This chapter focuses on supporting animal health and welfare at herd level and giving more emphasis to preventative animal health and welfare planning (AHWP) with less reliance on antibiotics. It outlines some of the major challenges currently facing improvements to dairy cow health and welfare and improving AHWP in organic dairy farming. These range from the complexity of animal health and going beyond the five freedoms for animal welfare, to the importance of farming systems and the varying approaches and perspectives to sustainability within organic dairy farming. The role and ongoing development of the farmer-advisor relationship is discussed. The chapter then goes on to discuss the importance of relationships and the benefits of developing enhanced communication skills alongside applying participatory and bottom-up approaches to change. The role of facilitators, peer-to-peer learning, informal and formal networks and the inclusion of other actors involved in dairy herd health planning are also discussed.