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HS01 JUNE 2015 EDITION To apply please see the form inside www.healthystart.nhs.uk Free milk fruit veg and vitamins for you and your family Has your health professional signed your application form and have you checked you have completed all the boxes that apply to you (see ‘Before you put your form in the post’ on page 10)? Tear off envelope here Healthy Start Issuing Unit FREEPOST RRTR-SYAE-JKCR PO Box 1067 WARRINGTON WA55 1EG 2904155 Healthy Start application leaflet Produced by Williams Lea for the Department of Health

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HS01JUNE 2015 EDITION

To apply please see the form inside www.healthystart.nhs.uk

Free milk fruit veg and

vitamins for you and your family

Has

yo

ur

hea

lth

pro

fess

ion

al s

ign

ed y

ou

r ap

plic

atio

n f

orm

an

d h

ave

you

ch

ecke

d y

ou

h

ave

com

ple

ted

all

the

bo

xes

that

ap

ply

to

yo

u (

see

‘Bef

ore

yo

u p

ut

you

r fo

rm in

th

e p

ost

’ on

pag

e 10

)?

Tear off en

velop

e here

Health

y Start Issuin

g U

nit

FREEPO

ST RR

TR-SY

AE-JK

CR

PO B

ox 1067

WA

RR

ING

TON

WA

55 1EG

2904155 Health

y Start app

lication

leaflet Pro

du

ced b

y William

s Lea for th

e Dep

artmen

t of H

ealth

M

ois

ten

stri

pTe

ar o

ff e

nvel

op

e h

ere

All about Healthy StartHealthy Start is here to help you give your family the very best start in life.

If you’re pregnant or have a young child under four you could get Healthy Start vouchers worth £3.10 a week for you and your child.

The vouchers can be spent on milk, plain fresh or frozen fruit and veg (fruit and veg with nothing else added) and infant formula milk at your local shops. Plus you’ll get coupons for free vitamins too.

And if your children enjoy eating healthy food when they’re young, their good eating habits will stay with them for a lifetime!

Contents What vouchers do I get? 1

What can I buy? 2

Do I qualify? 3

Who uses them? 4

A few Q & As 6

Who to contact 7

How do I claim? 8

Dos and don’ts 9

Handy checklist 10

PART APART B

If you

are 16 or o

ver, sign

and

date th

e form

you

rself. Ifyo

u are u

nd

er 16, ask a paren

t or carer to

sign

and

date

the fo

rm.

By sig

nin

g:

I declare th

at the in

form

ation

I have p

rovid

ed in

this

app

lication

form

is correct an

d co

mp

lete.

I have read

and

un

dersto

od

the d

os an

d d

on

’ts of H

ealthy

Start (describ

ed o

n p

age 9 o

f the H

ealthy Start leaflet).

I agree to

follo

w th

ese rules d

urin

g an

y perio

d I receive

Health

y Start vou

chers fo

r myself o

r my fam

ily.

I agree that the UK

Health D

epartments can share

information about m

e with other organisations to check

that the information I have given is correct and to stop

false claims (as described on page 9 under the heading

‘Data protection’).

Part B: H

ealth p

rofessio

nal’s statem

ent

Sig

natu

re____________________________________________

Nam

e________________________________________________

Date

_________________________________________________

No

w a

sk y

ou

r health

pro

fessio

nal (u

sually

yo

ur

mid

wife

or h

ealth

visito

r) to co

mp

lete

the

state

men

t belo

w. Y

ou

do

no

t need

to p

ay a

nyth

ing

to

have y

ou

r form

sign

ed

.

Please read th

is7I ce

rtify th

at

(nam

e o

f ap

plica

nt)

___________________________________

date

of b

irth (o

f ap

plica

nt)

has co

nsu

lted

me a

bo

ut h

er p

reg

nan

cy

The e

xp

ecte

d d

ate

of d

eliv

ery

is

(ple

ase

fill in fu

ll date

).

AN

D/O

R

I certify

that th

e in

form

atio

n (s)h

e h

as g

iven

inPart A

, qu

estio

n 5

ab

ou

t his/h

er ch

ildre

n is, to

the b

est o

f my k

no

wle

dg

e, co

rrect.

AN

D I co

nfirm

that I h

ave g

iven

him

/her

health

-rela

ted

ad

vice

.

This fo

rm ca

n b

e co

un

tersig

ned

by a

ny re

giste

red

mid

wife

, nu

rse o

r med

ical p

ractitio

ner.

DD

MM

YY

YY

DD

MM

YY

YY

Health

pro

fessio

nal’s sig

natu

re

________________________________________________________

Health

pro

fessio

nal’s n

am

e

________________________________________________________

Date

of sig

nin

g

Su

rgery

stam

p o

r wo

rk a

dd

ress

Surg

ery po

stcod

e

GM

C n

o./N

MC

pin

______________________________________(o

ptio

nal)

Ap

plica

tion

s for H

ealth

y S

tart v

ou

chers w

ill no

t be

acce

pte

d w

itho

ut a sig

natu

re (or letter) fro

m yo

ur

health

pro

fession

al.

DD

MM

YY

YY

Nam

e__________________________________________________________

Date

of b

irth ______________________________

Nam

e__________________________________________________________

Date

of b

irth ______________________________

Nam

e__________________________________________________________

Date

of b

irth ______________________________

You

r child

ren: Please g

ive details o

f any ch

ildren

(un

der 4) yo

u alread

y have (co

ntin

ue o

n an

oth

er sh

eet of p

aper if n

ecessary)5

Are yo

u p

regn

ant?

Yes

No

6

I understand that if I knowingly claim

support from H

ealthy Start that I am

not entitled to, this support may be stopped

and I will be liable to reim

burse the UK

Health D

epartments

the value of any vouchers and vitamin coupons I have

received and used.

1

• If you’re pregnant you get one voucher a week worth £3.10

• For each baby under the age of one, you get two vouchers a week worth a total of £6.20

• For each child aged over one and under four, your family gets one voucher a week worth £3.10

So what vouchers do I get?

And if you’re pregnant, or have a child under four, you’ll also get coupons for vitamins. Vitamin tablets for you; drops for your baby or child. Helping them to grow up strong and healthy.

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V4

• liquid cow’s milk

• plain fresh or frozen fruit

• plain fresh or frozen vegetables

• infant formula milk

2

What can I buy with my vouchers?

You can use them at local shops and greengrocers as well as supermarkets. To find your nearest participating shops go to www.healthystart.nhs.uk or call the Healthy Start helpline on 0345 607 6823.

And don’t forget your vitamins. Make sure you ask your midwife or health visitor where you can exchange your coupons for vitamins for you and your child locally.

3

Do I qualify?You qualify for Healthy Start if you’re at least 10 weeks pregnant or have a child under four years old AND you or your family get…

• Income Support, or

• Income-based Jobseeker’s Allowance, or

• Income-related Employment and Support Allowance, or

• Child Tax Credit (but not Working Tax Credit unless your family is receiving Working Tax Credit run-on only*) AND an annual family income of £16,190 or less in 2015/16.

You also qualify if you are under 18 and pregnant, even if you don’t get any of the above benefits or tax credits.

We know that the benefits system is changing and that Universal Credit is being expanded to families. This means that, due to a change in circumstances, you may be assessed for entitlement to Universal Credit instead of the benefits you or your partner were claiming previously. Alternatively you may be new to the benefits system and may be assessed for entitlement to Universal Credit from the start of your claim. Whatever your circumstances, if you are claiming Universal Credit and are pregnant, or have a child under four years old, make sure you call the Healthy Start helpline on 0345 607 6823 or email [email protected] for information about any discretionary support that may be available.

* Working Tax Credit run-on is the Working Tax Credit you receive in the 4 weeks immediately after you have stopped working for 16 hours or more per week (single adults) or 24 hours a week (couples).

4

Who uses Healthy Start vouchers?

Sabrina & AleshaSabrina has a three-month-old baby girl called Alesha and is on Income Support as well as Child Tax Credit.

Each week, she gets vouchers worth £6.20 – that’s over £322 in vouchers by Alesha’s first birthday! Right now Sabrina is breastfeeding, so she is using the vouchers for milk, fruit and vegetables for herself until Alesha goes on to solid food. She gets her free vitamins from the local baby clinic – and knows that by taking them herself she’s helping Alesha too.

Angela & her unborn babyAngela is pregnant. She’s 17 years old and lives at home with her parents, who don’t claim any benefits.

She gets one Healthy Start voucher worth £3.10 every week – and she’ll keep on getting them until her baby is born. Angela also picks up free Healthy Start vitamins from her midwife, helping to make sure she and her unborn baby get everything they need.

5

So...To find out how Healthy Start could help you, why not talk to your midwife or health visitor when you get the chance? They’re always happy to offer help and advice about health, including healthy eating and breastfeeding. They’ll also be able to tell you about local support services such as Sure Start Children’s Centres and family centres for pregnant women and families with young children.

David & Ryan25-year-old David is a single dad with a three-year-old boy called Ryan. He’s not working and gets the highest rate of Child Tax Credit. David gets one £3.10 Healthy Start voucher each week for Ryan.

That’s £3.10 every week to spend on milk, fruit and vegetables and David picks up free vitamin drops for Ryan from the local children’s centre.

6

A few questions and answers

How long will it take to get my vouchers?Once we get your application form we’ll check that we’ve got all the information we need. If everything is there and you qualify, we’ll send your first vouchers within two weeks. If you don’t hear back from us within two weeks, call the Healthy Start helpline on 0345 607 6823.

How often do I get my vouchers?Once you’re on the scheme, we’ll send you Healthy Start vouchers every four weeks, and a vitamin coupon every eight weeks.

What happens if I don’t fill out the form properly?We’ll have to send it back to you – or if we’ve got your phone number, we might be able to sort it out that way. Either way it’ll delay your application, so double-check all your details!

Why do I need to put my National Insurance number on the form?It’s to check that you qualify for Healthy Start – if you’re over 16 and don’t put it on your form, we won’t be able to send you vouchers. So please make sure we have it!

I’m pregnant and under 18. Do I need to tell you about any benefits or tax credits that me or my family’s getting?

If you’re under 18 and applying for vouchers because you’re pregnant, not because you already have a child, then you don’t have to tell us about any benefits or tax credits you are getting. But it’s good if you DO tell us if you are getting them, otherwise your vouchers will stop coming as soon as the baby is born.

7

What do I do about the National Insurance number if I’m under 16?Leave the box blank. It won’t affect your application, but as soon as you get your number, call or write to us and tell us.

How do I claim qualifying benefits or tax credits?To claim tax credits, or add a new child to an existing claim, ring the Tax Credit Helpline on 0345 300 3900. To claim any of the other qualifying benefits, ring Jobcentre Plus on 0800 055 6688.

What do I do if my circumstances change once I’m getting vouchers?

Tell us – but make sure you tell the Tax Credit Helpline or your local Jobcentre Plus or benefits office too. If you move home, it’s vital that you tell them right away because we always send your vouchers to the address you use to claim benefits or tax credits. If you delay, your vouchers will keep going to your old address and we won’t be able to replace them.

Our contact detailsStill have some questions or want another copy of the application form? Call Healthy Start: 0345 607 6823 (9am–5pm Monday to Friday), textphone: 0845 601 7698

If you wish to order copies of this leaflet in bulk, call: 0300 123 1002, textphone: 0300 123 1003 or go online at www.orderline.dh.gov.uk

This leaflet is also available in alternative formats.Legal notice

• This leaflet gives general guidance and should not be treated as a complete and authoritative statement of law

• The text of this leaflet may be reproduced without formal permission or charge for personal or in-house use

© Crown copyright 20142902036 Produced by Williams Lea for the Department of Health

Benefits are changing. For more information on the new Universal Credit visit GOV.UK

8

How do I claim?

8

1. YouEnter your details here. Or, if you’re filling in this form for someone else who is pregnant, enter their details. They will then need to sign section 7 unless they’re under 16.

2. Your address and telephone number

Make sure that the address you give matches the address you use to claim benefits and tax credits if you get them.

If the address on your Child Tax Credit or benefit claim is out of date, tell the Tax Credit Helpline on 0345 300 3900 or your local Jobcentre Plus or benefit office as soon as possible. If the address you put on your application form is different to the one that you use for your benefits or tax credit claim, we will send the form back to you.

3. Your partner - if they live with youIf you have a partner who lives with you, tell us about them.

4. Your carer and carer’s partnerIf you’re under 20 and live with a parent or carer, please tell us about them, and any partner they have who lives with them.

If you’re 18 or 19 and in full-time education, you must confirm in section 4c if your carer or carer’s partner has named you as a dependant in their claim for any qualifying benefits or tax credits.

5. Your childrenGive the full names and dates of birth of every child that you’re claiming vouchers for. If you’re claiming for more than three children, put their full names and dates of birth on a separate piece of paper and attach it to your application form.

Part A is your section – please complete clearly in BLACK ink and refer to the hints and tips below

Part B is for a health professional – your midwife, health visitor, nurse or doctor

9

6. PregnancyTick the box to tell us whether the person named in section 1 is pregnant or not.

7. Signing the form The person named in section 1 should sign and date the form here, unless they’re under 16. If they are under 16, the parent or carer named in section 4 should sign and date the form.

IMPORTANT INFORMATION

Healthy Start vouchers are for the people who need them most. It’s breaking the law to give us details that you know aren’t true when applying for Healthy Start, or not to tell us if your circumstances change.

You could be prosecuted.

DATA PROTECTION

The information you give us will only be used by the UK Health Departments and their service providers. They may contact other organisations to check that the information is correct and to stop false claims.

From time to time we, or our researchers, may invite you to tell us how the scheme is working for you, to help us improve it.

Dos Do make sure you use your vouchers before their use-by date

Do use your vouchers fully as shops can’t give you change

Do let us know if your circumstances change – and tell the Tax Credit Helpline and Jobcentre Plus too

Don’ts Don’t use your vouchers for anything not listed in this booklet

Don’t give your vouchers away

1010

Please tick off the list below before you post your form:

� I’ve checked that I qualify for Healthy Start on page 3

� I’ve filled in my details in sections 1 and 2

� I’ve completed sections 3 and 4 with any details of my partner and/or parent/carer (as appropriate)

� The National Insurance numbers on the form are correct

� I’ve given the full names and dates of birth of all children I’m claiming for in section 5

� I’ve stated if I’m pregnant in section 6

� I’ve signed and dated section 7

� I got a health professional to complete Part B, including my expected date of delivery (if pregnant)

A handy checklist

Finished? Great. Now send us the form, using the freepost envelope at the back of this leaflet (you don’t need a stamp).

Lost your freepost envelope? Never mind, just find your own envelope and send your form to the address below – you still don’t need a stamp!

Healthy Start Issuing UnitFREEPOST RRTR-SYAE-JKCRPO Box 1067WarringtonWA55 1EG