Quality standard

Quality statement 6: Advice on Healthy Start prepaid cards

Quality statement 6: Advice on Healthy Start prepaid cards

Quality statement

Parents and carers receiving Healthy Start prepaid cards are offered advice on how to use them to increase the amount of fruit and vegetables in their family's diet.

Rationale

Including more fruit and vegetables increases the nutrients in a diet and can help people to manage their body weight. Healthy diets rich in fruit and vegetables may also help to reduce the risk of heart disease, stroke, cancer and other chronic diseases. It is important that service providers such as local authorities, local health services and voluntary organisations provide advice to parents and carers to ensure that they use the prepaid cards to increase the amount of fruit and vegetables their family eats. This may also help to reduce outcomes associated with poor nutrition.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured and can be adapted and used flexibly.

Structure

Evidence of local arrangements to offer parents and carers who have a Healthy Start prepaid card advice on how to use it to increase the amount of fruit and vegetables in their family's diet.

Data source: Local data collection.

Process

a) Proportion of 6‑ to 8‑week health visitor appointments where parents and carers who have a Healthy Start prepaid card receive advice on how to use it to increase the amount of fruit and vegetables in their family's diet.

Numerator – the number in the denominator where advice is given on how to use the prepaid card to increase the amount of fruit and vegetables in their family's diet.

Denominator – the number of 6‑ to 8‑week health visitor appointments where the parents and carers have a Healthy Start prepaid card.

Data source: Local data collection.

b) Proportion of 8‑ to 12‑month developmental reviews where parents and carers who have a Healthy Start prepaid card receive advice on how to use it to increase the amount of fruit and vegetables in their family's diet.

Numerator – the number in the denominator where advice is given on how to use the prepaid card to increase the amount of fruit and vegetables in their family's diet.

Denominator – the number of 8‑ to 12‑month developmental reviews where the parents and carers have a Healthy Start prepaid card.

Data source: Local data collection.

c) Proportion of 2‑ to 2‑and‑a‑half‑year health reviews where parents and carers who have a Healthy Start prepaid card receive advice on how to use it to increase the amount of fruit and vegetables in their family's diet.

Numerator – the number in the denominator where advice is given on how to use the prepaid card to increase the amount of fruit and vegetables in their family's diet.

Denominator – the number of 2‑ to 2‑and‑a‑half‑year health reviews where the parents and carers have a Healthy Start prepaid card.

Data source: Local data collection.

d) Proportion of vaccination appointments at age 3 years and 5 months to 4 years where parents and carers who have a Healthy Start prepaid card receive advice on how to use it to increase the amount of fruit and vegetables in their family's diet.

Numerator – the number in the denominator where advice is given on how to use the prepaid card to increase the amount of fruit and vegetables in their family's diet.

Denominator – the number of vaccination appointments at age 3 years and 5 months to 4 years where the parents and carers have a Healthy Start prepaid card.

Data source: Local data collection.

Outcome

a) Fruit and vegetable intake.

Data source: Public Health England and Food Standards Agency National diet and nutrition survey (2008 to 12) and local data collection.

b) Obesity.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (such as children's centres, local authorities, local strategic partnerships, local health services and voluntary organisations) ensure that they offer parents and carers with a Healthy Start prepaid card advice on how to use it to increase the amount of fruit and vegetables in their family's diet.

Healthcare and public health professionals ensure that they explain to parents and carers with a Healthy Start prepaid card how they can use it to increase the amount of fruit and vegetables in their family's diet.

Commissioners (such as clinical commissioning groups or integrated care systems, NHS England, local authorities and local businesses that fund or provide community projects) specify that services offer parents and carers with a Healthy Start prepaid card advice on using it to increase the amount of fruit and vegetables in their family's diet.

People and carers who have a Healthy Start prepaid card are offered advice on how to use the card to increase the amount of fruit and vegetables in their family's diet. Eating more fruit and vegetables will help to improve their health and help them to stay at a healthy weight, and it may reduce their family's risk of developing some illnesses.

Source guidance

Maternal and child health. NICE guideline PH11 (2008, updated 2014), recommendations 4 (key priority for implementation) and 22

Definitions of terms used in this quality statement

Healthy Start scheme

The Healthy Start scheme provides a prepaid card, automatically topped up every 4 weeks, to buy healthy food, milk and vitamins to pregnant women, new mothers and parents and carers with young children (under 4 years) who are on low incomes. It aims to improve health and access to a healthy diet for families on low incomes across the UK.

The card can be used to buy:

  • plain liquid cow's milk

  • fresh, frozen, and tinned fruit and vegetables

  • fresh, dried, and tinned pulses

  • infant formula milk based on cow's milk.

It can also be used to collect:

  • Healthy Start vitamins – these support you during pregnancy and breastfeeding

  • vitamin drops for babies and young children – these are suitable from birth to 4 years old.

[Adapted from the Government's Healthy Start webpage]

Advice on how to use the Healthy Start prepaid card

This is advice which includes, but is not limited to:

  • the shops, markets and local and community food delivery services where the card can be used and how these can be accessed, for example, by public transport

  • the types of food that the card can be used to buy

  • simple healthy recipes using food bought with the card, taking the family circumstances into account, for example, their religion and culture, and the size of the family.

Advice can be given by primary and secondary healthcare professionals, public health nutritionists, dietitians and at children's centres, health centres, nursery schools and other community settings. It can be provided in a number of ways, including formal and informal group sessions and one-to-one discussions, and using practical cook and eat sessions, leaflets and online resources (for example, step-by-step cooking demonstrations). This advice can be given at any time, but particularly when eligibility for the Healthy Start scheme is established and then on an ongoing basis as needed. [Expert opinion]

Equality and diversity considerations

The information given should be both age-appropriate and culturally appropriate and sensitive to those who may have limited cooking skills and cooking equipment. It should also be accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. Pregnant women, parents and carers should have access to an interpreter or advocate if needed.

For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.