Health Visitors Arrangements Camden

Interview with Debbie Clark - Head of Integrated Early Years Service, May 2017

Camden has created a single early years integrated service. Planning for the transition has been taking place for a year, with the new integrated service going live in May 2017.

The integrated service creates a single team with health visitors and family support workers.  NHS colleagues and council staff work alongside each other in the same buildings and within a single line management structure. Teams are accommodated within existing council and NHS estate.

There are eight teams which sit across the borough. Four are managed by health visitors and four by family support managers. Teams have paired up into four clusters with each pair having a team led by a HV manager and a team led by a family support manager. This has helped facilitate strong peer support between the two organisations with team managers in each cluster working closely to advise and support the other.


The integrated early years service provides both universal and targeted services.  A range of other services sit around the early years service with which information sharing protocols have been agreed.  These close working arrangements across multiple teams help avoid referrals between different teams who are involved in providing support to the same family. A case management approach is taken with all relevant staff involved. Depending on support needs the most appropriate lead professional is appointed to case manage support, with decisions taken jointly to ensure all relevant professionals are involved.


IT has been a significant challenge. Currently health colleagues use System 1, with the council using a different software. There is  no single record yet but the Council’s long term goal is to move to this. As a short term solution managers across the eight locality teams have been given access to both systems. The plan in the longer term is to make this available to all health visitors and family support visitors.

CQC Registration and NHS provider licence

CQC and NHS provider licence registration still sits with the NHS provider Trust that employs the health visitors. Staff have kept existing contract arrangements with their distinct employers although structurally they sit within the one team. The benefit to this approach is that it has helped support existing well established professional relationships already in place with health visitors  i.e. with trade unions, clinical supervision arrangements and arrangements for maintaining professional registration and other training and development. 


As staff are employed on the same contracts and existing  terms and conditions, existing HR policies remain in place. Through transition to the single integrated team, HR colleagues in both organisations have been kept informed.


There is a Partnership Board with directors from the two organisations which has overseen the transition process. This has been important in ensuring senior buy in and having a forum in which to resolve issues as they arise, one example is in relation to clinical governance. 

Other Observations 

  • More information on the different models and approaches that councils are taking to insourcing/integrating services would be helpful.
  • Changing organisational culture takes time.