Today, the First 1001 Days Movement has released a new report: “Why Health Visitors Matter: perspectives on a widely valued service”. This report is a compilation of short testimonies about why health visitors are important in ensuring that all babies and children are safe, healthy, and able to thrive. The testimonies showcase the vital role of health visitors, demonstrating the breadth and depth of their work.

The First 1001 Days Movement is a campaigning alliance of over 200 organisations who work together to promote the importance of sensitive and nurturing relationships for babies and young children’s emotional wellbeing and optimal development. The iHV is privileged to be a member of the First 1001 Days Movement steering group and we are indebted to all the members of this alliance who have joined together to call on the Government for investment in health visiting. This forms part of the Movement’s wider ambitions to drive change by inspiring, supporting, and challenging national and local decision makers to value and invest in the first 1001 days.

Key messages from the report:

  • Health visitors have the potential to do so much for our babies, our families, and our public services.
    The first 1001 days is a period of opportunity and vulnerability. Support for our babies, children and families is needed now, more than ever. Health visitors support children’s development and help to keep them safe. They are skilled Specialist Community Public Health Nurses able to engage and build relationships with families, understand their health and care needs, offer support and intervention, and broker engagement with other services.
  • Current resourcing decisions mean that many health visitors cannot effectively do the important work they were trained to do.
    Since 2015, when responsibility for health visiting was transferred to local authorities, it is estimated that at least 30% of the health visiting workforce has been lost, with further losses forecast. The Public Health Grant has fallen in real terms from £3.99 billion in 2015–16 to £3.3 billion in 2022-23, this is at a time when need has increased.

Currently, the health visiting metrics include phone and virtual appointments as “reviews”; and the latest quarterly data shows that 18.6% of babies missed out on their 9-12-month review and 27.7% of toddlers missed out on their 2-2.5-year-old review. More children are also falling behind with their development, yet fewer are engaging with services such as early education and childcare.

There is wide and unwarranted variation in health visiting support between different local authority areas. Urgent national and local action is needed to ensure that all babies and young children receive services that they need and meet national guidelines.

Alison Morton, Executive Director, iHV said:

“We welcome this report which is published at a critical time in our country’s journey through the pandemic and its wake. It lays bare the problems and far-reaching impacts of years of under-investment in health visiting on babies, young children and their families. The report is also focused on finding solutions – it presents a series of testimonies from those who have first-hand experience of the breadth and depth of the health visiting service and the difference that it can make when sufficiently resourced.

“The report is a call to action – babies can’t wait. Will we be satisfied to accept the picture that is being painted of ‘ghost children’ being let down by ‘ghost services’ that have been stripped bare and left ill equipped to manage the level of unmet need? We have a real opportunity to make a difference before it is too late – we join with members of the movement and call for concerted action from national and local government, united by a shared vision to do better for babies.

“We thank all the report contributors who generously gave their time in sharing their experiences and testimonies to bring to life the real and solid difference that health visiting can make for babies, children, families, and our future society.”

The report has 4 policy calls:

  • Local authorities must commission and fund health visiting services that are able to offer a high-quality service to all those who need them in line with the Healthy Child Programme.
  • The UK Government must properly resource local authorities to enable them to provide health visiting services at al level that delivers everything that government and NICE guidance expects of them, and that families need.
  • The UK Government must do more to encourage local authorities to invest in health visiting services and to hold them to account when services are not meeting national guidelines.
  • The UK Government must also address shortages in the health visiting workforce: it is time for a demand-driven, well-resourced national workforce strategy and plan.

How can you help?

The First 1001 Days Movement needs your help to make the case for better services for our babies, children, and their families.

You can help by:

  • Sharing the report, and your perspectives on why health visitors matter, with local decision makers and politicians, with your networks, and on social media. You can use the hashtag #HealthVisitorsMatter, share the link to the report and tag: @first1001days @sajidjavid and @iHealthVisiting
  • Writing to your MP and asking them to attend the NSPCC’s parliamentary event on 16 May (details here)
  • Writing to the Health Secretary, Sajid Javid, about their concerns.






First 1001 Days logo

The Institute of Health Visiting (iHV) joins over 60 First 1001 Days member organisations who have today jointly written to the new Secretary of State for Health and Social Care, Sajid Javid, asking him to address the impacts of the pandemic on babies and their families, and to take longer-term action to ensure all our children have the best start in life.

Alison Morton, Executive Director iHV, said:

“The importance of getting it right for every child cannot be over-emphasised. The needs of babies, children, and young people have all too often been overlooked in pandemic policymaking. Although some money has recently been spent on mitigating the impact of the pandemic on older children, nothing has been spent or allocated to children aged under two.

“We now need the Government to prioritise on babies’ health and wellbeing, and those of their families, to ensure that all children have the best start in life. Giving our babies the best start in life can improve health and wellbeing for decades to come and positively impact future generations.”

The letter describes three things that the Secretary of State should prioritise to make a significant difference:

  1. Securing funding in the upcoming Spending Review to deliver the Government’s Best Start for Life vision.
  2. Setting out clear expectations in the Health and Care Bill that local partners will cooperate in order to improve outcomes and reducing inequalities for children in the first 1001 days.
  3. Ensure that the new Office of Health Promotion can intervene when a local area is not delivering the Healthy Child Programme or is experiencing poor, declining, or unequal outcomes in the first 1001 days, providing additional support and resources where needed.

At the start of Infant Mental Health Awareness Week, the leaders of nearly 80 organisations, including the Institute, have signed a letter to the Prime Minister calling on him to make the youngest children a national priority in order to mitigate the secondary and potentially long-term impact of the COVID-19 crisis.

Dr Cheryll Adams CBE, Executive Director iHV, said:

“Health visitors have seen at first hand the impact of COVID-19 and the lockdown on new families, and therefore support this important call for much more attention to be placed by government onto the earliest days. There is no other time in the lifespan where investment will save so much on later fiscal spend. It is not only the right thing to do, it also makes sound economic sense and we hope that the prime minister will want to support this call.”

The letter from the First 1001 Days Movement argues that, as politicians decide on COVID-19 relief and recovery packages, there is an opportunity now to invest in the wellbeing of babies and toddlers and the parents that care for them, as part of efforts to build back a better Britain.

The signatories, which include major children’s and mental health charities and professional bodies who are all part of the First 1001 Days Movement, ask the Prime Minister to champion a cross-government strategy for improving outcomes for all children. This should set out a vision for how families will be supported to recover from the impact of COVID-19 and how the Government will begin to ‘level up’ and close gaps in outcomes which have widened during the pandemic.