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This blog post was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government

Health visitors: Giving our children the best possible start

Posted by: , Posted on: - Categories: Giving children and young people the best start in life


In ‘From Evidence into Action’ PHE set out its seven priorities for the next five years. One of these national priorities is ‘Ensuring Every Child has the Best Start in Life,’ and thus to increase the proportion of children ‘ready to learn at two and ready for school at five’.

We know that one of the most important things we can do to build a healthy population is to give our children the best possible start and there is a really strong evidence base for the positive impact on the lifecourse of early years universal health services, supporting parents and providing ‘early intervention’ where there are problems.

Health visitors are part of the wider public health workforce with a key role in in supporting parents to give their children the best start in life.

As the national health visiting programme comes to a close and we prepare to transfer the commissioning of 0-5 services to local authorities it is timely to reflect on what has been achieved and the excellent work being done.

It is important that PHE and all those working in public health are aware of the transformed HV service – what it offers to parents in terms of access and experience and impact on health outcomes. This blog looks at the programme and the progress.

In 2011 we published the national 'Call to Action' to deliver the government’s commitment to increase the number of health visitors by around 50%, to increase professional capability in respect of new knowledge and leadership and thus to transform services for children families and communities.

The programme has delivered what is thought to be the biggest percentage professional growth ever achieved in the NHS in this timescale. We succeeded in training in excess of 7000 nurses and midwives to become health visitors having great support from the education and regulatory sector ensuring HV education incorporated new knowledge and models of practice.

Practice teachers did a great job training more students in new arrangements, supporting inexperienced HV mentors and providing local leadership for professional transformation. The current estimate is that by 1 April we will have around an additional 4,000 wte health visitors plus over 900 student health visitors in their final supervised practice element of training.

Alongside this a range of professional leadership initiatives have been undertaken to support transformation, including extensive professional materials and support developed with front line teams. We have raised the profile of public health nursing and health visiting using conventional and digital campaigns.

For service transformation we now have a clear, easily understood national framework on which local services can build. HV 456 sets out a four tiered service with increased reach from community action to complex needs (support for all parents – more help when needed) five vital (mandatory) universal health reviews for all children and six areas where health visitors have especially high opportunity and impact on child and family health and wellbeing.

We are already seeing improved access and outcomes on a number of the 6 high impact areas (see this Storify page for more information)

The contribution of parents has been vital. They contributed through local feedback and participating in research. Parents also participated through social media and our recent week of action on parents experience  'you said...we did ...we will' demonstrates how parents contribution continues to shape services.

At the front-line health visitors have trained new students and returners to practice, incorporated the rapidly emerging evidence around the early years into practice, developed strong local partnerships which bridge primary care and early years, led service transformation and demonstrated impact of the service on improved outcomes.

We have more health visitors now than at any time since community nursing statistics were first recorded in 1971. 'HV 456' has been developed to show what can be achieved through the additional capacity and frontline leadership - vital services for supporting families for children's health, development and resilience.

PHE takes the responsibility for the professional leadership of health visiting in April 2015. As the Best Start Programme and Health Visiting professional lead I look forward to working with health visitors to maximise their contribution to this next phase of promoting children’s public health.

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1 comment

  1. Comment by Bren posted on

    Hello Viv,

    Thanks for this blog and it will be good to see the Local Authority embedding Health Visiting in and across their community work.

    It is good that the actions of Health Visitors and progress to date is identified and recognised.

    I note from the blog there is no reference to the role of community and voluntary sector in contributing to the support of parents and families. I think they have close links and are an asset within this ever joining up approach to the lives of children and families.

    Best wishes,