The Lancaster Model is a robust step-by-step change management solution to drive service improvement forward and transform practice. It provides a validated, systematic approach to assess the needs of individuals and populations, identifying children and young people earlier who would most likely be 'under the radar'.

Stepping on the Travellator

The Lancaster Model generates early intervention alerts to identify and support individuals who are just “stepping on the Travellator” before they present with substantial problems and issues later on, and who are “already in the fire.”

Travellator Image


The data gathered by using The Lancaster Model has evidence resource allocation and ensured the delivery of our service specification”

Healthcare Providers

“Using the Lancaster Model has been successful because it has enhanced relationship building with other health and care organisations and given us a shared vision; It also helps us to deliver on the Healthy Child Programme”

Parents and Guardians

“We are grateful our child had the chance to be assessed as we have now had some information and support to help us all cope better with her Asthma”


“Working with the Lancaster Model is a joy! It is so rewarding to know I am now able to better support the children and their families that I come into contact with

Case Studies

Case Study A

“As the Strategic Lead and Operational Manager for School Nursing across Hertfordshire, I identified a gap in our current service delivery, with the recommended early intervention at key stage of transition not being delivered. In agreement with our commissioners, we implemented The Lancaster Model within one locality as a pilot site. This provided a wealth of information including:

  • Early indicators of needs to facilitate the delivery of individualised packages of care
  • A massive increase in contacts with parents, children and young people to provide information and advice
  • School level public health data to share with schools and develop public health plans

The results from our pilot area was vital to support our successful tender to continue delivering a 5-19 public health nursing service across Hertfordshire.


The lessons learned are now enabling us to roll TLM out across the county to enable us to deliver an evidence based, early intervention service to Hertfordshire children, young people and their families.

Andrea Harrington
Strategic Lead and Operational Manager, School Nursing, Hertfordshire Community NHS Trust “

Case Study B

A young child aged 10 years old was completing The Lancaster Model Year 6 questionnaires via the TLM Portal.

The child raised his hand and asked the nurse supervising the class session, “Does the question that says – Do you have any concerns and worries about your safety – mean safety in the street or at home?”

The Nurse replied “It can mean either, if you are concerned or worried about your safety at all you can tick the box and get help and support”.

The child ticked the box and then asked to see the Nurse in private, they then sadly disclosed how they were being abused and neglected at home. The outcome of this was an immediate visit to home from Social Services and the Police, resulting in a Child Protection Plan and safety strategy. This young man is now receiving 1-2-1 support from the school nurse team and is currently a child in need with social worker input.

If the child had not had the opportunity to express his concerns and worries via the HAPI Portal, he may have continued to accept the situation which could have ultimately resulted in a far worse outcome.

Case Study C

One of TLM questionnaires completed via the TLM Portal by a parent of a child at school entry generated a high number of alerts in relation to sensory development problems. The parents of this child were contacted swiftly by phone and following further investigation, several problems were identified for both the child being assessed and an older sibling aged 8 years old. Due to the alerts, a face to face holistic health interview was carried out with the Mother, both children and a member of the school nursing team.

This resulted in a further more in-depth health assessment on both children and care pathways to address their needs. The Mother was very appreciative for the early proactive contact and impressed with the health questionnaire process. The health needs clearly identified for both children are now being monitored and supported by the school nursing team, rather than going undetected.

Case Study D

During Year 6 sessions completing the Lancaster online questionnaire, 4 children questioned the nurses about their safety. With further enquiry, each of these children had concerns about their Mother abusing alcohol, and didn’t feel safe when their mother was under the influence of alcohol.

The nurse liaised with the safeguarding member of staff at each of the schools to discuss if this issue had arisen previously. Only one of the schools was aware that there was an issue. The parents were informed of the concerns, and one of the Fathers was greatly relieved that the issue had been identified and addressed.

Safeguarding protocols were followed, and referrals were completed to Children’s services, and one of the children is now subject to a child protection plan.

It was only due to the Lancaster questionnaire being completed that these children were identified, and would otherwise have continued under the radar of professionals.

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