CLINICAL GUIDANCE - Halton and St Helens PCT

CLINICAL GUIDANCE
Well Baby Clinic (Infant Welfare Clinic)
For use in:
Target Audience:
Purpose:
Document Author:
Approved by:
Ratified by:
Policy Index No:
PCT-wide
St.Helens Health Visiting Teams
To standardise procedures in the delivery of
Well Baby Clinics in St.Helens
Sue Large
Clinical Guidelines Group or Equivalent
Policy Sub-Committee (PSC)
HStHCL270
Version Number: 4.0
Effective From: November 2010
Review Date: November 2013
Statutory and legal requirements Policy based on recommendations from :
Healthy Child Programme 2009
ECM. Change for Children 2004
National Service Framework for Children,
Young People and Maternity Services 2004
Implementation Lead
Service Manager Health Visiting St.Helens
The Trust is committed to creating an environment that promotes equality and embraces
diversity, both within our workforce and in service delivery. This document should be
implemented with due regard to this commitment.
This document seeks to uphold the duties and principles contained within the Human Rights
Act. All Staff within the PCT should be aware of its implications.
If clinical activity takes place i.e. examination, hand decontamination should take place before
and after the procedure by following the “Hand Decontamination Policy”.
This guidance is due for review by November 2013. After this date, this guidance and
associated process documents may become invalid. All users should ensure that they are
consulting the current version of this document.

Key individuals involved in developing the document (Internal Staff Only)
Name(s)
Designation
Janice Lawson
Kath Rennison
Nikki Carter
Janice Halsall
Family Health Coordinator
Family Health Coordinator
Family Health Coordinator
Family Health Coordinator
Distributed to the following for approvals and comments
Committee(s)
Members of the Policy Sub Committee (PSC)
Members of the Clinical Policies Guidelines
Group (CPG)
Individual(s) (Include email address of external
individuals (NON NHS))
Designation
Julie Banat
Health Visitors, Community Nursery Nurses,
Community Health Nurses
Ann Hodgkinson
Karen Worthington
Health Visitors Halton
Service Manager Health Visiting St Helens
Health Visiting service St.Helens
Manager clerical officers
Service Manager Health Visiting Halton
Health Visiting service Halton
Revision History and Version Control
Revision
Date
Reason for Change Version No. By Who Version No.
16/08/10 First Issue Sue Large Draft 1.0
26.08.10 Review from consultation Draft 1.0 Sue Large Draft 2.0
08.09.10 Review from admin staff Draft 2.0 Sue Large Draft 3.0
02.11.10 Review from policy group Draft 3 Sue Large Draft 4.0
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Table of Contents
Rationale......................................................................................................................................4
Audit.............................................................................................................................................5
Equipment Required ....................................................................................................................6
References...................................................................................................................................7
Appendix 1 ...................................................................................................................................8
Glossary of Terms .....................................................................................................................8
Appendix 2 ...................................................................................................................................9
Equality Impact Assessment Tool .............................................................................................9
Appendix 3 .................................................................................................................................10
Dissemination and Training Plan.............................................................................................10
Page 3 of 10

RATIONALE
The rationale of this protocol is to enable the Health Visiting Skill Mix Team to provide universal
Well Baby Clinic services to babies and children aged 0-5 years.
The aims of the clinic are:
To monitor and assess a pre school child’s growth and development.
To offer parental advice and support to parents/carers
To offer early intervention packages of care or referral to other services /agencies
These guidelines are practiced in accordance with associated Trust policies and guidelines.
ACCESS
The service concentrates on the health and welfare of babies who are under one year old but all
pre school children can access the sessions at the following locations.
Trust clinic bases and identified premises
Open access with appointments for interventions
GP surgeries for those babies registered with the specific GP.
GP clinics operate as per individual practice preference
FREQUENCY OF MEASUREMENTS
When a baby is demonstrating normal growth and weight gain, it is recommended (UK-WHO
growth charts 2009) that a child is weighed and measured at the following times:
Weight:
monthly from 2 weeks to 6 months old
2 monthly up to 1 year old
3 monthly older than 1 year
Length/Height
At developmental assessments
Head circumference
At new birth visit and 6 week assessment,
More frequent measurements may be necessary at the discretion of the health visitor.
TRAINING/COMPETENCIES
All practitioners who provide Well Baby Clinic services must have the required competencies
and knowledge:
Child growth and measurement
Plotting and recording of growth centiles (WHO growth centiles)
Record keeping as per Geographical Caseload Policy 2010
Nutritional requirements of the pre school child
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RESPONSIBILITIES
Health Visitor
The health visitor will delegate functions to other team members and the most efficient use of
the skill mix team is considered in providing a quality service.
The Health Visitor retains overall accountability for the sessions and will locally manage staffing
and resource issues pertaining to the session in liaison with the senior administrator.
Health Visiting team skill mix
Health Visiting team skill mix staff must ensure compliance with the mandatory and essential
training requirements to fulfil their role
A diary is to be maintained in clinics to identify the dates when families have been asked to
return to clinic when there are stated concerns from any team member. This will provide a
check system to ensure attendance and any child who does not re-attend is reported to the
named health visitor for follow up. The diary is stored at the front of the clinic records box or
cabinet. This diary will offer effective communication between practitioners and entries will be in
accordance with standard guidance as detailed in the Geographical Corporate Working Policy
2010.
A contact sheet is completed
Where there are issues/concerns that are to be reported to the health visitor.
If the child’s health visitor is not based at the same venue as the well baby clinic
If case management of the child does not lie within the team conducting the community
baby clinic. Other practitioners who are providing clinic cover, must complete the contact
sheets
At all GP baby clinics
The top copy of the contact sheet is retained in the clinic record card, the middle copy is sent to
the named Health Visitor and the bottom copy is given to the parent/carer.
Administrative Staff
All Well Baby Clinic records to be filed in lockable filing cabinets.
The community receptionist will receive the name of the child in attendance and give the well
baby clinic record to the practitioner in attendance
Clinics held in GP premises will operate as per GP practice preference
AUDIT
Well Baby Clinic records will be audited annually.
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EQUIPMENT REQUIRED
Approved paediatric weighing scale, calibrated annually. This should be placed on a
safe, firm surface e.g. table at a suitable height
Approved weighing scales for older children
Approved length mat and height measure
Approved disposable head circumference measure (lasso)
Hand wash facility or hand gel
Baby changing mat
Blue tissue roll
Azo wipes
Waste bin and nappy bin
Stationary –
Well Baby clinic record
Male and female centile charts (WHO Growth chart range)
Conversion chart
Contact sheets
Appropriate referral forms
Continuation sheets
ACTION
RATIONALE
1. On arrival, receptionist receives red
book from parent/carer, identifies
corresponding clinic card and hands to
practitioner GP clinics operate as per
practice.
2. Ensure room is a suitable temperature
for the comfort of an undressed baby
To identify the child
To provide quality care
3. Baby seen by practitioner in order of
attendance/appointment
4. Baby weighed naked To offer best practice
5. Plot weight on growth chart In accordance with national guidelines
6. Complete documentation in;
Red book (CPHR)
Clinic card
Contact sheet as necessary
7. Wipe scale pan with Azo wipe and
replace tissue lining
8. Complete clinic diary if child asked to
return
To maintain record keeping
To practice infection control
To enable continuing care
Page 6 of 10

REFERENCES
UK-WHO growth charts
WHO 2009
Reference
Healthy Child Programme 0-5 years
DH 2009
ECM. Change for Children
DH 2004
National Service Framework for Children,
Young People and Maternity Services
DH 2004
Relevance (whole
document or section,
please state)
Whole document
Whole document
Whole document
Whole document
Evidence
Grade
Professional
guidelines
National
programme
National
document
National
document
Page 7 of 10

APPENDIX 1
Glossary of Terms
WHO World Health Organisation
Page 8 of 10

APPENDIX 2
Equality Impact Assessment Tool
To be completed with the corporate document when submitted to the appropriate committee for
consideration, approval and ratification.
1. Does the corporate document affect one group
less or more favourably than another on the basis
of:
Yes/No
Race no
Ethnic origins (including gypsies and travellers) no
Nationality no
Gender no
Culture no
Religion or belief no
Sexual orientation including lesbian, gay and
bisexual people
Comments
Age yes 0-5 years
Disability - learning disabilities, physical disability,
sensory impairment and mental health problems
2. Is there any evidence that some groups are
affected differently?
3. If you have identified potential discrimination, are
there any exceptions valid, legal and/or
justifiable?
4. Is the impact of the policy/guidance likely to be
negative?
5. If so can the impact be avoided?
6. What alternative are there to achieving the
policy/guidance without the impact?
7. Can we reduce the impact by taking different
action?
no
no
no
yes
no
Sessions for 0-5 year
old children according to
national Healthy Child
Programme
If you have identified a potential discriminatory impact of this corporate document, please refer it
to [insert name of appropriate person], together with any suggestions as to the action required
to avoid/reduce this impact. For advice in respect of answering the above questions, please
contact [insert name of appropriate person and contact details].
Page 9 of 10

APPENDIX 3
Dissemination and Training Plan
To be completed with the corporate document when submitted to the appropriate committee for
consideration, approval and ratification.
The status column must be given a Red, Amber or Green rating with evidence to demonstrate
an action has been completed.
DISSEMINATION PLAN
Title of document:
Well Baby Clinics
Dissemination Lead: (Print name and
contact details)
Julie Banat 01744 697573
Proposed action to retrieve out-of-date
copies of the document:
Date finalised:
Previous document already being used? no
If yes, in what format and where? Electronic/Intranet
Withdraw from the internet/intranet/portal
To be disseminated to:
Disseminated
by whom?
Timescale
(Date)
Status
R A G
Paper
or
Electronic
Comments
Trust Times
Team Brief
Training sessions (Give Details Below)x
Other (Give Details Below)
Julie Banat Within 3
months
G
electronic
IMPLEMENTATION PLAN
Training Timescale Owner Status
R A G
Training Event (Please provide details of available training venues/dates
to educate staff about this document)
Training in teams facilitated by team leaders
Within 3
months
FHC
G
Training Plan Lead (Please provide details of staff who will be
responsible for overseeing this training)
Team leaders
Compliance Monitoring Timescale Owner Status
R A G
Methodology to be used for monitoring/audit (please include PCT
Audit Proposal Form)
Audit of clinic
health
records
Team
leaders
Responsibilities for conducting monitoring/audit Skill mix
team
Frequency of monitoring/audit (e.g. annually, 6 monthly etc) annual
Process for reviewing/reporting results Link meeting
Denotes: Action not yet taken or deadline for action not met. Action plan to address this must be provided.
Denotes: Action partially implemented.
Denotes: Action complete.
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