Revitalising health visiting services

NHS England recently published information on improvements in health visitor service delivery over a 12 month period.

The data measures delivery of Healthy Child Programme reviews and assessments – specifically the antenatal check, the new birth visit, the 12 month and the two to two and a half year review. These checks and reviews are designed to provide timely support to parents at critical moments in their child’s development – assessing and identifying need and providing or referring on to the help required.

These are called the ‘universal’ checks, as they should be offered to all parents of babies and infants.

Before the inception of the Government’s health visiting programme in 2011 numbers of health visitors were dwindling and with it the percentage of parents who were receiving this support. But since 2011 there has been steady growth in health visitor numbers.

In April 2013 NHS England took on responsibility for commissioning health visiting. We set out our expectations in a service specification which included a requirement for delivery of the universal HCP checks and reviews, and collection of data on delivery.

New data collections take time to establish. We subjected all our data to validity checks to assure its quality.

Our first national analysis of the data covers July-August 2013. It was based on valid returns for the different checks and reviews from between only 54 per cent and 77 per cent of service providers. However, the quality of the data improved steadily so that between by the same period in 2014 we had returns for the different checks from between 81 per cent and 97 per cent of providers.

The relatively low returns at the beginning of the programme limit our ability to make comparisons over the year. We are not comparing like with like as the data for 2014 is based on reports from numbers of providers who didn’t report in 2013.

However, within those limitations we are pleased to report apparent improvements in delivery:

  • Overall, the percentage of children receiving health visiting services has increased from Quarter Two 2013/14 to Quarter Two 2014/15:
  • The percentage of new birth visits undertaken within 14 days in England increased from 74 per cent in Quarter Two 2013/14 to 79 per cent in Quarter Two 2014/15.
  • The percentage of children receiving the 12 month development review by the time they turn 15 months has increased from 64 per cent in Quarter Two 2013/14 to 77 per cent in Quarter Two 2014/15.
  • The percentage of children in England who received a 2-2.5 year review by the time they turned 2.5 years increased from 63 per cent in Quarter Two 2013/14 to 68 per cent in Quarter Two 2014/15.
  • The numbers of parents receiving antenatal visits increased from 32,541 to 45,232.

As health visitor numbers continue to increase we hope to expect to report steady improvements in the numbers and percentage of eligible parents and children receiving visits.

From 2015 we have also started to measure the percentage of eligible children receiving a visit at six to eight weeks. From summer 2015 – as Health and Social Care Centre establishes the Maternal and Child Data Set – it is hoped to begin to be able to collect meaningful data at a local authority level, which current systems do not allow.

Meantime, the service delivery metrics demonstrate the success of the national health visiting programme: increased numbers of health visitors are producing a better service for parents and their children.

NHS England, the Department of Health, Health Education England and our partners are working together to support health visiting services and to ensure that this better service translates in to improved health and wellbeing for of citizens of the future.

  • We hope you will join us in supporting health visitors. You can join in the discussion on Twitter by using the hashtag #healthvisiting


Sabrina Fuller is Head of Health Improvement in the Nursing Directorate.

She leads on health visitor service transformation for Hilary Garratt and Jane Cummings.

Her role in the organisation is to embed prevention in the clinical role of nurses in line with the Forward View and the NHS Mandate, building on her own experience as a clinician and her public health background.

Leave a Reply

Your email address will not be published. Required fields are marked *


  1. Carol Pratt says:

    Do the service delivery metrics demonstrate that the increase in HV’s are producing a better service, or are the figures showing an improvement in data collection? Can qualitative measures (a better service), be used from collecting quantitative (increased numbers of HV’s) data? Why hasn’t electronic data (inputted at local level for years) been collated for national comparisons? Why have electronic data collection systems been put in place that don’t speak to each other? The currrent data input, only measures service delivery from the providor. To truly improve service uptake, the client must be involved. The recipient must perceive the service to be meaningful, acceptable, accessible and of quality. I would like to see more qualitative research on parental satisfaction.

  2. Ellie Brewer says:


    I’m a Paediatric Nursing student currently on placement with Health Visitors. I am currently researching the importance of Health Visitors and the reviews they carry out. I understand that 3.5yr reviews used to be carried out and am wondering why they were stopped? Are there any reports or publications relating to this?

    Thank you,