The Institute of Health Visiting (iHV) is delighted to publish ‘Health Visiting in England: A Vision for the Future’, their evidence-based blueprint to rebuild health visiting services.

Developed in response to the government’s request for stakeholder engagement to inform their plans to refresh the health visiting model for England and the Healthy Child Programme, and taking into account the worrying loss of health visitors over the past 4 years, this publication sets out a new model of health visiting advising eight universal contacts and a particular focus on fifteen areas where health visiting can have a high impact on health outcomes.


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

“Despite overall improvements in child health, England lags behind other countries on many key health outcomes: infant mortality reductions have stalled, our breastfeeding and obesity rates are amongst the worst in Europe, our immunisation rates are falling and health inequalities are seen across all indicators.

“The current status of health visiting is not serving families well, based as it is on universally delivered process outcomes which risk “ticking the box, but missing the point”. There remains a persistent gap between what the evidence tells us, and the profession aspires to achieve, and what is currently able to be funded and provided since the year on year cuts to public health budgets starting in 2015.

“Based on the evidence, we recommend that the universal offer in England includes three additional service “review points”, increasing the offer to eight contacts, with additional tailored support where needed, aligned primarily to fifteen High Impact Areas where health visitors can make the greatest difference to infant, children and family outcomes. But also recognising the value of health visiting in, for example, supporting the mother postnatally to manage on-going physical consequences of giving birth, supporting the family of a child who has a chronic and worrying health issue such as asthma, supporting families through a bereavement or working with a people within marginalised groups.”

Health Visiting in England: A Vision for the Future

The new iHV Vision for Health Visiting in England sets out an “upstream” public health response with action based on the principles of proportionate universalism. It seeks to address some of the limitations of the current 4-5-6 model, balancing the need for a population approach alongside a more personalised individual response.

In addition to renewed investment and revised workforce modelling, a plan for rebuilding the workforce will be needed to establish the workforce requirements to deliver a refreshed Healthy Child Programme and all levels of the health visiting service offer.


Dr Adams continued:

“National leadership by government is essential to set ambitious and binding national goals to reduce health inequalities for children in key public health priority areas.

“The health visiting service of the future needs to be built more closely around eight key elements to ensure the service is: evidence-driven, accessible, responsive, personalised, collaborative, fairer and effective. This will only be achieved with greater professional autonomy and a recognition of the importance of relationships at the heart of everything we do.

“We need action today, to support every child to have the best start in life and a ‘bright’ future.”


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