, says The Health Foundation
The Royal College of Physicians clinical audit report on deprivation and respiratory health
For references
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Parents are increasingly turning to social media influencers and self-styled ‘experts’ for advice. How can CPs ensure their voices are heard in the new battle for good information? Journalist Jo Waters reports.
nstagram and TikTok influencers, and WhatsApp groups, are just some of the unregulated sources parents are using to fill the parenting ‘information gaps’ when they seek advice.
Around a third of parents of young children now scroll social media for parenting help (Department for Education [DfE] and Department of Health and Social Care [DHSC], 2025a).
CPHVA Executive chair Janet Taylor, a health visitor manager in Northern Ireland, says that health visitors are coming up against misinformation regularly in practice. ‘HVs are experiencing it with sleep advice, nutrition, immunisation and behaviour –it’s so frustrating,’ she says.
‘There are people on internet platforms telling mums their children won’t get measles if they only give them organic food for goodness sake, or advising them to lay their baby in unsafe sleep positions.
‘HVs are confident in delivering the evidence-based public health messages, but, often, they are having to dispel other information the parent has come across, and convince them that what they are saying is right and true.
‘We welcome these conversations with parents – where this falls down is where you don’t have enough HVs doing sufficient visits, as is the case in England currently.’
A PERFECT STORM
The explosion in information has coincided with shrinking HV numbers in England and fewer mandatory visits for under-fives.
‘We’ve got this perfect storm at the moment, where face-to-face contact with health practitioners is harder to get in England – and possibly in Wales too, and online, unregulated platforms have exploded,’ says CPHVA Executive member Rhian Ogden, lecturer in child nursing at the University of Leeds and former school nurse (SN).
One analysis, based on NHS England figures from April, found the number of HVs in England has fallen from 10,200 a decade ago to 5575 in January this year –a drop of 45% (De Ferrer and Clarke, 2026).
A separate analysis, from 2016 to 2021 –when HV numbers dropped by a fifth in five
‘WE’VE GOT THIS PERFECT STORM AT THE MOMENT, WHERE FACE-TO-FACE CONTACT WITH HEALTH PRACTITIONERS IS HARDER TO GET AND ONLINE, UNREGULATED PLATFORMS HAVE EXPLODED’
years in most areas of England – revealed some caseloads of 1000+ children per caseload-holding staff member (Conti et al, 2026). There’s been a similar decline in SNs; a 2024 study found that numbers had fallen by 32% across England since 2009 and were on track to halve in size compared with 20 years previously (Royal College of Nursing, 2024).
In a June parliamentary debate on maternity nurses, nannies and the infant sleep industry, Connor Rand, Labour MP for Altrincham and Sale West (Hansard, 2026) told MPs: ‘At the moment, we run the risk of unimaginable tragedies day after day, and it is happening more and more as the support we used to provide for new parents has shrunk.’
He continued: ‘The number of HVs has almost halved in the past decade, and home visits are not happening consistently across the country, as overstretched staff battle caseloads of up to 1000 families. That is the vacuum that causes parents to walk into the wild west of dangers.’
Dr Ruth Oshikanlu, an independent HV who runs a programme for mothers who have experienced pregnancy loss and assisted conception, says HVs do their best to challenge incorrect information that parents present to them, but she reiterates that CPs in England don’t see families as much as they did in the past, so there are
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fewer opportunities to build a relationship. Parents cannot be blamed for searching for alternative sources of advice when faceto-face support from health professionals is getting harder to access, says Rhian.
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THINK BEFORE YOU POST
CPHVA Executive member Rhian Ogden says: ‘Tempting as it might be to take to TikTok or Instagram to spread accurate health information for parents, we advise our student nurses not to do this, as it is potentially a legal minefield, and you’ll be representing your employer with the views and information you are sharing.’
Also, check the NMC Guidance on using social media responsibly. Its advice includes:
• Be informed Make sure that you familiarise yourself with how individual social media applications work, and be clear about the advantages and disadvantages.
• Protect your professionalism and your reputation If you are unsure whether something you post online could compromise either of these things, think about what the information means for you in practice and how it affects your responsibility to keep to the Code.
• Consider who and what you associate with on social media.
‘As parents get to see health practitioners less and less – whether it’s the GP, HV or SN – they are filling the gaps by seeking information online,’ she adds, ‘particularly with sleep, where new parents can get overwhelmed and sleep deprived, and end up feeling quite desperate.’
A spokesperson for baby sleep charity The Lullaby Trust says :‘It’s clear that, with HV workforce numbers having fallen, families are turning elsewhere for advice.’
THE PARENT EXPERIENCE
In a survey commissioned by the government, 48% of 2511 UK parents (of 0 to four-year-olds) said they relied on friends and family for advice, and 41% on HVs (DfE and DHSC, 2025b). However, 33% said they went to social media platforms for advice and 30% went to social networking sites, while almost one in five (18%) said they used Instagram, TikTok and Facebook, multiple times daily, for parenting advice. Perhaps unsurprisingly, the vast majority (68%) were struggling with conflicting advice (DfE and DHSC, 2025a).
A King’s College London (KCL) review around the same time found that many parents are negatively impacted by the breadth of information available: it found evidence of parents feeling overwhelmed and bewildered by all the inconsistent advice. Stephen Scott, professor emeritus at KCL and the King’s Maudsley Partnership, co-authored this evidence review on the effects of social media on parents of underfives (De Pablo and Scott, 2025 - in preprint). Professor Scott says the weak credibility of some sources can affect parents’ confidence and even prevent them from making key parenting decisions.
‘We found parents were really confused about what they were seeing and reading, and didn’t know whether to trust it or not,’ he says. ‘Sometimes “experts” weren’t terribly qualified either – they might psychology degree but no clinical
practice, for instance, and were just giving their opinions.
‘There were other experts who were commercially driven, trying to sell people vitamin supplements and wellbeing products. What surprised us was that parents – particularly women – said following influencers with a beautiful house and glamorous lifestyle actually made them feel worse, less confident and a failure as a parent.’
Dr Emily Crosby, a registered child and educational psychologist, says there is no such thing as perfect parents, but when parents are struggling it’s easy and natural for them to doubt themselves.
‘If parents are feeling like that, then going online can exacerbate those feelings, as people only tend to post highlights, so they may be comparing with something that isn’t necessarily their reality, which can make feelings worse,’ she adds.
Professor Scott believes parenting skills should be taught early on. ‘We definitely need parenting classes for all, and this should start at secondary school. There’s a programme, called the Roots of empathy, where you take a baby into a class and teach the pupils about attachment. We then need more classes prenatally, and again just before children start school.’
THE NEW ‘FAKE’ EXPERTS
In May this year, self-described ‘infant sleep experts’ were found by a BBC investigation to be giving dangerous and incorrect advice online to parents of newborns that could put babies at risk of serious harm and even death (Talwar, 2026). One ‘expert’ advised that a newborn should be placed on its front, a position proven to increase the risk of sudden infant death syndrome. Another recommended putting towels in a baby’s cot, another unsafe practice. The BBC film highlighted that, with no regulation, anyone can call themselves a sleep expert.
‘Recent media investigations have highlighted examples of some baby sleep experts giving guidance to families that contradicts evidence-based safer sleep advice, backed by decades of research,’ says a spokesperson for The Lullaby Trust. ‘This includes advice to place babies on their front
33 % of new parents scroll social media platforms for support
to sleep, using soft items in sleep spaces, or ways to hold the baby in one position.
‘We have heard from parents and carers that the overwhelming amount of conflicting advice can be confusing, particularly on social media. It can be difficult to know who to trust. Parents and carers may often seek sleep support when they are exhausted and sleep deprived, which can make finding trusted advice even harder.’
Labour MP Connor described the infant sleep industry in particular as ‘the wild west’ in the debate on maternity nurses, nannies and the infant sleep industry (Hansard, 2026). He told MPs: ‘Anyone can pose as an expert and give parents advice that puts their child’s life at risk. Sometimes, these people call themselves maternity nurses, practitioners or consultants. Sometimes they call themselves sleep trainers or specialists.
‘In all cases, there is no requirement for them to have any medical training or qualifications to justify their title. In addition, there is no legal accountability for advice provided and no recognised standard for support provided.’
Ruth puts this into context: ‘When parents are in crisis, they go online for advice, and some of them even pay for these private consultants, who are expensive… and who don’t have any training or qualifications. These people aren’t regulated or registered, and can say anything they want – and a lot of the time they are getting paid for spreading information.’
She adds: ‘Parents will see things about
Almost 1 in 5 (18 % ) use Instagram, TikTok and Facebook multiple times daily for parenting advice
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2026). He has also called for more investment in HVs and infant care.
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celebrities or influencers not immunising their children, and them being fine and looking healthy, weaning their babies before six months and placing their babies on their front and co-sleeping. It’s all dangerous information.’
Alongside more regulation of self-styled experts, Rhian says: ‘We need to get better at filling the gaps for parents seeking health information – but, at the same time, we are not going to be able to start doing weekly home visits to help with sleep problems, so we need to find a better way of signposting parents to effective evidence-based advice and content that is safe.’
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To complicate the picture further, there seems to be a ‘growing wave of AI-driven misinformation’ according to fact-checking charity FullFact (2025). Its investigation uncovered a series of social media accounts ‘using AI-generated deepfakes’ to promote supplements.
WHAT NEEDS TO HAPPEN?
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The Lullaby Trust would like to see stronger legal protection of professional titles such as ‘nurse’. ‘With many people calling themselves “night nurse” or “maternity nurse”, it’s understandable that families may assume they have undertaken recognised medical training and are accountable to a professional regulator’ it says.
When it comes to regulating health information for parents on the internet, Janet believes it would be like carrying water in a sieve. ‘It’s probably impossible to control, so what we need to do as HVs and SNs is be very visible and noticeable,’ she says – at every level. So, engagement during face-to-face contacts, ‘raising our profile at a community level – across our clients and families and population, as well as government’ and lobbying MPs ‘to value the input of public health nursing and invest in services and safer staffing’.
‘We have the correct health information from the DHSC; the message needs to be strong and consistent to give parents trusted sources of information,’ she adds.
68% of new parents struggle with conflicting advice and 69% feel overwhelmed
DfE and DHSC, 2025a
‘Families may make decisions about their baby’s care based on this. We believe titles such as these are misleading. Strengthened legal protection of these titles will help families make informed choices about their baby’s care.
‘We’d also like to see the government considering minimum standards, and accreditation or regulation of anyone providing infant sleep advice.’
Connor had similar requests for the government on protecting medical titles, and asked the minister for secondary care to explore the introduction of mandatory minimum safeguarding training and qualification standards in the baby sleep industry and nanny industries (Hansard,
Professor Steve Turner, president of the Royal College of Paediatrics and Child Health (RCPCH) says: ‘We welcome any measures that ensure parents and carers have easy access to accurate and clear information relating to the health and wellbeing of their children, and are able to speak to a regulated health professional when needed.
‘Following trusted, evidence-based guidance is one of the simplest and most powerful ways to keep your baby safe.’
IS THE GOVERNMENT FIGHTING FAKE EXPERTS?
‘Misinformation dressed up as expert advice can be dangerous,’ says a DHSC spokesperson. ‘That’s why we are taking decisive action to crack down on unqualified individuals masquerading
‘WE ARE NOT GOING TO BE ABLE TO START DOING WEEKLY HOME VISITS… SO WE NEED TO FIND A BETTER WAY OF SIGNPOSTING PARENTS TO EFFECTIVE, EVIDENCE-BASED ADVICE AND CONTENT THAT IS SAFE’
as professionals, including making it a criminal offence to misuse the “nurse” title. To make it easier for parents to access trusted, evidence-based information, we launched the Best start in life website last October, which supports parents from pregnancy to starting school.
‘We are also committed to strengthening health visiting services, as well as backing Best start family hubs and healthy babies programmes with an extra £900m.’
The government is planning to protect the “nurse” title through reforms to professional regulation, which will be delivered using secondary legislation rather than a new bill. Under these changes, it will become a criminal offence for someone to call themselves a nurse unless they are properly registered with the Nursing and Midwifery Council (DHSC, 2025).
‘Before introducing the legislation, the government will consult on which roles should still be allowed to use the word “nurse” in their job title. A call for evidence seeking views on how the title “nurse” should be protected is expected to be published shortly,’ said a DHSC spokesperson.
SUPPORTING CPs
The spokesperson continued: ‘We are committed to empowering the HV profession, as trusted faces in communities across the country. We recently launched a £2m pilot (DHSC, 2026) that will see HVs reach families facing barriers to vaccines – such as travel costs, language difficulties or vaccine hesitancy – to ensure more children are protected.’
The minister for secondary care (Karin Smyth), told the House of Commons that HVs and their teams have an important role to play in supporting infant heath, wellbeing and parenting confidence (Hansard, 2026). She said services such as health visiting are being strengthened by providing £13.4bn for a consolidated ringfenced public health grant for local authorities, starting in 2026/27.
Ruth’s advice? CPs should keep signposting families to the trusted sources of information, such as the Best start in life website. ‘When I meet families who are not vaccine confident, for instance, or who are wrongly convinced the MMR vaccine will give their child autism, my role as a HV is to inquire why and keep educating them in a non-judgemental way,’ she says.
Janet believes the internet, social media platforms and their associated issues are here to stay. ‘It’s what is happening, but community practitioners need to be the glue that holds things together. We need to be respected and the go-to person for parents to get credible information and advice on children’s health,’ she says.
‘But there is no quick fix for this. HVs in England are struggling with caseloads of 1000 families – how will they have capacity to have these meaningful conversations?’ CP
For references
What’s your experience?
How much time do you have to spend correcting wrong information that clients have seen online? How do you overcome the challenge? What do you think is the answer? To share your insight, email editor Aviva Attias aviva@ communitypractitioner.co.uk
RESOURCES
Best start in life website
Hazards of online advice for parents of young children (in preprint)
Information on safe baby sleep
Guidance on social media - NMC
FIGHTING FOR FAIRNESS A
Paul Seppman, Unite’s lead officer for health in Wales, gives an update on the ongoing health visitor dispute in South Wales, and implications for all CPs.
longrunning dispute between Unite health visitor members and Cwm Taf Morgannwg University Health Board (CTMUHB) has escalated into prolonged industrial action. It highlights concerns about workforce recognition, job evaluation processes, and social partnership working within NHS Wales (government, employers, and trade unions working together to improve public service delivery, and wellbeing).
THE CONTEXT
The dispute dates back to 2021, when HV members of Unite approached CTMUHB seeking a review of their outdated job description, which members argued no longer reflected the complexity and scope of their role, which had evolved significantly over time. Despite repeated requests, the issue remained ignored and unresolved for several years.
Frustrated by the lack of engagement from the health board, Unite members undertook action short of strike from February 2024 until October 2024 (as covered in the March/April 2024 issue of Community Practitioner). The objective was not to disrupt services but to secure meaningful discussions with the health board regarding
the role and responsibilities of HVs.
During this period, a revised job description was created in social partnership that reflected the current duties and responsibilities undertaken by HVs within CTMUHB. The contents of the job description were agreed, although an agreement could not be reached on the correct education level required.
The health board maintained that the existing qualification level was sufficient, equating to a Level 6 factor under the NHS Job Evaluation Scheme. However, Unite argued that changes introduced by the NMC required recognition of a higher qualification level. The NMC’s updated standards for SCPHN programmes state that the minimum academic level for SCPHN qualification is postgraduate Master’s level. Under NHS job evaluation rules, this corresponds to Level 7. For more on this and Unite’s SCPHN and Agenda for Change banding pay campaign, relevant to all SCPHN-qualified staff across the UK, see the March/April 2026 issue.
ATTEMPTED RESOLUTION
In an attempt to move things forward, both versions of the job description were submitted to an independent matching panel convened by the All-Wales Job Evaluation Group (JEG), with support from NHS Employers. The outcome was significant. The Level 6 education version matched to Band 6, while the Level 7 education version resulted in a mismatch, triggering an appeal process.
That appeal was jointly agreed and signed by Unite and senior health board representatives. Following independent evaluation by JEG, the appeal outcome
placed the HV role at Band 7.
The result was clear: the nationally agreed job evaluation process had been followed and independently assessed, and had determined that the current HV role with the correct education level should be graded at Band 7.
However, the dispute intensified when CTMUHB declined to implement the Band 7 outcome. The health board has since acknowledged and accepted the changes to educational requirements but continues to reject the jointly developed job description that formed the basis of the evaluation, despite agreeing and signing the appeal submission. NHS Employers has confirmed that educational requirements are determined by the regulator and are not subject to local interpretation.
POLITICAL SUPPORT
Political support has also emerged. The former cabinet secretary for health and social care, Jeremy Miles, met both parties and stated publicly at the Senedd and followed up in writing that the agreed job evaluation process should be honoured. The newly elected Plaid Cymru Welsh government has similarly called on the health board to honour the process, with the First Minister and leader of Plaid Cymru, Rhun ap Iorwerth signing an open letter calling for CTMUHB to upgrade all Band 6 HVs to Band 7 and restore principles of partnership working.
HVs at CTMUHB have now been on strike for more than 20 weeks. Unite members have recently been re-balloted, with 93% in favour of continuing the strike action and a 94% turnout. This very strong mandate could extend the strike action for a further 12 months. Prior to taking strike action, Unite discussed providing significant cover during the industrial action. However this was declined by the health board, leaving no option but for Unite members to take
BROADER QUESTIONS PERSIST ABOUT WORKFORCE RECOGNITION, EQUALITY, AND ADHERENCE TO NATIONALLY AGREED
NHS PROCESSES
full strike action and leaving families across the area with reduced access to vital health visiting services. Unite has now called for the resignation of CTMUHB executive director of people and lead negotiator Hywel Daniel because of the way the health board has handled this dispute.
WHAT NOW?
As the dispute continues, families across the region remain affected by reduced access to vital health visiting services, while broader questions persist about workforce recognition, equality, and adherence to nationally agreed NHS processes. Unite members are very committed to this cause,
remain resolute and are determined to see this through.
It’s quickly becoming a national issue; Unite are leading the way across the UK and are urging staff to join Unite and become part of the campaign to be paid what they rightfully deserve. Members should speak to their regional officer about how they can get involved.’ CP
For more information
Details on the SCPHN and Agenda for Change banding pay campaign
Meet the team
Here’s a reminder of the people who make up your CPHVA Executive committee, including some recent additions. Plus, discover how they can help you, as well as how to get in touch.
JANET TAYLOR
CPHVA Executive chair
Public health nurse manager, South Eastern Health and Social Care NHS Trust, Northern Ireland
‘I am proud to be chair and to represent the CPHVA on strategic consultations on behalf of all of our members. In supporting members on professional and industrial issues, I liaise with Unite officers. I am also a lead Unite representative in my workplace and sit on the OPC nursing committee for Northern Ireland. I am involved with multicultural and equality agendas, and am vice chair of the national women’s committee. I also represent the CPHVA on the editorial advisory board of Community Practitioner
CONTACT JANET ABOUT…
‘Professional or industrial issues that you are concerned about. I would also like to hear from members who are interested in becoming active within CPHVA and Unite.’ janet.taylor@setrust.hscni.net
ASHA DAY
CPHVA vice-chair and East Midlands Lead Nurse Central Patient Safety Team, Leicestershire Partnership NHS Trust
‘Health visitors, school nurses and community nurses are pivotal to the future NHS through prevention, early intervention, reducing health inequalities and integrated neighbourhood care.
‘CPHVA can lead by influencing national policy, developing leadership, coaching, sponsorship and research, championing anti-racism and digital innovation, strengthening career pathways, and positioning community practitioners as recognised public health leaders improving outcomes, communities and population health.’
CONTACT ASHA ABOUT…
‘We would be delighted to hear from our members across the East Midlands, even if just to share experiences and offer support.’ ashaday@btinternet.com
STEPHANIE GAVIN
CPHVA vice-chair and North West
Health visitor, Manchester University NHS Foundation Trust
‘I am passionate about our professions and the wonderful work our health visiting teams provide, with the tremendous support of our staff nurses and community nursery nurses. I have had a varied career, though my favourite job is being a HV. I am also a workbase and equality representative. I look forward to seeing some of you at the conference in Bristol.’
CONTACT STEPHANIE ABOUT…
‘Any workplace or professional issues you would like to raise or discuss.’
stephanie.gavin@mft.nhs.uk
NEW MEMBER
VICTORIA THORPE
London and Eastern joint chair
0-5 team lead for Royal Borough of Kensington and Chelsea North Health Visiting Team, Colville Health Centre
‘I am also a Unite and staff side branch secretary. I represent and support members across a wide range of workplace issues. These include formal HR processes, bullying and harassment cases, organisational change consultations, and workforce campaigns. I am passionate about empowering members, promoting fair treatment at work and building strong workplace organisation through collective action. On the CPHVA Executive, I am currently shadowing Elaine Baptiste (see above right). Going forwards, my role on the Executive will involve representing the interests of members across the region, supporting regional engagement and contributing to the national strategic direction of the organisation.’
CONTACT VICTORIA ABOUT…
‘Support on workplace issues, such as disciplinary or grievance processes, bullying and harassment, consultations on organisational change, representation, workplace campaigning, organising, and questions relating to regional CPHVA matters.’ Victoria.Thorpe@unitetheunion.org
ELAINE BAPTISTE
London and Eastern joint chair
‘I have recently retired, but continued to work as a bank HV for my trust till July this year. As a dedicated and compassionate nurse, with 50 years of experience caring for families and children in hospital and community settings, I’ve developed a passion for delivering high-quality, client-centred care. My 32 years as a health visitor and eight years as a continence specialist nurse have equipped me with expertise in building collaborative relationships, fostering mutual trust and empowering clients to take ownership of their health. As a strong advocate for children’s continence care and management, I’m committed to advancing the field and promoting optimal health outcomes for children and families.’
CONTACT ELAINE ABOUT…
‘Any queries you have regarding the CPHVA.’ Via Irene.Fynch@unitetheunion.org
ANNIE HAIR
Scotland Senior nurse, practice development in children’s services, Glasgow and Clyde Health Board
‘My work includes health visiting, school nursing, family nurse partnership and specialist children’s services. I support and manage SCPHN training, and learning and development of our extensive staff group. I am also chair of the Unite HV occupational professional committee (OPC). My time
NEW MEMBER
DOROTHY MURRAY
Northern Ireland chair
Safeguarding Children Nurse Specialist (SCNS)
is split in practice 50/50 as a senior steward for Unite.’
CONTACT ANNIE ABOUT…
‘Practice and industrial issues. Special interests include audit and assurance, developing careers, clinical supervision, and preceptorship, as well as all aspects of professional practice. I would also love to recruit interested members representing their regions to the HV, school nurse and community nursery nurse OPC.’ annie.hair@ggc.scot.nhs.uk
‘I am part of a team of six SCNSs, who are responsible for supporting practitioners with safeguarding children across the Northern Health and Social Care Trust. I cover three public health nursing teams supporting health visitors, school nurses, clinical leads and nurse managers with specialist advice within safeguarding children. I complete one-to-one supervision, facilitate group supervision and attend multidisciplinary safeguarding meetings. I am involved with the development and implementation of safeguarding policies. I represent the CPHVA at various levels within Northern Ireland, and represent the country on the national committee where I update on the work being completed within Northern Ireland. I am also an industrial representative.’
CONTACT DOROTHY ABOUT…
‘Public health nursing professional and industrial concerns within Northern Ireland.’ dorothy.murray74@gmail.com
KATE PHILLIPS
RHIAN OGDEN
Deputy chair: North East, Yorkshire and Humberside Child nursing lecturer at the University of Leeds
‘I am committed to embedding community practice into all nurse education; improving early intervention and health promotion practice for children, young people and families; and helping build and strengthen the future community nurse workforce. I am also keen to promote the community workforce voice within the CPHVA Executive, whether that’s through sharing good
Chair: North East, Yorkshire and Humberside Lecturer supporting the delivery of the child nursing programme at the University of Leeds, HV
‘I am really keen to ensure the voices of the North East, Yorkshire and Humber community workforce are heard among the CPHVA Executive team, so that we can share good practice and recognise the challenges – and, in turn, enable us to continue to promote the health and wellbeing of our future generation.’
CONTACT KATE ABOUT…
‘Any practice developments and innovative ways of working that you would like to share, or if you want to discuss any community practice challenges that you would like the Executive to consider and address.’ k.phillips@leeds.ac.uk
practice or highlighting challenges and issues.’
CONTACT RHIAN TO…
‘Share the positives and the challenges of your community practice. I am happy to share these with the Executive, and to help support change and innovation in practice.’
r.ogden1@leeds.ac.uk
STELLA MANN
South West Community nursery nurse, Dorset Health Care Trust, Poole, Dorset
‘The South West is a large geographical area, covering from Cornwall to Dorset. I am also the CNN South West rep and was previously CNN chair. I have been a CNN at the trust for about 30 years.’
CONTACT STELLA ABOUT…
‘Professional issues in the South West, CNN professional issues, or any interest in the South West branch.’ stella.mann1@nhs.net
Time to get published?
If you’ve been thinking about sharing your expertise in this award-winning professional journal, now’s the time to start the process. You may want to write on an element of your practice, offer a reflection or submit a research paper. Email editor Aviva Attias with your article/paper for consideration, main points or questions at aviva@communitypractitioner.co.uk
For the full author guidelines, click here
Look who’s talking
Introducing some of the leading speakers at this year’s Unite-CPHVA Annual Professional Conference, 4-5 November, including the keynotes –plus how you can contribute.
Dr Chris Turner
Chris is a consultant in emergency medicine at University Hospitals of Coventry and Warwickshire and has been leading trauma and cardiac arrest teams for more than 20 years. He is interested in highly performing teams, which has led him from being blame- and process-focused to something completely different – Civility Saves Lives, a campaign that aims to raise awareness of the impact of behaviour on performance.
A high-energy, highly practical speaker, Chris brings the evidence base behind civility and the real-world difference it makes in high-stakes environments. He has spoken around the world, including at the Houses of Parliament, and has given two TEDx talks.
He is a contributor to the NHS Civility Toolkit and has served on multiple NIHR research groups. He’s worked on restorative justice programmes, with the NMC and GMC, the States of Guernsey and Jersey, county councils, universities, and police forces.
He is particularly proud of his work with the Defence Safety Authority and with Premiership rugby clubs, and for making Princess Anne laugh!
Conference session
Keynote speaker, day one 4 November 2026
The discomfort of disagreement: why civility saves lives
Have you ever had a professional interaction that has left you feeling disrespected? Left you feeling distracted and not performing at your best? It turns out that this isn’t just you, it’s all of us.
Results are dependent on teams, and teams work best when all members feel safe and have a voice. Civility between team members creates that sense of safety and is a proven key ingredient of great teams. Understanding who we are to each other within teams and how we respond to the challenges of being in a team determines the quality of outcome. Incivility, on the other hand, robs teams of their potential. This idea has gained momentum and traction across healthcare and beyond.
Chris has spoken about how incivility impacts us at an individual, team and organisational level in leading health and political organisations. And now he’s coming to speak at the Unite-CPHVA Annual Professional Conference.
Professor Aisling Swaine
Aisling Swaine is professor of peace, security and international law at the Sutherland School of Law, University College Dublin, Ireland. She holds a PhD in law from the Transitional Justice Institute, Ulster University, Northern Ireland.
Aisling works on research and global law/ policy development in the areas of conflictrelated violence against women, the UN’s Women, Peace and Security agenda and gender equality in global peacebuilding. She was awarded €2m by the European Research Council to lead a five-year study expanding understanding of women’s experiences of coercive control in contexts where armed and/or criminal groups are present.
Aisling led UN and NGO programmes in humanitarian emergencies and post-conflict settings, including Sudan, Kosovo, Burundi, and Timor-Leste. She also had global policy roles in UN Women headquarters in New York and the Irish Department of Foreign Affairs. As part of the UN Generation Equality Forum in 2021, Aisling was named by international government partner platform A-Political one of the world’s 100 most influential people in global gender policy.
Conference session
Keynote speaker, day two, 5 November 2026 What’s going on in the background? Making visible wider structures & networks of coercion
Sue Tranka
Sue is the chief nursing officer for Wales and nurse director of NHS Wales as of 2021. She was formerly the deputy chief nursing officer for patient safety and innovation at NHS England and NHS Improvement.
Sue has more than 30 years of varied experience in nursing and has spent the last 27 years working in the NHS. Sue trained as a midwife, registered general nurse, mental health nurse and community nurse. She has a strong interest in quality improvement, human factors and safety systems.
As of April 2022, Sue also holds the title of honorary visiting professor at Cardiff University.
In October 2020 and again in 2024, Sue was listed among the Health Service Journal’s 50 most influential people in health from a Black, Asian and minority ethnic background. She is a fellow of the Queen’s Nursing Institute, and a fellow of the Royal College of Surgeons in Ireland at the Faculty of Nursing & Midwifery.
Conference session
The nursing and midwifery public health practice framework in Wales
Professor Helen Bedford
Helen is professor of children’s health at University College London (UCL), Great Ormond Street Institute of Child Health. She is also a director of the UCL Master’s programme in paediatrics and child health.
With a background as a health visitor, vaccination issues have been the major focus of Helen’s research and teaching for the past 40 years. She has conducted research into public and health professionals’ knowledge and attitudes to vaccines including new and established ones, new uses for established vaccines, and in the determinants of vaccine uptake.
Helen is also co-theme lead in the NIHR funded Health Protection Research Unit in Vaccines and Immunisation. She contributes to immunisation training for health care professionals locally and nationally and frequently discusses vaccination issues in the media.
Conference session
Child, adolescent and maternal vaccination: an update
There’s still time to shine
You still have the exclusive opportunity to showcase your work, and highlight the work of others, at the Unite-CPHVA Annual Professional Conference 2026, but be quick!
NOMINATE FOR AN AWARD
It’s your chance to help a colleague or team’s outstanding efforts shine brightly – but make sure you get your nomination in before the end of August.
The Unite-CPHVA Awards recognise and celebrate a colleague or team who go above and beyond to deliver services to the communities that they serve. The awards celebration will take place on 4 November, the first night of conference in Bristol.
What you need to do
Unite-CPHVA invites you to nominate a person who meets the criteria set out on the application form. Simply describe how your nominee meets the criteria of the category you’ve selected. More details on the apply link.
A category reminder
Health visitor of the year
School nurse of the year
Community nursery nurse of the year
Team of the year
Student HV and student SN of the year
Diversity, equality and inclusion award
Innovation award
Advocate award
Long-service award
Local accredited representative of the year
Final call for papers
Unite-CPHVA continues its formal invitation to submit research papers, projects, or best practices to be considered for verbal presentation or poster display at the conference in November. This is the final call, with the end of August closing date fast approaching.
It’s always a fantastic opportunity to showcase your work to conference delegates and leading speakers, as well as to share best practice. Abstracts will be independently and anonymously assessed.
A reminder – there are two types of presentation to apply for:
1. Verbal presentations
These will take place on day two of the conference and form a 15- to 20-minute seminar session, to include Q&A.
2. Visual presentations
These will be in the form of academic posters (created as a 16:9 PowerPoint slide) displayed at the conference.
How to apply
Include a brief description of your research/best practice/project topic (maximum 300 words), and indicate if you would like your abstract to be considered for a verbal or poster presentation.
CONFERENCE CELEBRATION
Conference participation alert!
That’s right – you could be contributing to this year’s special 130 years celebration at the UniteCPHVA Annual Professional Conference in Bristol. To celebrate 130 years of health visiting, CPHVA would like to take a closer look at how the profession has changed over the years, from what it was then to what it is now.
To help facilitate this, CPHVA is looking for members who are willing to share stories of their experiences via the following platforms:
Audio recordings
Video clips/recordings
Photos
Written accounts
Whether you are just starting out or in the twilight, everyone is welcome!
Interested members, please get in touch. Simply email cphva@unitetheunion.org
JOINT PROTECTION
HV practice educator Lisa Smith discusses successful integrated approaches to safeguarding and infant safety in the Derbyshire health visiting service.
The health visiting service across Derby and Derbyshire has undergone significant transformation in recent years, with a marked emphasis on integrated care and safeguarding the welfare of infants. This transformation is rooted in the principles outlined in the NHS 10 Year Plan (Department of Health and Social Care (DHSC), 2025) which champions collaborative and connected service delivery to optimise outcomes for children and families. Local initiatives such as Keeping baby safe (Derby and Derbyshire Safeguarding Children Partnership (SCP), 2025), the Care of the Next Infant (CONI) programme (The Lullaby Trust, 2026) and SOSA – the emerging Stay One Step Ahead
project in Nottingham City (Orton, 2024) which is already a commissioned programme that’s shared among other organisations; collectively exemplify the commitment to joined up working and the integration of multi-agency teams.
COLLABORATIVE INITIATIVES
These programmes are designed not only to safeguard infants, but also to ensure that families have consistent access to support and guidance, reflecting the wider aspirations of national policy frameworks.
The three steps for baby safety partnership strategy (Derby and Derbyshire SCP, 2025)
An important document supporting
families with infants in Derby and Derbyshire, this focuses on three core strands: safer sleep, safe handling and safe space. These steps provide a comprehensive framework for practitioners and agencies to deliver consistent, clear messages about infant safety, ensuring all families receive guidance and support tailored to their needs.
Integrating approaches across services is crucial for safeguarding babies, as vulnerability and risk factors rarely occur in isolation. The strategy emphasises the need for child-centred assessments and ongoing evaluation of risks, recognising that parental challenges – such as mental health issues, substance use, domestic abuse and deprivation – can impact
a baby’s wellbeing. Practitioners are encouraged to liaise across agencies, using tools such as Every baby matters (Derbyshire Community Health Services, 2023), foster professional curiosity and identify vulnerabilities through quality conversations and observation. This collaborative approach helps ensure the lived experience of the baby is central to all safeguarding efforts.
Addressing the specific needs of diverse groups of young parents, including those with disabilities, experiencing domestic abuse, or using alcohol or drugs, requires flexibility and proactive engagement. Professionals must adapt their communication, provide information in accessible formats and assess sleeping environments routinely. By aligning services and maintaining multi-agency partnerships, the strategy aims to reduce preventable harm, including sudden infant death syndrome (SIDS) or sudden unexplained death in infancy (SUDI), by promoting safer sleep practices and supporting families through targeted interventions. Ultimately, integrated approaches help practitioners deliver consistent, effective safeguarding messages, improving outcomes for the most vulnerable infants (Child Safeguarding Practice Review Panel, 2026).
CONI and Keeping baby safe
Care of next infant (CONI) is a bereavement support programme designed for families who have experienced the sudden and unexpected death of a baby or young child. It offers specialist advice, emotional support and practical guidance to help parents confidently care for their subsequent babies and enjoy the first year of life. The programme is delivered
THIS
COLLABORATIVE
MODEL
NOT ONLY IMPROVES THE SAFETY OF INFANTS, BUT ALSO STRENGTHENS PROFESSIONAL RELATIONSHIPS, ENCOURAGING THE SHARING OF KNOWLEDGE
by trained health visitors, and includes information on modifiable risk factors for SIDS, basic life-support training, movement monitors and signposting to further resources.
Integrating CONI’s principles into Keeping baby safe training is crucial for partner agencies. It ensures that all professionals consistently deliver clear, targeted safer sleep messages and assess vulnerability factors within families. By embedding CONI principles, agencies can support bereaved families more effectively, encourage engagement and reduce the risk of SUDI/SIDS. Consistency across multi-agency partnerships is key to safeguarding babies and ensuring families receive the support they need.
Preventing harm
Unintentional injuries are a leading cause of preventable death and disability for underfives in England, with children from deprived areas most at risk. Most injuries, such as falls, poisoning, burns, drowning and choking, are preventable and linked to home environment, parental knowledge and social factors (Public Health England, 2018a and 2018b). PHE’s report highlights the need for local authority leadership, partnership working and evidence-based interventions. Key strategies include embedding safety advice in health contacts, home safety assessments and fitting safety equipment. The document urges prioritising high-risk areas, continuous evaluation, and coordinated efforts to reduce both injuries and health inequalities among young children.
ALIGNING BEST PRACTICE
At the heart of these service improvements is the drive to align local safeguarding measures with the Healthy child programme (DHSC, 2026) and the newly identified target impact areas. The Healthy child programme, as referenced in the NHS 10 year plan, sets out a blueprint for delivering universal and targeted interventions that promote the health
and safety of children from birth onwards, and the significance of the 1001 critical days (HM Government, 2021).
By embedding the Keeping baby safe initiative and the CONI programme within local service structures, Derby and Derbyshire have created a robust framework for identifying and addressing risks to infant safety. The consideration and introduction of the SOSA project in Nottingham City – a shared accident prevention model – further bolsters this approach, providing additional opportunities for cross-boundary collaboration and the sharing of best practice between neighbouring regions.
Responsibility for spearheading these integrated projects has involved the coordination of Keeping baby safe training sessions, the organisation of conferences to disseminate learning, and the leadership of the CONI programme. These activities have not only raised awareness of safeguarding issues, but have also fostered a culture of continuous improvement among professionals working with children and families. The demonstrable impact of these efforts has been recognised by strategic leadership, which aligns with joined-up care systems and multi-agency partnerships (NHS England, 2026). Regular evaluation focuses
on the effectiveness of the Keeping baby safe initiative, the CONI programme and broader health visiting services, with the aim of identifying opportunities for further integration and enhancement.
SAFEGUARDING INSIGHTS
A key outcome of this integrated approach has been the effective use of organisational data and care insights from multiple agencies. By pooling information and expertise, professionals are better equipped to identify safeguarding concerns at an early stage, and to implement timely interventions that protect vulnerable children and support families in need. This collaborative model not only improves the safety of infants, but also strengthens professional relationships, encouraging the sharing of knowledge and the development of innovative solutions to complex challenges. Multi-partnership working, as advocated in the NHS 10 year plan, is central to this process, bringing together health, social care and voluntary sector organisations in pursuit of safe and highquality care outcomes.
The establishment of family first partnerships and family hubs, as highlighted in national policy (Department for Education (DfE), 2026a), further reinforces the value of integrated service delivery (Derbyshire County Council, 2026). These hubs serve as focal points for coordinated support, enabling families to access a range of services in a seamless and holistic manner.
Looking ahead, the continued alignment of local initiatives with the NHS 10 year plan and the DHSC’s guidance on safeguarding children (DfE, 2026b and UK Government, 2026) will be essential in sustaining progress and ensuring that health visiting and safeguarding programmes remain effective and responsive to emerging needs.
CHALLENGES AND CONCLUSIONS
Transformation in health visiting service improvement, particularly in relation to integrated safeguarding and infant safety approaches across Derbyshire, has required clear alignment with local strategic priorities and the NHS 10 year plan. This highlights the importance of effective leadership, shared governance and multi-agency collaboration.
Potential challenges to implementation of such a plan include workforce pressures, competing clinical demands, financial limitations, venue costs and restricted time for shared learning. Practitioners are often required to coordinate improvement activity alongside complex caseloads, which may affect capacity and consistency. When implementing, therefore, a dedicated transformation lead is needed to support structured planning, accountability and equitable practice across services.
In conclusion, the journey towards integrated health visiting and safeguarding in Derby and Derbyshire demonstrates the power of collaborative working and datadriven decision-making. By building on these foundations and maintaining a focus on continuous improvement, local services can continue to deliver positive outcomes for infants and families, ensuring that the principles of the NHS 10 year plan are fully realised in practice. CP
For references
SHARE YOUR INSIGHTS
Do you have lessons from service improvement to share? Insight into both challenges and successes are invaluable – email editor Aviva Attias aviva@communitypractitioner.co.uk
Lisa Smith is a HV practice educator at Derbyshire Community Health Services NHS Foundation Trust.
Alcohol It’s a family issue
HV Carolyn Stapleton discusses the need for health visitors to receive better training in assessing parental alcohol misuse in the home and the dangers for children when it is not addressed.
Alcohol misuse remains a major global health concern and is acknowledged as being at the forefront of public health policy prevention (WHO, 2024a).
Although recent indications have shown deaths caused by alcohol have fallen in the UK for the first time since the pandemic (Lacobucci, 2026), it should be acknowledged that this is not a time for complacency, but for policies and health professionals to go further in the challenge to reduce preventable deaths from alcohol misuse.
PARENTAL ALCOHOL HARM
Alcohol is known to play a causal role in harm to individuals, but what about those who are bystanders? It is an individual choice whether to drink alcohol, but those affected by alcohol’s harm are not usually given that choice (WHO, 2024b). Children are most likely to be affected by parental alcohol harm, and yet they are given little say as to whether their parent consumes alcohol and how this will impact their home life.
HVs are at the forefront of assessing risks within the home environment. It is a NICE recommendation that health professionals assess alcohol use with a validated assessment tool such as the alcohol use disorder identification test
(AUDIT) (NICE, 2025). Furthermore, HVs are expected to ‘make every contact count’ (MECC) (for example, Public Health Wales, 2025) and address alcohol misuse at any available opportunity.
Motives for drinking should be assessed at each contact with families, but in a study by Fleming et al (2023), women reported that conversations with professionals about alcohol harms were around the care of the newborn, breastfeeding and co-sleeping, rather than the motives for drinking and the reasons behind this issue. This may suggest that while HVs are recognising alcohol is consumed within families, the focus stays on the physical care of the child when discussing the risks of alcohol use.
Nevertheless, harm to the parent, and therefore to the child, is also present; national statistics report 9809 deaths from alcohol-specific causes in the UK in 2024 (ONS, 2026). These are likely to be individuals with children and adolescents who, prior to the death, have witnessed the harm to their parent, and therefore experienced secondary harm themselves.
THE IMPACT ON CHILDREN
The data mining Wales annual profile for substance misuse report (2025) found that 5190 children were receiving care and
support because of parental substance misuse. Although the figures are not wholly in relation to alcohol, they suggest a picture of child need. These needs will be in relation to safeguarding, and will lend themselves to neglect, poverty, and physical and sexual abuse.
The trilogy of risk (NSPCC, 2023) reports that children are at increased risk if there are mental health issues, domestic abuse and/or substance misuse in the home, and the three are likely to co-occur.
Interestingly, in Wales, the three main factors recorded for care and support were in relation to these, with 42% of 17,513 children receiving care and support (CRCS) because of parental mental ill health, 32% through alcohol misuse and 30% down to domestic abuse (Welsh Government, 2024).
HVs have responsibility for the child up until the age of five, so perhaps are
CHILDREN IN THEIR INFANCY EXPOSED TO ADVERSE EXPERIENCES MAY GO ON TO USE SUBSTANCES THEMSELVES
unaware of what may occur for children after this time in relation to parental alcohol misuse. Substance misuse data for CRCS aged 10 and over showed 37% had developed a misuse problem and had a parent with one. Further, 44% of CRCS with a substance misuse issue had a parent with a mental health problem.
This means that children in their infancy exposed to adverse experiences may go on to use substances themselves. Childhood exposure to alcohol may have a causal effect on the early onset of problem drinking. Jester et al (2015) found that children living in homes with alcoholdependent caregivers may develop beliefs that drinking will result in a heightened positive social experience, leading them to explore the use of alcohol in adolescence. This is known as a positive alcohol expectancy, which has a consistent
predictor of alcohol use initiation and subsequent excessive alcohol use.
Studies have historically explored older children’s alcohol use, which potentially misses their opinions on alcohol (Skylstad et al, 2021). Nevertheless, a study by Kuntsche and Kuntsche (2018) found that, even from the age of four, children start developing ideas of the positive and negative effects of alcohol. This is important in understanding how early childhood effects the long-term health trajectory of the child.
THE HV ROLE
HVs play a key role in recognising and responding to the research on childhood exposure to alcohol, and tackling the issue of excessive parental drinking early through screening. Discussing key motivations for
consuming alcohol and discussing longterm health trajectories for the family may be one way to move families from reactive to preventive measures.
Scott (2017) sought to explore HVs’ thoughts about screening parents for alcohol misuse and found that their knowledge of screening was poor, even though they recognised that alcohol misuse was a significant public health concern. This could suggest that it is not a lack of knowledge that prevents it being addressed, but inadequate training for HVs.
Training appears scarce, with poor available evidence of HVs receiving specific training on how to address parental alcohol misuse. With no standardised practice, anecdotal evidence suggests that HVs address this issue on their own terms, which means that they enquire about alcohol units
as recommended by NICE (2025), and share health advice in relation to MECC (PHW, 2025).
Although this is a positive step towards understanding risk within homes, it potentially does not address the issue directly if a concern is found. A lack of training and screening could lead to a lack of HV confidence and a ‘postcode lottery’ of addressing this issue, with potential avoidance of it.
THE HV TRAINING NEED
More needs to be done by HVs to address alcohol misuse, and an effective and standardised training package might be one way to support this. Mandatory training is one of the core elements of clinical governance that is an essential and expected part of the Health and Social Care (Quality and Engagement) (Wales) Act (Welsh Government, 2020). Furthermore, the Equality Act (Crown, 2010) places a legal expectation that all health boards provide equitable care to individuals, and this shouldn’t be dependent on a postcode lottery of service provision. What also needs to be addressed are HV views on the barriers and facilitators of addressing alcohol misuse in families. Gathering views of a profession is an important part of any development of skills and training, with it being recognised that a skilled healthcare professional is ready to deliver better health outcomes (Health Education Institute Wales, 2024).
As a HV myself, I have a real interest in this area of need within society. Alcohol
RESEARCH HAS SHOWN THERE IS A LACK OF TRAINING AVAILABLE TO HVs THAT SPECIFICALLY ADDRESSES THEIR ROLE WITHIN THE FAMILY AND WHAT SUPPORT HVs COULD PROVIDE IF AN ALCOHOL PROBLEM IS FOUND
is widely available and used freely, but it does not come without risk. This article has highlighted that alcohol plays a causal role in children receiving care and support, and increases safeguarding risks at home. Furthermore, children as young as four will start to develop their own ideas about what alcohol means to them, and exposure to parents who consume alcohol to harmful levels may increase their risk of early exposure to substances.
HVs are aware of this public health issue and address it through enquiring about units of alcohol and the risks in relation to the care of the newborn, co-sleeping and breastfeeding. HVs should be discussing parental alcohol use not only regarding parental and children’s physical health issues, but also in relation to what the child is experiencing and how this may shape their thoughts and expectancies of alcohol.
However, research has shown there is a lack of training available to HVs that specifically addresses their role within the family and what support HVs could provide if a problem is found with parental alcohol misuse. Specific training should aim to increase confidence in addressing this issue and encourage collaboration with other agencies to support families.
Having recently been awarded a MacQueen bursary, I will be conducting further research into alcohol and HV
practice. It will include a focus group in relation to the facilitators and barriers of addressing parental alcohol misuse in families. This will collect views on what HVs experience when asking questions about alcohol within the home.
The long-term plan would be for these results to feed into a research project that may influence the development of a standardised training package to support HVs to address this important public health issue. CP
Carolyn Stapleton is a health visitor and Queen’s Nurse at Glanrhyd Hospital.
For references
Share your insight
Would you find additional training on parental alcohol misuse beneficial? What’s your experience among the families you look after? To share your insight, email editor Aviva Attias aviva@ communitypractitioner.co.uk
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Psoriasis
Exacerbated by misinformation online, psoriasis is a much misunderstood condition, making it especially tricky for young people to navigate. Journalist Louise Parfitt investigates the challenges and solutions.
Psoriasis is more than a skin condition. Although usually identified by its visible symptoms – raised red or dark patches of skin covered with white or silvery scales – its effects run much deeper. Treatments can be time-consuming, with unpleasant side effects (such as being smelly and greasy), and people with psoriasis can experience discomfort, pain and embarrassment, affecting confidence and self-esteem.
WHAT IS IT?
‘While psoriasis and skin conditions such as eczema may look similar [scaly, red and itchy], psoriasis is classed as an immune-mediated inflammatory disease,
which simply means that the immune system is not functioning correctly,’ explains Amy Ball, of the Psoriasis Association (PA).
‘Common triggers for skin conditions are related directly to the skin – for example, an allergy, clothing or cold weather – whereas psoriasis is triggered by changes in the immune system that cause it to become overactive. This can include streptococcal throat infections, physical and emotional stress, certain medications, excessive alcohol consumption, or the site of injury to the skin, known as the Koebner phenomenon.’
WHO’S AFFECTED?
It is estimated that psoriasis affects between two and three per cent of the UK population
– around 1.8 million people – and it affects males and females equally (PA, 2026).
Psoriasis can occur at any age, although there are two main ‘peaks’; from 15 to 25, and between the ages of 50 and 60 (NHS, 2026).
Although psoriasis in babies and young children is relatively rare, the PA estimates that a third of people develop the condition before the age of 16 (PA, 2022).
The most common forms of psoriasis in children are plaque psoriasis – where patches (plaques) of inflamed skin form, mainly affecting the elbows, knees and lower back – and guttate psoriasis. The latter often presents as a rash of small, scaly patches affecting the trunk, limbs and scalp, following a throat infection, and generally clears over time. Many people who have guttate psoriasis never experience another flare-up, although up to half will have a recurrence or go on to develop another type of psoriasis.
HOW IS IT TREATED?
Some people may only experience a handful of flare-ups in their lifetime; others will have flare-ups much more frequently or
‘PSORIASIS IS UNIQUE TO EVERYONE, AND A TREATMENT THAT WORKS FOR ONE PERSON DOESN’T NECESSARILY WORK FOR ANOTHER’
have some patches that never really go away.
‘Psoriasis is unique to everyone, and a treatment that works for one person doesn’t necessarily work for another,’ says Amy. ‘Initial treatments are usually topical, such as creams, ointments or gels applied to skin. It’s important to use treatment as prescribed, even if psoriasis improves, as continuous treatment can help prevent flare-ups and minimise side effects.’
People with psoriasis that does not respond to topical treatments, covers a large area of skin or is on a high-impact site – such as the palms of the hands, soles of the feet or face – may be referred to a specialist.
‘Specialist treatment can include UV therapy or phototherapy delivered by a dermatologist, systemic treatments [oral tablets to decrease the overactivity in the immune system] or biologics [injections targeting the immune system to reduce inflammation],’ adds Amy.
POTENTIAL ISSUES
It can take time to find the most effective treatment. This can be incredibly frustrating and disheartening for people, but it is important that they see their doctor or dermatologist regularly, and speak honestly about how they are feeling to find out what works for them.
One in five people with psoriasis will develop psoriatic arthritis, an inflammatory arthritis affecting the joints and areas such as the heel and lower back (British Association of Dermatologists [BAD], 2023). There is a misconception that arthritis only affects older people, but it can occur at any age, although it is most common within the first 10 years of being diagnosed with psoriasis, or between the ages of 30 and 50 (PA, 2026).
People affected by psoriasis may also have a higher risk of experiencing other health problems, such as heart disease and depression – so a healthy lifestyle and regular contact with a GP or dermatologist remain invaluable (BAD, 2023; PA, 2026).
MANAGEMENT AND IMPACT
Psoriasis can disrupt people’s lives in different ways, including: preventing them from getting a good night’s sleep; having to wear certain clothes; and finding ways to manage symptoms during the working or school day.
‘Psoriasis is different for each person, so there is no single list of activities to “avoid”,’ says Amy. ‘For some people, psoriasis may not have a huge impact on day-to-day life, but for others its impact can be significant.
‘Activities such as swimming shouldn’t be stopped completely, but it’s worth being wary of chlorine and rinsing off thoroughly after using a pool.’
Itching can be one of the most persistent and frustrating symptoms, and can be particularly difficult for children. Dry skin is often itchier, so keeping it well moisturised is key.
Avoiding irritants such as soaps and detergents can help, and cotton clothes may also be more comfortable against irritated skin. Keeping nails short can also help to break the ‘itch-scratch’ cycle.
HOW YOU CAN HELP
There is a lot of material on psoriasis available online, but the PA cautions that there is also a lot of misinformation. Viral treatments, trends and online debates make it hard to know what to believe – and young people are especially susceptible to this.
‘When it comes to supporting children and young people to navigate this, we’d recommend referring them directly to trustworthy health information,’ says Amy. ‘All information produced by the PA has been awarded the PIF TICK – the only quality mark for health resources –having demonstrated that our information has been through a professional and robust production process.’
The PA also advises that the routine
childhood immunisations may be safely given to a child with psoriasis, but medical staff and the child’s carers should be aware that psoriasis may come up at any site where the skin has been injured – where the needle has entered the skin, for example.
If a child or young person is taking psoriasis treatments that suppress the immune system – such as a systemic or biologic treatment – school nurses should speak to the child’s parent/carer well ahead of any immunisation being offered, so that they can take advice from their dermatologist or rheumatologist.
This is because not all vaccinations will be suitable for young people using immunosuppressive medication (PA, 2022) – namely, they should not be given live (‘attenuated’) vaccines. Such vaccines in the UK that should be given careful consideration include the live influenza, MMR and rotavirus vaccines. CP
Look out for: Psoriasis Awareness Week
Date: 29 October to 4 November
Theme: ‘Look beyond my skin’, focusing on empowering young people living with the condition
RESOURCES
Psoriasis Association (PA) Facts, research and news
PA information for teens and young adults living with psoriasis
Green book vaccine information
For references
Research digest
A round-up of research news from around the globe.
US TRAINING FOR LIFE
About two hours’ strength training every week could be the optimum level to reduce risk of dying from cardiovascular or neurological disease, a study suggests.
Researchers found that 90 to 119 minutes’ weekly sessions involving weights or body weight such as press-ups, lowered the risk of death of cardiovascular and neurological disease by 19% and 27% respectively.
Doing more than two hours appeared to offer no further benefit. However, the effects were amplified by the addition of aerobic exercise.
The study collated data from three studies spanning 30 years, with 147,374 participants (115,834 women and 31,540 men) questioned once every two years about their resistance workouts. The participants were health professionals (including nurses) with an average age 54 at study entry.
The researchers acknowledged some limitations to their observational study, including the self-reporting of data and exclusion of pilates. However, they concluded their finding ‘supports current recommendations encouraging both types of activity to maximise mortality benefits’.
British Journal of Sports Medicine
UK
CHILDREN’S SLEEP AND DEPRESSION
Young children who have consistently shorter sleep may be at greater risk of developing depression as teenagers.
A study of 8771 young people found that those who experienced persistently less rest as children were twice as likely to suffer poor mental health later on.
The research collated data from the study, which tracked children’s sleep up to the age of seven, with the results of a mental health survey taken from ages 12 to 22.
Although only 2% had ‘persistent
shorter nighttime sleep’, 4.5% of these ultimately displayed higher depressive symptoms –double the ratio of those who’d had consistently good sleep.
UK
NHS CHATBOTS PROS AND CONS
Patients who attempt to book cervical screenings through an AI chatbot can be put off if the messaging is too ‘pushy’.
The study involved 300 women eligible for screening at a surgery. Many said follow-up messages 24 hours later were ‘intrusive’, and called phrasing such as ‘let’s book you in’ aggressive, while the AI receptionist’s advice to ‘chat to me as if I am a real person’, raised suspicion rather than reassurance for a lot of patients.
However, women who responded well to the AI receptionist described its tone as friendly and kind. They also appreciated how the system fitted into their lives. Several noted that having a female-presenting AI made it easier to share sensitive details.
The study highlights the vital need for AI communication to feel ‘respectful, transparent and supportive’ for users.
Lead author Dr Doris Dippold said: ‘Human-like features can build rapport but when they clash with patients’ expectations they undermine the trust the chatbot is trying to build.’
Lingua
Dr Isabel Morales-Muñoz said: ‘Efforts to address persistent poor sleep during childhood will have a host of benefits including addressing any potential mental health risks.’
European Child & Adolescent Psychiatry
AUSTRALIA
SOCIAL MEDIA AND TEENAGERS’ MENTAL HEALTH
Adolescents who spend at least two hours a day on social media are more likely to experience symptoms of depression.
A 10-year study followed a total 1200 children from the ages of nine to 19, and found that those aged between 12 and 18 who used social media two hours a day were slightly more likely to display signs of poor mental health a year later than those whose daily use was less than one hour.
Girls aged 12 and 13 showed the most impact, according to the
JAPAN BRAIN HEALTH AND VITAMIN C
Child To Adult Transaction Study (CATS), carried out before Australia imposed a social media ban for under-16s in December 2025.
Lead author Dr Nandi Vijayakumar said: ‘While the increases in risk were modest, even small effects can have important public health implications when large numbers of young people are exposed. This is why early adolescence may be the key time to intervene.’
Medical
Journal of Australia
Vitamin C could help boost cognitive function in older adults, research suggests.
A study of 2044 participants aged above 64 discovered that those with lower vitamin C levels in their blood plasma had a lower volume of grey matter. The team analysed MRI scans and plasma vitamin C levels, measuring each participant’s grey and white brain matter. They then evaluated its connection with the default mode network (DMN) – a key brain network associated with functions including attention. Participants with lower plasma vitamin C levels also tended to have lower connectivity within the DMN. While the findings can’t confirm a cause-effect relationship between vitamin C levels and brain health, and more research is needed, the authors say it offers positive possibilities.
Researcher Tomohiro Shintaku said: ‘This finding generates the exciting hypothesis that a diet rich in vitamin C might play a supportive role in maintaining brain health and mitigating age-related cognitive decline in older adults.’
INDONESIA SUPPORTING REFUGEE WELLBEING
Just a simple workbook and some supportive phone calls have been shown to greatly improve the mental health of displaced refugees.
Researchers evaluated an existing WHO study of 303 Farsispeaking Afghan refugees living ‘in a state of waiting’ in Indonesia. The programme - Doing What Matters In Times Of Stress - supplied participants with a workbook in their own language and five support calls from counsellors trained from within their own refugee community.
Compared with the control group, participants reported a greater reduction in psychological distress and post-traumatic stress symptoms, as well as improvements in wellbeing and daily life.
After a month, around half of participants showed meaningful improvement or recovery, compared with 30% in the control group.
Lead researcher Dr Philippa Specker said: ‘We were really excited to see that such a brief, light-touch intervention could have a meaningful impact.’
JMIR Mental Health
PLOS One
Saving generations
Helen Hyndman, of The Eve Appeal, discusses the positive updates on cervical cancer prevention and yet why there’s still much work to do.
In June, research was published in The Lancet that showed deaths from cervical cancer have plummeted in age groups that have been offered the HPV vaccine (Sasieni and Falcaro, 2026). The researchers estimate that women who had the HPV vaccination at 12 to 13 have an almost zero chance of dying before the age of 30 from cervical cancer.
The research found that between 2020 and 2024 in England, for the first time, there were no deaths from cervical cancer in women aged 20 to 24. What’s more, nine out of 10 women in this age group have had the HPV vaccination.
It also revealed that from 2015-19 there was an 80% reduction in cervical cancer deaths for women aged 20 to 24. Around one in two women in this group had their vaccine when they were 12 to 13; the other half had it at 15 to 18. This is powerful evidence that with HPV vaccination we are protecting generations to come from
HPV – back to basics
Human papillomavirus (HPV) is a common virus: four in five people will get it at some point during their lives. There are more than 200 types, some ‘low risk’ and some ‘high risk’. Low-risk types can cause warts on the hands, feet and genitals, and high-risk types can lead to certain cancers – including anal, penile, cervical, vulval and vaginal cancers, plus some head and neck cancers. In fact, one in five cancers is caused by HPV and nearly all cervical cancers are caused by HPV.
cervical cancer, but with HPV vaccination rates plummeting after the Covid pandemic, more must be done to increase uptake.
VACCINATION RATES
The HPV vaccination is offered to boys and girls aged 12 to 13, as part of the schools’ vaccination programme. It helps protect against HPV-related cancers and genital warts. The vaccination is most effective before having any sexual contact, which is why the vaccination is offered in Year 8 (S2 in Scotland) at school.
The current vaccination covers nine strains of HPV, some ‘low risk’ and some ‘high risk’. There is also a catch-up programme for the vaccine, where it is available for free on the NHS at GP surgeries, until the age of 25 for those who missed it at school, or up to 45 for certain higher-risk groups. The vaccine is also available privately until the age of 45.
In January, the UK Health Security Agency (UKHSA, 2026) announced HPV vaccination rates in schools across England for the 202425 academic year. HPV vaccination rates had risen, although they are still way below what’s needed (as is similar across the UK).
Key takeaways from the UKHSA report are:
Around 1 in 4 school leavers hasn’t had the HPV vaccine
Coverage for Year 9 girls was 75.3%, which is 1.2% higher than the previous year
Coverage for Year 9 boys was 70.5%, which is 2% higher than the previous year
By Year 10, coverage was at 75.5% for girls and 70.5% for boys.
The report showed significant variation and inequities in vaccination uptake rates:
Coverage was lowest in London for both girls (62.6%) and boys (57.7%)
Coverage for girls was nearly 20% higher in the top area of England, the East of England, which had 81.1% uptake
Coverage for boys was more than 20% higher in the East of England (76.2%) than in London
CERVICAL CANCER ELIMINATION
As nearly all cervical cancers are caused by HPV, it is almost wholly preventable. In 2025, the government and NHS England launched their plan to eliminate cervical cancer by 2040 (NHS England, 2025). Scotland and Northern Ireland have a similar plan, and Wales is supporting the WHO’s target.
This would mean fewer than four cases per 100,000 women. To get us to our goal of elimination, three key things are needed:
9 in 10 girls vaccinated by the age of 15
7 in 10 women and people with a cervix screened as part of the cervical screening programme
9 in 10 women and people with a cervix identified and treated promptly: includes precancerous cell changes and cervical cancer.
WE MUST MAKE SURE EVERYONE HAS EQUITABLE ACCESS TO INFORMATION, SUPPORT AND SERVICES
We have a long way to go to get vaccination and screening rates to a level where we can eliminate cervical cancer by 2040. A different study found that, at our current trajectory, we will only reach elimination in 2050 (Palmer et al, 2026).
BARRIERS TO HPV VACCINATION
HPV vaccine uptake is influenced by a combination of practical, cultural and confidence-related barriers. Many parents and young people have low awareness of the vaccine’s purpose or its role in preventing cancers (The Eve Appeal, 2026).
Other barriers include needle phobias, parental concerns about safety and a lack of confidence among school staff when responding to questions. Not only are HPV vaccination rates below what is needed to eliminate cervical cancer, but cervical screening uptake is also falling year on year (NHS England, 2024). Increasing uptake of both programmes is a key part of the cervical cancer elimination strategy, but we need urgent action. We must make sure everyone has equitable access to information, support and services.
Around
1 in 4
Uptake is also lower where information is not accessible or culturally tailored, particularly in schools with higher proportions of students from minoritised ethnic backgrounds (NHS England, 2025). Cultural resistance can arise from beliefs that the vaccine encourages early sexual activity or conflicts with values of abstinence, while stigma around STIs can make open discussion difficult.
school leavers hasn’t had the HPV vaccine
HOW YOU CAN HELP
Clear, inclusive and codeveloped information from trusted sources, such as healthcare professionals and charities, can help answer concerns and reduce misinformation. It is important to reach communities in which uptake is lower by using easy-to-understand messages, communicated sensitively, that meet people’s needs. School nurses can help by offering awareness-raising sessions, supporting schools to address
barriers and offering catch-up vaccination sessions. GP practices can help by offering opportunistic vaccines to eligible young people who missed it at school. Catch-up clinics in the evenings or at weekends would make it easier for older teenagers and young adults to attend. We have more information on how to talk to your clients about HPV on our website, as well as for young people and parents (see Resources). CP
Helen Hyndman MBE is lead nurse at The Eve Appeal and manages the Ask Eve nurse information service. She is a former assistant director of nursing.
RESOURCES
How to talk to your clients about HPV
Facts for young people, parents and people who missed the HPV vaccine at school
Gynae Cancer Awareness Month is in September, raising awareness of the five gynae cancers
TIME TO REFLECT
How can you help to get vaccination and screening rates up to a level where the goal of eliminating cervical cancer can be achieved? Join the conversation on X (Twitter) using #ECC via @CommPrac and on LinkedIn
For references
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You won’t beat us on choice and price
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CosmoCol® is an osmotic laxative that is indicated for the treatment of chronic constipation in adults, the elderly and children aged at least 2 years, and the treatment of faecal impaction in patients aged 5 years or above2.
CosmoCol® is an osmotic laxative that is indicated for the treatment of chronic constipation in adults, the elderly and children aged at least 2 years, and the treatment of faecal impaction in patients aged 5 years or above2.
Please refer to the appropriate Summary of Product Characteristics (SmPC) before prescribing CosmoCol® powder for oral solution. CosmoCol Orange, Lemon and Lime Flavour, Orange Flavour, Lemon and Lime Flavour and CosmoCol Plain. Each sachet of powder contains 13.125 g macrogol 3350, 0.3507 g sodium chloride, 0.1785 g sodium hydrogen carbonate and 0.0466 g potassium chloride as active ingredients. CosmoCol Paediatric and CosmoCol Half 6.9 g powder. Each sachet of powder contains 6.563 g macrogol 3350, 0.1754 g sodium chloride, 0.0893 g sodium hydrogen carbonate and 0.0233 g potassium chloride as active ingredients. Products may contain orange, lemon and lime flavourings as labelled. Indications: The treatment of chronic constipation in adults, the elderly and children aged at least 2 years. The treatment of faecal impaction in patients aged 5 years or above. Dosage and administration: Chronic constipation: Adults and adolescents aged 12 years and above: CosmoCol: 1–3 sachets daily in divided doses, according to individual response. Each sachet should be dissolved in 125 ml of water. CosmoCol Half: 2–6 sachets daily according to individual response. Each sachet should be dissolved in 62.5 ml (quarter of a glass) of water. CosmoCol Paediatric for children aged 2 – 11 years: 1–4 sachets daily adjusted according to individual response. Each sachet should be dissolved in 62.5 ml (quarter of a glass) of water. Faecal impaction: Adults and adolescents aged 12 years and above: CosmoCol: 8 sachets daily all of which should be consumed within a 6 hour period. A course of treatment does not normally exceed 3 days. This dosage regime should be stopped as soon as the impaction is cleared. CosmoCol Half: 16 sachets daily. CosmoCol Paediatric for children aged 5–11 years: A course of treatment may take up to 7 days. Take the daily number of sachets in divided doses over a 12 hour period. In adults with impaired cardiovascular function and faecal impaction the dose should be divided so that no more than 4 sachets are taken in any one hour. The use of CosmoCol Paediatric to treat faecal impaction is not recommended in children with impaired cardiovascular or renal function. Contraindications: CosmoCol is contraindicated in intestinal obstruction or perforation caused by functional or structural disorder of the gut wall, ileus and in patients with severe inflammatory conditions of the intestinal tract (e.g. ulcerative colitis, Crohn’s disease and toxic megacolon). Hypersensitivity to the active substances or any of the excipients. Warnings and precautions: If patients develop any symptoms indicating shifts of fluids/electrolytes (e.g. oedema, shortness of breath, increasing fatigue, dehydration, cardiac failure) CosmoCol should be stopped immediately and electrolytes measured and any abnormality should be treated appropriately. When using high doses of this medicine to treat faecal impaction, use caution in patients with impaired gag reflex, reflux oesophagitis or reduced levels of consciousness. The lemon and lime flavour in CosmoCol Orange, Lemon and Lime Flavour sachets, Lemon and Lime Flavour sachets, Paediatric and Half products contains sorbitol (E420). Patients with rare hereditary problems of fructose intolerance should not take this medicine.
Interactions: Macrogol 3350 raises the solubility of medicinal products that are soluble in alcohol and relatively insoluble in water.
Reference
It is a theoretical possibility that absorption of these drugs could be reduced transiently. There have been isolated reports of decreased efficacy with some concomitantly administered medicinal products, e.g. anti-epileptics. Pregnancy and lactation: There is no experience with the use of CosmoCol during pregnancy and lactation and it should only be used if considered essential by the physician. No effects during pregnancy or breastfeeding are anticipated as systemic exposure to macrogol 3350 is negligible. Effects on ability to drive and use machines: CosmoCol has no influence on the ability to drive and use machines. Undesirable effects: The following adverse events have been reported at an unknown frequency. Allergic reactions including anaphylaxis, angioedema, dyspnoea, rash, erythema, urticaria and pruritus. Electrolyte disturbance particularly hyperkalaemia and hypokalaemia. Headache. Gastrointestinal disorders including diarrhoea, vomiting, nausea, dyspepsia, abdominal distension, borborygmi, flatulence and discomfort. Peripheral oedema. Overdose: Refer to the SmPC.
CosmoCol Lemon and Lime 20 sachets NHS price: £3.29
Flavour: 30 sachets NHS price: £4.72
It is a theoretical possibility that absorption of these drugs could be reduced transiently. There have been isolated reports of decreased efficacy with some concomitantly administered medicinal products, e.g. anti-epileptics. Pregnancy and lactation: There is no experience with the use of CosmoCol during pregnancy and lactation and it should only be used if considered essential by the physician. No effects during pregnancy or breastfeeding are anticipated as systemic exposure to macrogol 3350 is negligible. Effects on ability to drive and use machines: CosmoCol has no influence on the ability to drive and use machines. Undesirable effects: The following adverse events have been reported at an unknown frequency. Allergic reactions including anaphylaxis, angioedema, dyspnoea, rash, erythema, urticaria and pruritus. Electrolyte disturbance particularly hyperkalaemia and hypokalaemia. Headache. Gastrointestinal disorders including diarrhoea, vomiting, nausea, dyspepsia, abdominal distension, borborygmi, flatulence and discomfort. Peripheral oedema. Overdose: Refer to the SmPC.
Marketing Authorisation Holder: Stirling Anglian Pharmaceuticals Ltd, Hillington Park Innovation Centre, 1 Ainslie Road, Hillington Park, Glasgow G52 4RU
Adverse events should be reported. Reporting forms and information can be found at http://yellowcard.mhra.gov.uk or downloaded from Google Play or the Apple App store. Adverse events should also be reported to JensonR+ on 01271 314 320 or Stirling Anglian Pharmaceuticals on 0141 585 6352.
Further information is available at medinfo@ stirlinganglianpharmaceuticals.com or via the office number 0141 585 6352
Date of preparation: 30 November 2022
Unique Code: API-001-22-001 2.0
1. Haymarket Medical Media. MIMS.Available at: http://www.mims.co.uk/. Date accessed Jan 2023
2. Cosmocol SmPc available at https://www.medicines.org.uk/emc/search?q=%22Cosmocol%22. Date accessed June 2023
3. Movicol 13.8g sachet, powder for oral solution - Summary of Product Characteristics (SmPC) - (emc) (medicines.org.uk) June 2023
Please refer to the appropriate Summary of Product Characteristics (SmPC) before prescribing CosmoCol® powder for oral solution. CosmoCol Orange, Lemon and Lime Flavour, Orange Flavour, Lemon and Lime Flavour and CosmoCol Plain. Each sachet of powder contains 13.125 g macrogol 3350, 0.3507 g sodium chloride, 0.1785 g sodium hydrogen carbonate and 0.0466 g potassium chloride as active ingredients. CosmoCol Paediatric and CosmoCol Half 6.9 g powder. Each sachet of powder contains 6.563 g macrogol 3350, 0.1754 g sodium chloride, 0.0893 g sodium hydrogen carbonate and 0.0233 g potassium chloride as active ingredients. Products may contain orange, lemon and lime flavourings as labelled. Indications: The treatment of chronic constipation in adults, the elderly and children aged at least 2 years. The treatment of faecal impaction in patients aged 5 years or above. Dosage and administration: Chronic constipation: Adults and adolescents aged 12 years and above: CosmoCol: 1–3 sachets daily in divided doses, according to individual response. Each sachet should be dissolved in 125 ml of water. CosmoCol Half: 2–6 sachets daily according to individual response. Each sachet should be dissolved in 62.5 ml (quarter of a glass) of water. CosmoCol Paediatric for children aged 2 – 11 years: 1–4 sachets daily adjusted according to individual response. Each sachet should be dissolved in 62.5 ml (quarter of a glass) of water. Faecal impaction: Adults and adolescents aged 12 years and above: CosmoCol: 8 sachets daily all of which should be consumed within a 6 hour period. A course of treatment does not normally exceed 3 days. This dosage regime should be stopped as soon as the impaction is cleared. CosmoCol Half: 16 sachets daily. CosmoCol Paediatric for children aged 5–11 years: A course of treatment may take up to 7 days. Take the daily number of sachets in divided doses over a 12 hour period. In adults with impaired cardiovascular function and faecal impaction the dose should be divided so that no more than 4 sachets are taken in any one hour. The use of CosmoCol Paediatric to treat faecal impaction is not recommended in children with impaired cardiovascular or renal function. Contraindications: CosmoCol is contraindicated in intestinal obstruction or perforation caused by functional or structural disorder of the gut wall, ileus and in patients with severe inflammatory conditions of the intestinal tract (e.g. ulcerative colitis, Crohn’s disease and toxic megacolon). Hypersensitivity to the active substances or any of the excipients. Warnings and precautions: If patients develop any symptoms indicating shifts of fluids/electrolytes (e.g. oedema, shortness of breath, increasing fatigue, dehydration, cardiac failure) CosmoCol should be stopped immediately and electrolytes measured and any abnormality should be treated appropriately. When using high doses of this medicine to treat faecal impaction, use caution in patients with impaired gag reflex, reflux oesophagitis or reduced levels of consciousness. The lemon and lime flavour in CosmoCol Orange, Lemon and Lime Flavour sachets, Lemon and Lime Flavour sachets, Paediatric and Half products contains sorbitol (E420). Patients with rare hereditary problems of fructose intolerance should not take this medicine.
Interactions: Macrogol 3350 raises the solubility of medicinal products that are soluble in alcohol and relatively insoluble in water.
Adverse events should be reported. Reporting forms and information can be found at http://yellowcard.mhra.gov.uk or downloaded from Google Play or the Apple App store. Adverse events should also be reported to JensonR+ on 01271 314 320 or Stirling Anglian Pharmaceuticals on 0141 585 6352.
