Understanding the rise in 0–4-year-old Emergency Department (ED) attendances and changing health visiting practice

This report presents the findings from a rapid review to understand changing Emergency Department attendance rates in children aged 0-4 years, alongside changes in health visiting practice to support parents to manage minor illnesses in England.

Tackling increasing demands on urgent care services is a national priority. This review was undertaken due to heightened concerns about ED attendance rates for children aged 0-4 years which have continued to increase in England for more than a decade – and compared to all other age groups, babies under one have the highest rate of ED attendance, however the rate of potentially avoidable ED attendance is much higher in babies and young children.

The review was completed by the Institute of Health Visiting (iHV), in partnership with paediatricians in three large Emergency Departments in England, using mixed methods including: reviews of national and selected local ED attendance data; a narrative summary of literature; and a national survey of health visiting practitioners.

This project was funded by a grant from Kindred Squared and we thank them for their support. 

📖 To read the final report and find out more click here.

🎥 Watch our short film, ‘Can you see my baby? Health visitors prevent emergencies’ developed to raise awareness of the issues

📖 Four supporting documents are presented as standalone appendices:

Appendix 1 | Narrative review of the literature (Dec 2023)

Appendix 2 | Healthier Together case studies, supporting a whole system approach to address increasing demand on children’s Emergency Departments (Dec 2023)

Appendix 3 | Digital parental support via ChatHealth messaging in health visiting (Dec 2023)

Appendix 4 | Analysis of infants under 12-months who attended Northwick Park ED, London (Dec 2023)

Plus read:

Opinion piece in Journal of  Family & Child Health – Troubling rise in emergency department attendance of babies and young children in England: Time to focus on prevention and support (September 2025)