As well as supporting health visitors, one of the iHV’s most important roles is to influence policies that affect the health of babies, children and families.  We do this in a number of ways – by working with policymakers and politicians across the UK and by raising the profile of what health visitors do, and its importance in a modern healthcare system.

We are fortunate to live in a time when we have more evidence than any other generation on the importance of getting it right in the earliest years of life – alongside supporting every child to reach their full potential, investing in these formative years also makes sound economic sense.

It is now time for the future government to step up to the plate to make “giving every child the best start in life” a reality!

Alongside tackling the wider determinants of health, all families should expect modern health services during pregnancy, the postnatal period and the earliest years of life that are on a par with the best in the world. Currently, families with babies and young children face a postcode lottery of support, health inequalities are widening, more children are falling behind with their development and are being harmed by conditions that are entirely preventable. Families are calling for better care.

On 4 July, voters will be going to the polls to decide which party they will trust with the leadership of our country, with health as one of the key issues.

The iHV is calling for a significant increase in the number of health visitors in England with three clear asks of the next government:

Policy: All families should receive the full offer of health visiting support as set out in national policy in the Healthy Child Programme and Health Visiting Model for England.


  1. Funding: All areas need sufficient funding to deliver the full specification for the national health visiting model and Healthy Child Programme Schedule of Interventions. Long-term investment, with ring-fenced funding, will help services to plan and build world-class services, ending the uncertainty of short funding cycles.
  2. Workforce: The national long-term workforce plan to retain, train and reform the health visiting workforce needs to be delivered in full, alongside funding for substantive posts. Demand-driven workforce modelling is needed to ensure that the workforce plan enables sufficient capacity to deliver the Healthy Child Programme to all babies, children and families as intended – it is estimated that 5,000 more health visitors are needed to meet the scale of families’ needs and replace workforce losses since 2015.
  3. Governance: Update OHID 0-19 Commissioning guidance – providing greater clarity and system levers to ensure equity of health visiting provision throughout England and ending the current postcode lottery of support that families face during pregnancy, postnatally, and through the first five years of their child’s life.

Key Messages:

  • Children born in England have some of the worst child health outcomes compared to other similar nations, with widening health inequalities, growing concerns about invisible vulnerable children, and soaring costs of late intervention. Tackling this requires a whole system response, including action to address the wider determinants of health. Action is also needed at an individual and community level to prevent, identify and treat problems before they reach crisis point. Health visitors provide an important part of the solution. When sufficiently resourced, they provide a vital infrastructure of support for families with babies and young children – with benefits that accrue across the health, education and social care system.
  • There are currently no levers to ensure that national policy set out in the Healthy Child Programme and Health Visiting Model for England are delivered. Families face a postcode lottery of support, with health visiting services experiencing significant cuts and role drift from their core “health” functions across numerous clinical pathways during pregnancy, postnatally, and throughout the early years. The needs of babies, children and families do not vary that much between local authority areas to justify the current variation in health visiting services across England.
  • Health visiting is the only service that proactively and systematically reaches all families from pregnancy and through the first five years of a child’s life. This provides support for all families across a breadth of physical health and mental health needs (for babies, children and adults), child development, social needs and safeguarding, and a vital safety-net for the most vulnerable that is not provided by any other service.
  • Cuts to health visiting services are having knock-on consequences across the health, education and social care system (for example, falling immunisation rates, fragmented postnatal care, increase in A&E attendance for children 0-4 years, inequalities in obesity rates, poor school readiness and soaring costs of late intervention/ child protection). Through their specialist public health role, health visitors can prevent, identify and work with families to treat problems before they reach crisis point.

Alison Morton, CEO iHV, joined Mishal Husain as a guest on the BBC Radio 4 Today programme this morning to speak about the state of health visiting in England. The interview was set up in response to yesterday’s hard-hitting report from the Academy of Medical Sciences which was featured on their programme, highlighting a growing crisis across the early years – with wide ranging evidence of declining health that takes root from preconception through pregnancy to the first five years of life.

If you missed Alison’s interview, the news item on the Today programme starts at 53:36 with Mishal Husain summarising the findings from Sir Andrew Pollard’s report and its urgent call for the health of the under 5s to be addressed. Mishal questioned the role of health visitors in addressing some of these issues and asked Alison for her views on why so many families were missing out on this vital support:

Alison said:

“We just heard yesterday, Andrew Pollard’s report talks about how important it is to identify problems and treat them early….. We have a huge problem with the number of health visitors in England.

“All families in England should be entitled to see a health visitor from pregnancy to age of 5…We know many are missing out.

“Health visitors are supporting millions and millions of families every year, but we’ve had a 40% cut in our workforce over the last 9 years and now there aren’t enough health visitors to meet the scale of need. And sitting alongside the increased need that we heard about yesterday, we really should be investing in health visitors rather than cutting the service further.”

When asked if it was an England problem when comparing to the 11 health contacts that Scotland provides and that 9 that Wales provides, Alison commented:

“It’s hugely variable across all the UK nations, and also within England itself. So in some parts of the country, families are getting a pretty good level of support and in other areas families are getting virtually nothing.

“We know many children are not receiving the support that they need. And actually what that does is that it strips out the mechanism to identify problems early, to treat them before they reach crisis point. So, what we’re seeing is knock-on consequences into other services – we’ve heard about the soaring rates of A&E attendance… the under 1s are the highest users of A&E, and the rate has increased by 42% in the last 10 years in England. Whereas, in Scotland, they don’t have this problem, because they have intensive home visiting by health visitors who support families in the heart of the community.”

When asked about the 5 mandated visits in England, Alison commented:

“This is the bare minimum…. That is an opportunity to reach families. Health visitors’ USP is that they reach all families. They are the only service that proactively and systematically reaches families with babies and young children. This is vitally important because we know that babies are our most vulnerable citizens, at the highest risk of harm, and also, we know that the foundations of future health and wellbeing are laid in early childhood, so getting support early really makes a huge difference.”

  • Recording available for 29 days only from 6 February 2024
  • Listen to the full 4 minute interview with Alison Morton – starts at 53:36
  • Piece ends 57:45




The Institute of Health Visiting (iHV) publishes the findings from the largest UK survey of frontline health visitors working with families across the United Kingdom.

Our survey findings paint a bleak picture with health visitors seeing first-hand the realities that families with babies and young children in the UK are facing. Health visitors are reporting epidemic levels of poverty, with more parents struggling under the weight of the cost-of-living crisis that is forcing them to turn to food banks to feed their children.  Alongside this, more parents are living with mental health problems, domestic abuse and adversity, that pose risks to the health and wellbeing of babies and young children.

Health visitors are witnessing the impacts of stress associated with poverty on children’s safety, health and development. At the same time, there are insufficient health visitors to meet the scale of rising need. This is being felt most acutely in England, as health visitors are battling to deliver a service following a loss of almost 40% of health visitors since 2015.  Consequently, despite health visitors’ best efforts, many families are not receiving the support that they need, and this is being intensified by a lack of capacity in other health and social care services who are also experiencing extreme pressures.

Alison Morton, Executive Director at the Institute of Health Visiting, says,

“Through their universal reach, health visitors have a privileged and unique view into the lives of babies, young children and their parents/ carers across the UK. Health visitors’ experiences presented in this report provide an important ‘early warning signal’ of the most pressing threats and challenges to the health and wellbeing of our youngest citizens which are often hidden behind front doors and invisible to other services.

“The findings also paint a deteriorating picture of a health visiting workforce under immense pressure as practitioners struggle to meet the scale of rising need. Families are facing the brunt of these challenges with a widening postcode lottery of health visiting support across the UK.”

We publish at a time of ongoing uncertainty with political and economic instability, and ever-increasing health inequalities that will get worse if not addressed. The whole of the health and care system is also struggling to rebuild in the wake of the pandemic. As health visitors often work alone, or in small teams in families’ homes, their work is often hidden and it’s easy to overlook how important it is. The NHS backlogs regularly hit the headlines, but they are only one part of the legacy left by the pandemic on the healthcare system; less high-profile backlogs of care and unmet need in health visiting services have been overlooked within a ‘baby blind spot’ in national policy which will leave equally serious challenges for both mental and physical health for babies, children and families across the UK, now and in years to come.

Alison concludes:

“Because the first years of life are so important for lifelong health, wellbeing and success, ignoring this tsunami of unmet need being experienced by our youngest citizens risks undermining the life chances of so many children.

“It is not too late to change direction and pursue reforms, but the situation is serious. There is now unequivocal evidence that the current rate of health visitor workforce attrition, and insufficient training places to plug the forecasted gaps, is not sustainable and will jeopardise the delivery of all UK Governments’ child health programmes.

“In England, the Government categorised health visiting as one of six priority services in its Start for Life Vision for the first 1001 days. However, this commitment is at risk without investment and a plan to rebuild the health visitor workforce.”

Rising needs and widening inequalities – child safety, health and development: the problem, some key facts and stats:

  • 91% of health visitors reported an increase in poverty affecting families over the past 12 months
  • 91% reported an increase in families needing foodbanks
  • 83% reported an increase in perinatal mental illness
  • 75% reported an increase in domestic abuse.

Health visitors have witnessed first-hand the impact on babies and young children’s safety, health and development:

  • 84% of health visitors reported an increase in children with speech, language and communication delay
  • 76% an increase in child behaviour problems
  • 60% of health visitors reported further increases in child safeguarding over the last 12 months (building on significant increases reported last year).

Health visitors in England also raised serious concerns that national data mask increases in child safeguarding, as:

  • Children living with significant risk and vulnerability are not detected as services are cut, and
  • Social workers’ caseloads are capped to a maximum – growing numbers of children living with significant risk and vulnerability now fall below higher thresholds.

Only 7% of health visitors in the UK felt confident that all families would be able to access the support they needed when a problem was identified. 86% reported that there was not enough capacity in other services to pick up referrals for support/ treatment

Our main policy recommendations:

  1. Prioritise the first 1001 days of life – a shared cross-government ambition and strategy for the first 1001 days is needed to improve health outcomes and reduce inequalities for babies, young children and families. This needs to be prioritised by the Treasury and seen as the smartest of all investments in our nation’s future, rather than as a cost.
  2. A shift towards prevention and early intervention is needed to support all people to lead healthy and fulfilling lives by addressing the key public health priorities that pose the greatest threats to our nation’s health, thereby preventing debilitating and costly ill health in later life.
  3. Equity of access to support is needed for all babies, children and families across the UK and an end to the current postcode lottery.
  4. System’s thinking – the benefits of an effective health visiting service accrue to numerous government departments and across a person’s lifetime. Complex system’s principles need to be applied across all aspects of health and care delivery, including workforce planning, funding and the development of measures that capture health visitor’s input and impact across the system.
  5. Integrated clinical care pathways with significant ‘front-loaded’ investment in prevention and early intervention are needed across health visiting, school nursing, midwifery, social care, General Practice, and early years, to ensure:
  • All babies, children and families are supported to reduce inequalities in key priority areas
  • All children at risk of poor outcomes are identified early
  • A continuum of support for a continuum of need is provided to achieve shared goals for key public health priorities for babies, children and families.
  1. Strengthening the health visiting service requires a clear plan focused on the following three areas:
  • Funding – All areas need sufficient funding to deliver the full national specification for the health visiting service and preventative public health programme for children
  • Workforce – A demand-driven, well-resourced national workforce strategy is needed to increase the number of health visitors to address current and forecasted losses, and improve retention, job satisfaction and career progression for experienced staff
  • Quality – National government must do more to:
    • support local authorities with resources to provide health visiting services at a level that delivers everything that government and NICE guidance expects of them, and that families need
    • hold local authorities to account when services are not meeting national guidelines
    • support the ongoing research, development and sharing of evidence-driven models of best practice based on proportionate universalism.

Would you like to share your practice developments or research at our 2022 annual evidence-based practice (EBP) conference – “Together | Fairer | Stronger” on 15 September 2022 at King’s House Conference Centre in Manchester?

If so, we would love to hear from you! The EBP conference will be a fabulous event for you to showcase your work whilst sharing learning and innovations in practice.

We welcome submissions that support the overall theme of reducing health inequalities and strengthening integrated working from researchers, and educators. We know that many practitioners are also leading innovative improvement projects in practice, and we want to provide an opportunity for you to showcase and disseminate your findings to a wider audience.

We are keen to showcase best practice examples of effective integrated working and would also be especially delighted to receive applications from community nursery nurses and other health visiting associate practitioners. Non-UK applicants will also be considered if their work can demonstrate transferable learning.

Why should I submit an abstract?

  • To showcase your work, disseminate your findings to a national audience and raise the profile of your organisation
  • To enhance research in health visiting
  • To inform others about positive, innovative approaches to improve evidence-based practice in health visiting and preventative public health work focused on families with babies and young children
  • To raise the profile and benefits of an effective health visiting service focused on reducing health inequalities

Abstract/conference themes:

We are inviting abstracts that support the overall theme of the conference: Reducing health inequalities and strengthening integrated working:

  • Improving access/ reducing inequalities: We are particularly interested in submissions that improve the experience and outcomes of health visiting service users who encounter obstacles accessing health care, and/ or people with protected characteristics, for example: people from minoritised ethnic groups; people with disabilities; LGBTQI+ women and people; families experiencing homelessness; domestic abuse; substance misuse problems; mental illness and mental health problems; and safeguarding.
  • Integration: Innovations in health visiting practice or service delivery models from across the UK that can demonstrate impact within integrated/ ‘whole system’ public health approaches to addressing health inequalities.
  • Themes may also include, but are not limited to current priority public health topics:
    • Transition to parenthood, including preconception care
    • Breastfeeding
    • Perinatal mental health (mothers, fathers, and partners)
    • Infant and child mental health
    • Healthy nutrition, physical activity, and healthy weight
    • Managing minor illnesses, building health literacy and prevention of sudden infant death syndrome (SIDS)
    • Reducing unintentional injuries
    • The uptake of immunisations
    • Primary prevention and health promotion in oral health
    • Child development 0-5 years, including speech, language and communication and school readiness
    • Sleep
    • Children with developmental disorders, disabilities, and complex health needs
    • Tobacco, alcohol, and substance misuse in the perinatal period
    • Healthy couple relationships
    • Teenage parenthood

Abstract Submissions

The abstract submission deadline is 4 April 2022.

Please see Abstract Submission Guidelines and Timeline for further details on format and how to submit.

We are very excited that our EBP conference will be face to face. It will provide a great opportunity to showcase local work and network with colleagues and national experts from across the country. It really is a conference that can’t be missed!

Our Booking system is due to go live on 11 March so, in the meantime, please hold the conference date in your diary – 15 September 2022 at King’s House Conference Centre in Manchester.




Charity collective, Best Beginnings, Home-Start UK and the Parent-Infant Foundation, publish a new report sharing families’ experiences of lockdown during pregnancy or with a baby.

Babies in Lockdown: listening to parents to build back better (2020), based on a survey of over 5000 families, highlights the chronic under resourcing of services for families, the inequalities in babies’ early experiences and its worsening forecast due to the COVID-19 pandemic. The report warns that many families with lower incomes, young parents and those from Black, Asian and minority ethnic communities, will have been hit hardest by the pandemic. The Babies in Lockdown Report shines a light on UK baby inequalities as charities call on Government to act now to avoid a “Post-COVID19 lottery”.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“The iHV welcomes this excellent report which lays bare just how challenging it has been for many parents during lockdown. It was distressing to read their stories and, in particular, how the most disadvantaged have felt the hardest impact of lockdown and lack of support. It is important that we listen to the voice of these parents and ensure that we are better prepared to meet the needs of young children and their families as the pandemic continues. We support the report title, we now need to build back better for infants and their families and this will include ensuring that all families receive support from the health visiting service during this crucial stage of their parenting journey”.

The report tells us that:

  • COVID-19 has affected parents, babies and the services that support them in diverse ways.
  • Families already at risk of poor outcomes have suffered the most.
  • Without action, the pandemic could cast a long shadow on the lives of some babies.

The Babies in Lockdown: listening to parents to build back better (2020) report makes three policy calls for the UK Government:

  • A one-off Baby Boost to enable local services to support families who have had a baby during or close to lockdown.
  • A new Parent-Infant Premium providing new funding for local commissioners, targeted at improving outcomes for the most vulnerable children.
  • Significant and sustained investment in core funding to support families from conception to age two and beyond, including in statutory services, charities and community groups.

The iHV welcomes and supports the call from the Royal College of Paediatrics and Child Health (RCPCH) and Children Poverty Action Group (CPAG) on the next UK Government to take urgent action on poverty to ensure a healthier future for the UK’s infants, children and young people.

Poverty and low income is seriously affecting the health of UK children according to paediatricians – and any new Government must tackle health inequalities or risk storing up health problems for future generations. That’s according to a new report from the Royal College of Paediatrics and Child Health (RCPCH) and Child Poverty Action Group (CPAG) launched today.

The report “Poverty and child health: views from the frontline” is based on a survey of more than 250 paediatricians across the country, whose comments provide an insight into the grave reality of life for the millions of UK children living in poverty.

Latest figures show that 30% (4 million) children in the UK live in poverty – with projections suggesting this could rise to 5 million by the end of the decade.

Dr Cheryll Adams CBE, executive director, iHV, commented:

“The iHV welcomes and supports the call from the Royal College of Paediatrics and Child Health (RCPCH) and Children Poverty Action Group (CPAG) on the next UK Government to take urgent action on poverty to ensure a healthier future for the UK’s infants, children and young people.

We particularly welcome the call to reverse public health cuts to ensure universal early years services, including health visiting and school nursing, are prioritised and supported financially, with additional targeted help for children and families experiencing poverty.  The recent reduction in health visitor numbers impacts the vital support that babies, young children and families need at such a critical time in their lives – we want to ensure that every child has the best start in life.”

The report looks at a number of areas including food insecurity, poor housing and worry, stress and stigma – and their effect on the health of children.  It reveals that:

  • More than two-thirds of paediatricians surveyed said poverty and low income contribute ‘very much’ to the ill health of children they work with
  • Housing problems or homelessness were a concern for two thirds of respondents.
  • More than 60% said food insecurity contributed to the ill health amongst children they treat 3
  • 40% had difficulty discharging a child in the last 6 months because of concerns about housing or food insecurity
  • More than 50% of respondents said that financial stress and worry contribute ‘very much’ to the ill health of children they work with

The RCPCH and CPAG are calling on whoever forms the next Government to tackle poverty urgently through:

  • The restoration of binding national targets to reduce child poverty, backed by a national child poverty strategy.
  • The adoption of a ‘child health in all policies’ approach to decision making and policy development, with Her Majesty’s Treasury disclosing information about the impact of the Chancellor’s annual budget statement on child poverty and inequality.
  • The reversal of public health cuts to ensure universal early years services, including health visiting and school nursing, are prioritised and supported financially, with additional targeted help for children and families experiencing poverty.
  • The reversal of cuts to universal credit which will leave the majority of families claiming this benefit worse off.

Download full report (PDF, 1.1 MB) or read summary here.