Health visiting has been a cornerstone of public health for over 160 years, evolving from Victorian home visits reducing infectious disease to today’s focus on a breadth of child and family health priorities and the reduction of health inequalities - guided by the best available evidence. Health visiting policy and practice draw on a wide range of evidence because they aim to address the needs of individuals, families, and entire communities.
In this collection, we present the iHV Vision for Health Visiting – an evidence-driven policy blueprint series for health visiting published by the iHV in 2019 and 2020. Please also see our range of recent consultation responses, position statements and iHV research which illustrate the impact and value of health visiting – and which have shaped policy and practice in the UK and internationally. These examples provide a snapshot of the evidence base, but they are not in any means exhaustive. A much wider body of research is available through academic databases and specialist journals, reflecting the ongoing evolution of practice and policy.
For those wishing to explore further, we recommend searching academic platforms such as PubMed, CINAHL, or Google Scholar for comprehensive and up-to-date research.
iHV Evidence-based Vision for Health Visiting
Published in October 2019, ‘Health Visiting in England: A Vision for the Future’ sets out our evidence-based blueprint for health visiting.
Our ‘Vision’ was developed in response to the government’s request for stakeholder engagement to inform their refresh of the health visiting model for England and the Healthy Child Programme, and against a backdrop of significant workforce losses. It sets out our model for a proportionate universalism approach for health visiting with a particular focus on fifteen areas where health visiting can have a high impact on health outcomes. Note: Whilst there have been some changes to the policy context in England since 2019, the Vision contains key principles for best practice, which are also transferable for other nations.
In addition to the full report, a suite of supporting publications were also published in 2019/2020 – these can be accessed using the links below:
📄 Health Visiting in England: A Vision for the Future (full report, October 2019)
📄 Health Visiting in England: A Vision for the Future (Executive Summary)
📄 Health Visiting – Good practice case studies – First Edition (January 2020)
📄 What do parents want from a health visiting service? Results from a Channel Mum survey
(January 2020)
Background: The first edition of ‘Health for All Children’ (HFAC) in 1989 was the result of a BPA working party chaired by David Hall, and set out an evidence-based programme of screening and surveillance for children. The book became known as the ‘Hall report’ and the RCPCH supported 3 subsequent revisions, with the last being published in 2006. A new edition (HFAC 5) was published in 2019 in response to the growing evidence base, the changing commissioning landscape, and divergence between the child health programmes in different UK nations. The evidence presented in Hall 5 has been used in different ways by the UK nations to inform their policy blueprints for child health.
Aim: To provide an up-to-date concise review of evidence supporting child health programmes to inform commissioners and support practitioners.
Methods: In 2015, the RCPCH and Oxford University press (OUP) established a multidisciplinary editorial group to undertake a comprehensive critical review of evidence supporting child health from all over the world, and make recommendations for the UK. A weighting of the strength of the evidence is attached to each recommendation.
Results: HFAC 5 reviews the evidence supporting preventive health care, health promotion and an effective community-based response to the needs of families and children, from pregnancy to age 7. The philosophy is to improve child health by reducing inequalities through a programme of proportionate universalism, with enhanced and targeted services for families with extra needs. This book summarises evidence about ‘why’ and ‘what works’ in health promotion and health surveillance with children and families, and where possible gives guidance on ‘how’ to implement and quality assure a programme – but does not conclude on ‘who’ should provide the service.
Recommendations are made for commissioners of child health services, provider organisations and Trusts, and practitioners. The strength of recommendations is determined by the balance between the quality of evidence, variability in values and preferences, desirable and undesirable consequences of alternative strategies, and resource use. HFAC 5 has 35 chapters divided into 6 sections. Each chapter concludes with ‘learning links’: recommended e-learning courses and online materials to support evidence-based practice
HFAC 5 is available as an e-book and a paperback published by OUP, and on Paediatric Care Online.
This important review was led by Professor Dame Sarah Cowley, one of the founders of the iHV and current iHV Trustee. The research formed part of the national ‘Health Visitor Implementation Plan 2011-2015: A Call to Action. London: Department of Health’ The research team synthesised 348 papers and identified the core components of health visiting practice, including person-centredness, needs assessment, and home visiting. These were linked to reducing health inequalities through proportionate universalism.
Ref: Cowley S, Whittaker K, Grigulis A, Malone M, Donetto S, Wood H, Morrow E, Maben J. Why health visiting? A review of the literature about key health visitor interventions, processes and outcomes for children and families. London: National Nursing Research Unit, King’s College London; 2013.
Other reports and papers published in this series included:
- Donetto S, Malone M, Hughes J, Morrow E, Cowley S, Maben J. Health visiting: the voice of service users. Learning from service users’ experiences to inform the development of UK health visiting practice and services. London: National Nursing Research Unit, King’s College London; 2013.
- Cowley S, Whittaker K, Malone M, Donetto S, Grigulis A, Maben J. Why health visiting? Examining the potential public health benefits from health visiting practice within a universal service: a narrative review of the literature. Int J Nurs Stud. 2015;52(1):465–480. doi:10.1016/j.ijnurstu.2014.07.013.