Tags: inquiry

iHV provides evidence at the COVID-19 Inquiry

iHV CEO, Alison Morton, provided evidence on the impact of the pandemic on children, young people and their health services at today’s COVID-19 Inquiry Module 8 Public Hearings.

Alison Morton, iHV CEO, providing evidence on the impact of the pandemic on children, young people and their health services at the COVID-19 Inquiry Module 8 Public Hearings

The UK COVID-19 Inquiry has been set up to examine the UK’s response to and impact of the COVID-19 pandemic, and learn lessons for the future.

Module 8 is examining the impact of the pandemic on children and young people in England, Wales, Scotland and Northern Ireland. It will consider the impact of the pandemic on children across society including those with special educational needs and/or disabilities and from a diverse range of ethnic and socio-economic backgrounds.

Alison, on behalf of the Institute of Health Visiting, was invited to be a core-participant in the Inquiry Module 8 – having previously also submitted evidence to Module 3 – Impact of Covid-19 pandemic on healthcare systems in the 4 nations of the UK (read our news story here).

Alison joined today’s other speakers: Duncan Burton (on behalf of NHS England); Prof. Steve Turner (on behalf of the Royal College of Paediatrics and Child Health); Claire Dorer OBE (on behalf of the National Association of Special Schools); and John Barneby (on behalf of Oasis Community Learning).

Alison’s evidence

In her written submission and oral evidence today, Alison described how the needs of our nation’s babies and children were not given the attention they deserved in the emergency plans – and babies were ignored and largely forgotten. Other areas of healthcare were prioritised and the response failed to adequately consider the breadth of the pandemic’s wider harms.

As a direct consequence, too many children were harmed – yet, these harms were entirely foreseeable and predictable, and impacted child health, development and safety.

The pandemic was a highly stressful time for both families and services, with plans operationalised under huge pressure, lack of staff and multiple competing priorities. Staff came to work to do a good job – but this was very challenging. Like any emergency, lots of decisions were made; some were good, some were wrong from the start, and some were found to be flawed and caused unnecessary harm. And it took too long to reverse bad decisions.

One of the biggest failings for health visiting was the decision to “stop” the service and redeploy health visitors, under the misguided impression that they were needed most to care for acutely ill patients. In reality, health visitors were needed most on their own ‘frontline’, supporting babies, children and families during this stressful time. During the pandemic, health visitors were incredibly resourceful and supported millions of families – but as a result of these decisions, many missed out.

The second notable failing was the decision that contacts should be ‘virtual by default’. This was driven by insufficient PPE, a lack of understanding of the role of health visitors, and the importance of babies, young children and families being seen in person.

Thirdly, when it was clear that large numbers of families were struggling and demand for health visiting support soared, services should have been strengthened. Instead, health visiting experienced further cuts in real terms.

Commenting on the Inquiry, Alison said:

“It is clear that babies, children and families were failed in this pandemic. Their needs were not prioritised. Too many were not given care, support and protection when they needed it most. To put this right, children need more than an apology – because there is a burning platform for us to do better. And there are two urgent priorities:
– Firstly, for the children in this generation, now! who have been harmed, or have needs that aren’t being met. We need a national “Babies, Children and Young People Covid-19 Recovery and Rebuild Plan”. This cannot be ignored any longer – inequalities are not inevitable. And we know enough about what works to make a difference now.
– Secondly, for the babies, children and young people in the future – for the next emergency. We need to be better prepared to cope next time – as things stand now, we look to be worse off.

“It’s clear that the failures were due to systemic failures, in the way that children’s needs – and child health services – are resourced and prioritised in the heart of government. We need to create a better future. And this will take investment and a plan to tackle the root causes of poor health and rebuild child health services. This cannot be put at the bottom of the pile again.”

Recommendations

In her statement, Alison provided a full list of recommendations and set out her ‘top three’:

  1. A cross-government strategy is needed to prioritise the earliest years of life and reduce inequalities. This must include actions to tackle the wider determinants of health and a commitment to world class child health services.
  2. Ensure that the holistic needs of babies, children and young people are explicitly addressed in future emergency plans. And this must include the pandemic’s wider impacts.
  3. Specifically for health visiting:
  • Health visitors are most needed as Specialist Community Public Health Nurses working with families during emergencies. The health visiting service must be categorised to continue and not stop during these worrying times.
  • There is an urgency to rebuild health visiting services in England where services have been decimated, following years of cuts. We urgently need more health visitors because health visitors are a vital child health workforce, providing a frontline service that reaches all families and works with others to ensure they get the support they need to thrive.

And this is needed to help create the healthiest generation of children ever.

Recordings

Watch a clip of Alison at the COVID-19 Inquiry Module 8 Public Hearings:

Watch the full Module 8, 8 October PM session, with Alison Morton - Alison starts at 34:56

Read the full transcript here

Read Alison Morton's written evidence for Module 8 of The Covid-19 Inquiry here (publicly available 8 October 2025)

Alison’s submission for Module 8 builds on her submission for Module 3, with the inclusion of additional evidence and iHV position statements on key issues affecting babies and young children.

See all recordings from the COVID-19 Inquiry proceedings – https://www.youtube.com/@UKCovid-19Inquiry

Speaking up – Alison Morton gives powerful oral evidence to First 1000 Days Inquiry

This week, on 4 June, Alison Morton, iHV CEO, gave oral evidence to the Health and Social Care Committee Inquiry on the First 1000 Days. Wednesday’s session was the second oral evidence session for the First 1000 Days Inquiry which accepted written evidence earlier this year (including a submission from the iHV) to examine progress made in this area since their last inquiry in 2019.

Health and Social Care Committee – First 1000 Days Inquiry

The session, titled “The First 1000 Days: a renewed focus”, examined local authority provision of early years services through the Family Hubs Model, with MPs posing questions about access to services, funding and workforce capacity. The cross-party Committee, chaired by Paulette Hamilton MP, were also particularly interested in the current state of health visiting and its impacts on babies, children and families.

During the two-hour session, Alison responded to numerous lines of questioning on the health visitor workforce, regional variation, commissioning arrangements, as well as opportunities to maximise the role of health visitors in the government’s three key shifts for the NHS and plans to improve uptake of immunisations.

Alison was joined on the panel by:

  • Christine Farquharson, Associate Director at the Institute for Fiscal Studies
  • Rukshana Kapasi, Director of Health at Barnardo’s
  • Rachel Roberts, Strategic Lead for Early Help and Prevention, Children, Young People and Family Services at Hull City Council.

The session considered the Family Hubs model in comparison with the Sure Start model, with Members questioning Christina Farquharson, the witness from the Institute for Fiscal Studies (IFS), on the recent IFS report on the impact of Sure Start centres and variations with Family Hubs. The cross-party Committee explored how effective Family Hubs had been at reaching families from different communities – and also included lines of questioning on the adequacy of current funding and where additional funding should be targeted, if it were available.

Influencing policies affecting health and advocating for others is a central tenet of health visiting. Whilst there were many examples shared by panellists on successes in Family Hubs, Alison provided a powerful voice for our profession – and for the babies, children and families who we support – highlighting the differences between the Family Hub model and the Healthy Child Programme, and the current gaps in healthcare provision for the first 1000 days.

Alison challenged the Committee to have high aspirations for children, stating:

“Every child deserves a robust healthcare system – postnatal care shouldn’t be left to chance… as much as we want to have a positive spin on this… there is a burning platform that we need to do better. And actually, what we’re seeing is huge variation across the country… and we need to think bigger and be ambitious for children.”

Responding to the evidence, Ben Coleman MP, gave a heartfelt response, stating:

“I’ve been listening to this discussion with rising fury. I think the situation we are in now, the collapse in health visitor numbers, the collapse in funding for… helping parents and children to start life is – I’ve got to say it – it’s an absolute disgrace! And we are letting our communities down, we are letting our families down, we are creating huge problems in our communities – and I want to say well done [to all health visitors] for what you are doing in an absolutely stinking situation! We have to put it right now.”

Alison said she hoped a commitment to improve health visiting would form part of the government’s highly anticipated 2025 spending review on departmental spending:

“What [health visitors] want is a government to stand up and say, ‘we back our health visitors, we support them, and we show you this by putting our words into action, and we’re going to invest in you’, so I’m hoping that might be the outcome of the spending review.”

Recognising the ‘burn out’ that many health visitors are facing, she also praised the tenacity of the workforce at an increasingly tough time for the profession.

“I am overwhelmed every day by the tenacity of health visitors and the brilliant work they’re doing despite the pressures that they are under.”

The session was broadcast live on Parliament TV – if you missed it, you can catch up and watch the recording of the full 2-hour session here.

And a short sample of the session here or click below:

Covid-19 Inquiry Module 3, witness statement on health visiting published

In June 2023, our CEO, Alison Morton received a formal request for evidence for Module 3 of The Covid Inquiry from The Rt. Hon Baroness Hallett DBE PC (Chair of the Inquiry). All witness statements for Module 3 are now publicly available.

Alison’s witness statement presents evidence of the impact of the Covid-19 pandemic on health systems across the UK, between: 1 March 2020 and 28 June 2022. In particular, it provides a historical record of policy decisions and the healthcare systems’ response related to health visiting in England. The scope of the evidence includes people’s experience of health visiting, and workforce implications (including redeployment, access to PPE, the use of technology, and the impact of the pandemic on health visiting practitioners, including those in training).

Background

The UK Covid-19 Inquiry is the independent public inquiry set up to examine the UK’s response to and impact of the Covid-19 pandemic, and learn lessons for the future. The Inquiry is Chaired by Baroness Heather Hallett, a former Court of Appeal judge, who has the power to compel the production of documents and call witnesses to give evidence on oath. The UK Covid-19 Inquiry covers the handling of the pandemic in England, Wales, Scotland and Northern Ireland (a separate additional Inquiry is taking place in Scotland).

The Inquiry is split into 10 modules, which have different subject topics. Module 3 of the Inquiry opened on 8 November 2022, with a statement from Baroness Hallett:

“The pandemic had an unprecedented impact on health systems across the UK. The Inquiry will investigate and analyse the healthcare decisions made during the pandemic, the reasons for them and their impact, so that lessons can be learned and recommendations made for the future…”

Alison was asked to provide evidence on health visiting, in relation to the following key topics:

  • Topic 1: The impact of government decision-making on health visiting during the pandemic
  • Topic 2: The use of technology to conduct appointments and meetings
  • Topic 3: The impact of Covid-19 on people’s experience of healthcare and quality of care – the impact on those requiring care for reasons other than Covid-19
  • Topic 4: Staffing capacity including the redeployment of health visiting practitioners from one area to another
  • Topic 5: Infection prevention and control. The availability of appropriate personal protective equipment (PPE) for those working in the health visiting during the pandemic. The effect of national guidance on infection control within healthcare settings
  • Topic 6: The impact of the Covid-19 pandemic on the Institute of Health Visiting and its members/ practitioners working in health visiting teams, including those in training.

Timeline

The initial period for gathering evidence was relatively short, with the call for evidence received on 20 June 2023 and the first submission due by 15 August 2023. This was then followed by two further rounds of clarification questions from the Module’s legal team and the management of redactions of personal information (unless it related to senior officials), with the final submission completed in February 2024. This evidence will form part of the Inquiry, alongside the evidence gathered through the public hearings for Module 3 which were held between 9 September 2024 and 28 November 2024 (available to access here). The evidence is all currently being reviewed and the recommendations will then be formulated, with a clear monitoring process in place to ensure that they are acted upon.

Commenting on being part of the Covid-19 Inquiry, Alison Morton said:

“When I first received the formal request to provide evidence on health visiting from Baroness Hallett, I felt an enormous weight of personal responsibility for our profession, recognising the importance of telling our story. And a mantle to do justice to the experiences of all my health visiting colleagues across the country, as well as the babies, children and families that we all seek to serve. My witness statement provides an account of the decisions that were made, based on the information that was available at the time. My overriding goal is that it provides a foundation for learning and adds to the weight of evidence to drive lasting change for the better!

“My statement comes with a ‘health warning’ – it is lengthy – and reading it back today, I had vivid flashbacks to March 2020. A time when the world shut down – but babies kept on being born, and the struggles of family life were magnified for so many. A lot happened in the next 30 months. There were so many brilliant examples of the tenacity of the human spirit to care for others, as well as harrowing accounts of the multiple harms experienced by so many people.

“At the iHV, we were involved with national policymakers, frontline practitioners, service leads, researchers, and families with babies and young children. The evidence brings together pieces of the jigsaw from that time, when a pandemic exposed vulnerabilities and weaknesses in healthcare systems, as well as fantastic examples of professionalism and rapid innovations. Health visiting practitioners up and down the country will also have their own stories to tell of this challenging time.

“Since I first submitted the evidence in August 2023, more research and evidence on the wider impacts of the pandemic on babies, children and families has been published – there are also still many unanswered questions. And more learning will no doubt come to light in the years to come. With a growing weight of evidence on the importance of the earliest years of life, and soaring levels of need, we need to learn from the past and now get on with the serious business of building a better future.”

Read Alison Morton’s written evidence for Module 3 of The Covid-19 Inquiry here

Read iHV's latest State of Health Visiting Report to see evidence of the soaring levels of need

iHV submits response to Prevention of ill health inquiry

iHV has submitted its response to the Health and Social Care Select Committee’s Prevention of ill health inquiry.

Researchers, organisations and individuals interested in or working in preventative healthcare were invited to submit their responses – to get involved and suggest what specific issues the Health and Social Care Select Committee should be exploring.

The submitted proposals will be used to help the Committee decide where to focus its attention in subsequent stages of its inquiry: further calls for evidence inviting more detailed submissions from interested stakeholders may then be issued on these topics.

Read iHV's response to Prevention of ill health inquiry

 

Government response to the ‘First 1000 days of life’ report

Today, the government has published the Command paper which sets out the government’s response to the Health and Social Care Select Committee report on ‘First 1000 days of life’, published by the House of Commons in February 2019.

The iHV supported the recommendations set out in the Health and Social Care Select Committee’s report ‘First 1000 days of life’, which makes a clear case for early intervention and a strengthened national strategy for the first years of life. The government’s response today and renewed commitment to ensure every child has the best start in life is welcomed – although today’s response is, in many ways, a holding response as we await the results of the Spending Review, the publication of the Prevention Green Paper and Inter-Ministerial group on early years (Leadsom Taskforce) which will hopefully fill the many gaps in detail.

Today’s response recycles a number of existing policy commitments to improve maternity services, support Troubled Families and address the inequalities in early language. In particular, we welcome the renewed commitment to the ambitions of the Maternity Transformation Programme “for maternity services across England to become safer, more personalised, kinder, professional and more family friendly; where every woman has access to information to enable her to make decisions about her care; and where she and her baby can access support that is centred on their individual needs and circumstances.” It also calls for all staff to be supported to deliver care which is women-centred, working in high performing teams, in organisations which are well led and in cultures which promote innovation, continuous learning, and breakdown organisational and professional boundaries. We would welcome a similar ambition for health visiting services.

We are concerned that there is a notable absence of new policies for children and families once discharged from maternity services and limited national levers to reverse the current unwarranted variation in the quality and quantity of support that families receive based on where they live, rather than their level of need.

Ultimately the success of any programme will rest on sufficient resources being allocated nationally through a cross-departmental plan, and the Spending Review funding settlement for local government will have an important impact on whether wider improvements in population health and prevention can be delivered. We will continue to advocate for a strengthened health visiting service as set out in our recent letter to the Treasury.

 

Go to Government response to the Health and Social Care Select Committee 'First 1000 days of life' report

Read iHV's response to Health and Social Care Select Committee’s report ‘First 1000 days of life’, February 2019

Stop Press – New Keynote speaker: Dr Paul Williams MP

Stop Press

Dr Paul Williams MP

The Institute is delighted to announce that Dr Paul Williams MP, Chair of the First 1000 Days of Life inquiry for the Health and Social Care Select Committee, is to address the Institute of Health Visiting conference – Health for All Children Now – on 9 May in Manchester.

Book early to avoid disappointment – and to get your earlybird ticket!

Earlybird ends 29 March 2019.

For more conference details and to book your place

 

iHV welcomes Committee’s visionary report on the First 1000 Days of Life inquiry

The Institute of Health Visiting very much welcomes the Health & Social Care Committee’s visionary report on the First 1000 Days of life – which calls for cross-government action to improve support and services for children and families in England and to reduce health inequalities in childhood through a range of actions.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“We know every health visitor will join us in being delighted that the Health & Social Care Committee’s six principles reflect our own health visiting priorities for offering effective early years services for every infant and reducing health inequalities.

“We particularly support the H&S Committee’s call for the Government to produce a long-term cross-government strategy for the first 1000 days of life to give every child the best start in life supported by joint NHS/Local Authority joint commissioning. We believe the vision could realistically be enhanced by adding an objective of reducing the number of children requiring referral to mental health services, something not unrealistic if the recommendations are implemented, and this would quickly demonstrate an economic benefit to the NHS from doing so.

“We also warmly welcome the report’s call for the Healthy Child Programme (HCP) to be revised, strengthened and given more importance in policy. We are pleased that an extra mandated contact at 3-3½ years by a health visitor is recommended to extend the current reach of the HCP and we continue to recommend there should also be an extra contact (home visit) at 3-4 months, and for these mandated contacts be seen as the minimum and to all be done by a health visitor.

“The report helpfully endorses most families’ desire to have continuity of care with a named midwife and health visitor and we welcome the call for strengthened links between obstetricians, midwives, health visitors and primary care services – this is so fundamental alongside continuity of care. Health visitors, who are often trained to master’s level are well placed to build relationships with families and identify those at risk of poor outcomes who would benefit most from targeted interventions. We fully support the strengthening of early identification of families’ needs during pregnancy, with provision available at all levels (universal, targeted and specialist). Movement between levels of intervention needs to be fluid as needs may change over time; some families only require short-term additional support whilst others require much longer-term input involving a range of partners, as so importantly stated in the report.

“The Committee’s recommendation that the Government uses the forthcoming Spending Review to focus public health funding towards early intervention for children and families is essential. This will also reduce future expenditure in later life for children requiring high levels of support which is the unfortunate cost from not acting early.

“We look forward to seeing how this report is accepted by the Government and hope that its recommendations could receive early endorsement if the ‘Prevention’ green paper takes a pathway approach from pregnancy to old age. We further hope that, if it attracts additional validation by the Taskforce led by Andrea Leadsom MP, its recommendations and framework for action can quickly be implemented, offering an early years building block to the Government’s new prevention strategy and creating some parity in the quality of early years services for infants across the UK.”

Read H&S Committee news story on the publication of their report

Download H&S Committee Report on the First 1000 Days of Life inquiry

Find out more about iHV’s written and oral evidence to the inquiry

iHV's written submission to the First 1000 Days of Life inquiry

iHV's oral evidence to the First 1000 Days of Life inquiry

iHV evidence in call for national early intervention strategy to transform lives

Following the collation of evidence for their Evidence-based early-years intervention inquiry , the House of Commons Science and Technology Committee has published their report and is calling on the Government to draw up a new national strategy for early intervention approaches to address childhood adversity and trauma.

The Evidence-based early years intervention Report urges the Government to capitalise fully on the opportunity that early intervention provides to transform the lives of those who suffer adversity in childhood, while also saving long-term costs to Government.

Read iHV written evidence submission to the Early-years intervention and Adverse Childhood Experiences (ACEs) inquiry

This is a very important and hugely interesting report which includes the call for secure funding for early interventions and also cites the Institute in one of the recommendations:

Recommendation 9.

The Healthy Child Programme is the only mechanism in place through which all children in England should receive early years practitioner support before the age of five. Its coverage is therefore critical for identifying ACEs and other child development issues early. The Government should review the current provision of the
Healthy Child Programme across England and set out, as part of the new national strategy, a date for achieving complete coverage in the number of children who receive all five mandated health visits. Given existing workforce pressures, the Government must ensure that this required increase in coverage does not negatively impact the quality of health visits. It should consult the Institute of Health Visiting on how this can be managed, and be ready to recruit additional health visitors as required.
(Paragraph 54)

The Committee’s Report identifies examples of early intervention working well around the country, but also the challenges that local authorities and their partners currently face in delivering effective, evidence-based early intervention. It concludes that the overall provision of early intervention in England is fragmented, with varying levels of support, focus on evidence, and success.

The Committee calls for a new national strategy to be drawn up to ensure that the opportunity provided by early intervention—to transform lives and save long-term costs to Government—is seized fully, and by all local authorities in England.

Go to Full Evidence-based early years intervention Report

Read the report's conclusions and recommendations

Read the Committee's press release on the report's publication

iHV gives oral evidence to First 1000 Days inquiry

Yesterday, 13 November 2018, Dr Cheryll Adams CBE joined a fantastic group of leaders from the sector to give oral evidence to the Health and Social Care Select Committee into the First 1000 Days inquiry.

There were lots of discussions about the important role that health visitors can play and also lots of support from others giving evidence to the committee – making the case for early intervention, prevention, relationships and  babies in the First 1000 days. But key was that as a society we need to value early childhood and encourage and support parents in their role.

Cheryll’s oral evidence starts from 15:46 on the link to Parliament TV.

Go to oral evidence session on Parliament TV

 

 

 

 

This oral evidence session follows the submission of written evidence from iHV to the committee earlier this year and published on the inquiry website.

Read iHV written evidence submission

 

Find out more about the Health and Social Care Select Committee inquiry into the First 1000 Days

 

 

iHV publishes submission to parliamentary inquiry into the First 1000 Days of Life

The Institute of Health Visiting (iHV) has published its written evidence submitted to the parliamentary Health and Social Care Committee inquiry into the First 1000 Days of Life.

The bulk of public spending during a child’s life comes in their teenage years, but there is a significant case for investing public money much earlier – i.e. during a child’s first 1000 days of life. There is strong evidence showing spending then has many later benefits to individuals and society – the problem is the gap between that evidence and what is currently provided.  This inquiry is to review that gap.

Dr Cheryll Adams CBE, Executive Director, Institute of Health Visiting said:

“We welcome this inquiry into the First 1000 day of a child’s life. Evidence supports a specific priority for focusing spending on early intervention, prevention and inequalities as they affect children in the first 1000 days of life. We know that this would have a significant impact on their future health and development across the life-course. Investing more resources in the first 1000 days, would lead to less investment being needed for secondary and tertiary care in later life, by preventing problems (and increased costs of later healthcare) from occurring in the first place.

“Health visitors have highly developed skills in assessment and the formation of trusting relationships with families, each being critical to effective engagement with families in the first 1000 days.  Adequate resourcing of the service could be delivering enhanced and earlier support to prevent problems or reduce their impact and in so doing reduce later expenditure for the NHS.”

The parliamentary Health and Social Care Committee inquiry into the First 1000 Days of Life is not re-examining the evidence base, or the economic case. Instead it plans to focus on the following three key areas: national strategy, current spending and barriers to investment and local provision.

Dr Adams continued:

“On national strategy, we propose that the NHS should act with others to strengthen the governance of the Healthy Child Programme (HCP) across all partners.  This should be through joint integrated NHS and local authority commissioning within a national quality framework for systems-based practice for child and family public health.  That should realise the benefits of closer working both with NHS child health services and primary care, alongside local authority services such as children’s centres. In such a context, health visitors are well equipped to more realistically fulfil their long-recognised mandate to both deliver in practice and to lead the HCP at system level.

“On current spending and barriers to investment, we highlight the impact of recent reductions in public health funding and evidence of the impact of reductions in the resourcing of health visiting. We also recommend that health visitor caseload size should not exceed 250 children per full time health visitor or a maximum ratio of 1:100 in more deprived areas.

“Our written evidence submission lays out what the Institute believes a high-quality evidence-based approach to service provision would look like for the First 1000 Days of life if more spending happened during this period.  Health visitors, with their highly developed skills, are well placed and critical to supporting this agenda.”

Download iHV Written evidence to the parliamentary Health and Social Care Committee inquiry into the First 1000 Days of Life