New evidence consolidated from across the decade-long ‘A Better Start programme’ demonstrates that investing in health visiting can deliver lasting benefits for babies, young children and families, while helping to reduce pressure on public services over the longer term.

A new policy briefing published today by the National Children’s Bureau (NCB) brings together learning from the £215 million National Lottery Community Fund programme and calls on government to strengthen investment in health visiting as a key pillar of prevention.

The briefing highlights how enhanced health visiting models in Blackpool, Bradford and Nottingham have improved outcomes for children and families, particularly in communities experiencing higher levels of deprivation.

Over the past decade, A Better Start has supported local partnerships across five areas of England to improve children’s health, development and life chances through evidence-based early years interventions. Working alongside health visiting services, the programme has tested and evaluated a range of approaches, including additional universal contacts, sustained home-visiting support for families facing greater challenges, and peer-led support programmes that complement professional services.

The evidence shows that investing in health visiting can improve child development, strengthen parent-child relationships, support family wellbeing and reduce longer-term demand on health, education and social care services.

Among the examples highlighted are Blackpool’s pioneering eight-contact universal health visiting pathway, Bradford’s health visitor-led sustained home-visiting MECSH programme, and Nottingham’s Family Mentor Service, which has supported more than 6,000 children and created local employment opportunities.

Based on the findings, NCB is urging policymakers to protect and invest in universal health visiting, expand opportunities for sustained family support, strengthen workforce development, and place health visiting at the heart of the Government’s ambition to shift from treatment to prevention.

We thank colleagues at NCB and the A Better Start partnerships for bringing together this important body of evidence. The findings add to the growing case for sustained investment in health visiting, ensuring that every baby, child and family can access the support they need to thrive.

The full briefing is available from NCB.

About us and the role:

This is a rare and exciting opportunity to join a growing, forward-looking organisation at a pivotal time. With a strong and expanding membership, iHV is working to strengthen the health visiting workforce and shape the future of child and family health across the UK.

As Policy Manager, you will play a key role in influencing national policy across priority areas including early years, prevention, public health, child protection and workforce. Your work will directly support iHV’s mission to improve outcomes and reduce inequalities for babies, children, families and communities and spread excellence in health visiting.

Working closely with our clinical team, members and partners, you will develop evidence-based policy positions and help ensure frontline expertise informs decision-making at the highest levels.

You will be joining a collaborative, passionate team in a fast-paced environment where no two days are the same – and where your work will make a real and lasting difference.

Key responsibilities:

  • Lead the co-development of evidence-based policy positions with iHV’s clinical team, members and partners.
  • Monitor policy developments and identify opportunities to influence change.
  • Produce high-quality briefings, consultation responses and reports.
  • Build relationships with stakeholders across government, charities and the health sector.
  • Gather, synthesise and apply frontline insight to inform policy development – including the production of iHV’s high-profile ‘State of Health Visiting’ survey and report.
  • Work closely with the Systems and Digital Manager, applying digital and data expertise to leverage digital tools and emerging technologies (including AI) to strengthen evidence-gathering, inform policy development, and improve organisational effectiveness.
  • Support delivery of policy elements of iHV projects and organisational priorities.
  • Represent iHV at meetings and contribute to sector discussions.

About you:

We are looking for the following essential skills and experience:

  • Strong understanding of UK policy-making processes and child and family health/ early years policy – ideally informed by experience working within or closely with government or public sector organisations.
  • Exceptional writing skills, with a proven ability to produce authoritative, high impact briefings, reports and policy documents that are clear, persuasive and tailored to diverse audiences.
  • Highly developed analytical skills, with the ability to interpret complex information and evidence from multiple sources and translate this into clear, practical and actionable policy recommendations.
  • Ability to collate, synthesise and critically assess diverse sources of insight, including frontline practitioner perspectives, quantitative and qualitative data, to inform robust policy development.
  • Experience developing or contributing to evidence-based policy outputs (e.g. briefings, reports, consultation responses).
  • Strong interpersonal and relationship-building skills, with the ability to work effectively and collaboratively with a wide range of stakeholders and partners.
  • Strong organisational and project management skills, with the ability to manage competing priorities, coordinate inputs and deliver work to deadlines.
  • Confident verbal communication skills, with the ability to contribute effectively to meetings, events and external discussions, presenting complex ideas clearly.

Closing date for applications: Midnight on Thursday 23 July 2026.

Contact Information: For further information or for an informal chat about the role, please contact Alison Morton, CEO via [email protected] 

Today, the Department of Health and Social Care published its long-awaited policy blueprint for improving child and family health. The Healthy Child Programme (HCP) is the national framework for improving the health and wellbeing of children and young people aged 0 to 19 (age 25 for care leavers or those living with special educational needs and disabilities) in England.

It sets out evidence-based approaches to prevention, early intervention and family support – supporting the government’s ambition of raising the healthiest ever generation of children.

The updated Healthy Child Programme (HCP) is presented in a suite of resources, including refreshed:

  • Delivery guidance which outlines the expected delivery expectations for public health nursing teams for ages 0 to 19 and their provider organisations.
  • Commissioning guidance which sets standards for commissioners to establish, monitor and assure the quality of public health nursing services for ages 0 to 19 delivered by provider organisations.
  • High-impact area framework which complements these by translating principles into nationally recognised, actionable priorities across ages 0 to 19.

The Department of Health and Social Care has thanked the hundreds of people and organisations (including the Institute of Health Visiting) who contributed feedback for the development of the guidance. Following feedback on the lack of clarity in the previous HCP guidance and wide variation in service equity and quality across England, the purpose of the refreshed guidance is:

  • To make the guidance clearer and easier to use for commissioners, providers and practitioners.
  • To strengthen assurance around service delivery.
  • To ensure the consistency of service quality nationwide.
  • To better reflect emerging population health trend and better align with the direction of travel set out in Fit for the future: 10-year health plan and in the context of other government ambitions, including Giving children the best start in life.

Whilst the guidance does not introduce any new statutory duties, it reaffirms the importance of health visitors as a qualified clinical public health workforce and their vital role in healthcare and prevention (from preconception to age 5).

It also maintains the clinical importance of face-to-face contact (where these have drifted in some areas), the importance of high-quality care, and the breadth of health visitor’s role across multiple clinical pathways and ‘high-impact areas’ – while also embedding digital options and supporting research and innovation to ensure services remain proportionate and responsive.

Alison Morton, iHV CEO, provided her initial thoughts on the new guidance:

“We welcome the publication of the updated Healthy Child Programme, which powerfully reaffirms why health visitors are essential and provides a clear, national benchmark for the quality expected in commissioning and delivering services. For too long, families have faced a postcode lottery of health visiting support in the crucial earliest years – a costly mistake in both human and financial terms, leaving too many without support when they needed it most.

“This guidance is an important step forward. By offering long overdue clarity, when fully implemented, it has the potential to transform the quality and consistency of support available to all families. It recognises and enables the full contribution of health visitors, as Specialist Community Public Health Nurses, to help create the healthiest generation of children ever.

“It goes without saying, that this guidance will only be turned into reality with a strong workforce plan to deliver it – and we look forward to seeing this reflected in the forthcoming 10-Year NHS Workforce Plan and supporting its delivery.”

We are still working our way through the details and would value your thoughts on the guidance.

The new HCP focuses on:

  • The importance of health visitors (as registered and regulated Specialist Community Public Health Nurses) to lead the delivery of the HCP. This is crucial to ensure quality and safety. The guidance states that every family should be allocated a named health visitor, to support continuity of care and the relationships required for safe and effective practice.
  • The importance of home visiting – to enable health visitors to gain a fuller understanding of the family’s living conditions and dynamics, which are central to a robust assessment of health needs. The guidance recognises that certain indicators of risk may not be apparent in clinical or community settings.
  • Proportionate levels of service to meet individual needs (all 4 levels of support should be available within every local authority, with service delivery tailored to assessed individual needs):
     – Community
    – Universal
    – Targeted
    – Specialist
  • Clarity on purpose and content of health reviews – and role of the health visitor:
    – A minimum of 5 health and development reviews must be offered (with 3 suggested targeted reviews). In line with best practice, the antenatal, new birth and 6-to-8-week health and development reviews should be delivered face to face in the home by a health visitor.
    – Other reviews may be offered in alternative settings (including Family Hubs and Neighbourhood health centres) based on family preference and individual circumstances, rather than service convenience.
    – Named health visitors should deliver all 5 statutory health and development reviews at specified stages to support continuity of care and relationship building.
    – In certain circumstances, a health visitor may delegate a review to a suitably qualified health professional or nursery nurse, provided they are supervised and the health visitor maintains overall accountability.
  • Clarity on the purpose of health visitors’ targeted and specialist service offer:
    – At the targeted level, practitioners deliver additional support based on an assessment identifying specific needs (including a targeted-indicated and targeted-selective offer).
      – At the specialist level, practitioners deliver substantial interventions for families requiring intensive or more complex care, based on ongoing assessment. The HCP clearly sets out statutory obligations for specific populations and the crucial role of health visitors in identification, early support and access to services.
  • Safeguarding: Includes description of the role of health visitors and requirements on local authorities to consider capacity of the health visitor workforce and prioritise delivery of the HCP.
  • Collaboration – integration with Family Hubs and Neighbourhood Health Centres: The 10-Year Health Plan commits to the inclusion of health visiting services within Neighbourhood Health Centres, stating ‘health visitors should be system leaders and active partners in neighbourhood teams’. Health services are also a major component of effective Best Start Family Hubs.
  • Workforce capacity: The workforce that delivers the HCP – and its numbers, skill mix ratios (and therefore competencies of the different staff) and training commissions – should be based on the current population need. The guidance includes details of provider organisations’ responsibility to ensure that services are delivered by enough appropriate practitioners with the necessary qualifications, skills and experience to carry out the work effectively (including adherence to the NMC Code requirements on scope of competence, delegation, accountability and supervision).
  • Workforce and service sustainability: The guidance highlights that delivery of the HCP depends on strategic investment in the qualified SCPHN workforce across both health visiting and school nursing services. Commissioners and provider organisations should ensure there is sufficient SCPHN capacity to lead, deliver and research care safely and effectively for all babies, children, young people and families.
  • Workforce development: Clarity on roles and responsibilities, and skills needed to deliver the remit of the HCP and high-impact areas. Clearer supervision, preceptorship and mentoring guidance, alongside continuous professional development to support safe and effective practice and an emphasis on local workforce planning and career development (including recognition of the value of specialist health visitor roles).
  • Digital delivery: Improved data sharing, integrated digital records and tailored digital resources; reflect direction set out in the 10-Year Health Plan on digital delivery (whilst ensuring safe and effective practice).
  • Quality and implementation: with expectations on a clear approach to monitoring, auditing and benchmarking to secure expected outcomes for babies, children, young people and families – with a focus on purpose and assessment against outcomes. The guidance includes a full list of KPIs for national reporting, and commissioners are also encouraged to introduce their own local KPIs (with examples provided).
  • Parental engagement and inclusive practice: Services delivered by 0 to 19 public health nursing teams as part of the HCP should actively engage families from the earliest point of contact, beginning in the antenatal period (including both parents and wider family members where possible). The guidance also highlights the importance of co-production – the design, delivery and review of services should be shaped in response to feedback from children, young people and families.

Read the full suite of HCP documents:

In response to our growing policy portfolio at the iHV and the need to strengthen our policy presence across Scotland, we are delighted to announce that Christopher Sweeney has been appointed as iHV Expert Adviser for Scotland Health Visiting Policy.

Christopher Sweeney, iHV Expert Adviser for Scotland Health Visiting Policy

Christopher will bring his expertise and knowledge of Scottish policy relating to babies, children and families and health visiting practice to the iHV. He will be supporting iHV engagement within Scottish networks to strengthen our involvement in national workstreams which relate to improving outcomes for babies, children and families, and creating excellence in health visiting.

The iHV has a committed and highly regarded team, with professional expertise in numerous public health priority topics for babies, young children, and families. We work with leading experts, practitioners, parents, and carers through our advisory forums, networking events, surveys, and co-production groups. Our growing network of voluntary Expert Advisers ensures our members’ perspectives shape our work, keeping the iHV’s decisions and policy positions grounded in practice and evidence.

Christopher joins this growing network of iHV Expert Advisers, bringing a wealth of experience to the role. He is a Health Visitor and Clinical academic fellow and has previously worked as a Practice Development Nurse and Health Visitor in NHS Greater Glasgow and Clyde, and Nurse Activity Manager with Médecins Sans Frontières in South Sudan, Sierra Leone, and Ethiopia.

Christopher completed his master’s research titled ‘Exploring Glasgow parents’ views of the Equal Protection from Assault (Scotland) Bill’ and he is now in the final stages of his PhD where he is exploring how new parents respond to childhood illness and make decisions to use urgent care services.

Christopher is also one of our Scottish iHV Health Visiting Advisory Forum (HVAF) members and he has been supporting our work, including iHV Practice Education and Research workstreams.

Below is a picture of Christopher in action when he attended Parliament during this Summer with Alison Morton, iHV CEO. Alison was giving oral evidence to First 1000 Days Inquiry and invited Christopher and Amanda Hall (another HVAF member) to join her in Parliament.

We are looking forward to working with Christopher and strengthening our engagement and involvement across our Scottish national workstreams and our mission to create excellence in health visiting.

Yesterday, the iHV submitted its policy proposals to the government’s Spending Review making the case for rebuilding health visiting services in England. The Spending Review provides an important opportunity for professional bodies to influence government spending over the next three years. The government has stated that they will use the Spending Review to change the way public services are delivered by embedding a mission-led approach, driving forward public service reform and making the best use of technology to better deliver services.

Our response brings together the collective voice of health visitors captured in our annual survey and the wider work of the Institute, outlining the poor state of child health and rising levels of need experienced by babies, children and families that cannot be ignored any longer. We are delighted that our call for investment in health visiting has attracted widespread support from across the child health and early years sector – the message is clear, we need more health visitors!

To improve our nation’s health and reduce pressure on NHS services, much greater attention needs to be given to prevention, early identification of health needs, and early intervention in the critical earliest years of life. Health visitors have a vital role to play as part of the “health” workforce, contributing to multiple clinical pathways through pregnancy, the perinatal period, and 0-5 years (for babies, children and adults).

It is therefore vital that the “broken” state of health visiting is addressed, alongside the NHS, with action to reverse the loss of more than 40% of health visitors since 2015. The cuts to health visiting services have been a false economy, impacting on families’ quality of healthcare and placing additional burdens and costs on other parts of the healthcare system.

Our request aligns with the government’s objectives to prevent ill-health by improving child health, and reform health visiting to reduce spiralling costs of late intervention. Our brief summary sets out our policy proposal:

  • To address the loss of more than 40% of health visitors (HVs) since 2015 and ensure all families receive support in line with the Healthy Child Programme, ring-fenced funding is needed for 1,000 extra HV posts each year for the next 3 years.
  • To reform health visitor services and support workforce retention, salary uplift funding is needed for 689 specialist HV posts (providing clinical leadership for government priorities, like perinatal mental health, immunisations and SEND).

Benefits and policy rationale

More health visitors are needed to deliver the government’s ambitions for prevention and early intervention (across health, education and social care), including reducing children’s A&E attendance and improving immunisation uptake, the quality of postnatal care, and early identification and support for “school readiness” and SEND.

Deliverability of proposals: It is far easier to rebuild and reform a tried and tested service like health visiting than invent a new preventative health workforce, with all the regulatory and training infrastructure needed for quality assurance and to protect the public. We welcome the government’s commitment to “reform health visiting”. This will require actions to improve workforce capacity, recruitment and retention.

Costs:

  1. Costs of 1,000 more health visitor posts are £52.9m for year 1, £105.8m for year 2, and £158.7m for year 3.
  2. Salary uplift costs for 689 specialist HV posts are £8.64m per annum (from band 6 to band 7).

We submitted our brief policy summary online on 10 September, alongside our supporting information and costings – available here.

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.

Asks: 

  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.

New and exciting opportunity with the Institute

Are you:

  • A leader in 0-5 public health policy and practice?
  • Passionate about the potential of improving babies, young children and their families’ outcomes through a strengthened health visiting service and greater emphasis on evidence-driven prevention and early intervention?
  • An excellent communicator, motivated by presenting the evidence needed to inform change?

If yes, then come join us. This is an excellent opportunity to join the iHV as our Policy and Quality Lead to support the further development of our policy and quality functions, and particularly to support the Executive Director and wider team activity.

This is a senior position at the iHV and the successful applicant will have a track record of policy development, managing change and quality improvement, with experience of managing and coordinating public health projects and building strong collaborations with stakeholders. As the Policy and Quality Lead, you will have a central role in developing and delivering the iHV policy and quality portfolio, including further development of the iHV Vision for health visiting. You will work in a matrix way across all the departments at the iHV and with external stakeholders to ensure that we achieve our policy and quality objectives.

Candidates must have at least a masters in a relevant area. You will apply your expertise and knowledge of preventative public health and the policy environment to accelerate progress of the potential within health visiting to address key questions in health inequalities and health improvement for population health (with a focus on babies, young children and their families). You will have significant personal drive and be able to demonstrate that you are passionate about improving the lives of children and families.

The post will suit candidates who have worked in government/the charity sector supporting the development of policy, as well as experienced health visitors and those who have a portfolio of additional skills including research, quality assurance and supporting local or national policy development.

Applications close: 8am Monday 29 March 2021
Interviews: Thursday 1 April 2021

iHV responds to Local Government Association (LGA)’s analysis on children’s social care, published today, which calls for Government to use the upcoming Spending Round to fully fund the demand on children’s services next year to allow councils to provide the vital support that children and families rely on.

Severe funding shortages and huge demand pressures mean councils were forced to overspend on their children’s social care budgets by nearly £800 million last year in order to try and keep children safe, the Local Government Association reveals today.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“The Institute has long warned that more children entering safeguarding procedures and care would be an inevitable consequence of cutting preventive services such as health visiting which identifies needs in families early, mobilises support for families in need and reduces long-term negative consequences of late identification for these children, such as safeguarding issues and care proceedings. These new figures should be of concern to the whole population as, as well as negatively impacting on the child his/herself and their potential future, these high levels of vulnerable children impact crime rates and criminal justice budgets and increase demand on the NHS from complex health needs.

“One in three health visitors has been lost over the past 4 years and the imposition of unhelpful new ways of working makes it impossible for the profession to adequately offer the necessary long term support that some families need. Alongside the LGA, we also call on the Prime Minister and Treasury to use the upcoming spending review to reinvest into public health, preventative and children’s services. The economic arguments are clear.”

The Institute of Health Visiting is delighted to announce the appointment of their first Director, Alison Morton, who joined the Institute today as Director of Policy and Quality.

Alison Morton, Director of Policy and Quality iHV

 

 

Alison was one of the Institute’s first five Fellows. Her most recent role has been as Best Start in Life Programme Manager at Public Health England.

 

 

 

Alison commented:

“I am delighted to be joining the Institute at a time when the spotlight is once again shining on the importance of the first few years of a child’s life as a foundation for future health and wellbeing. The evidence is clear that investing in early intervention and prevention is the right thing to do if we are serious about wanting every child to achieve their potential. Yet there remain persistent, unacceptable inequalities in outcomes for children from disadvantaged backgrounds and those with disabilities, as well as unwarranted variation in support for children and their families dependent on where they live. These inequalities result in poorer physical and mental health, academic achievement and employment prospects throughout the life-course.

“Whilst it can be tempting to invent a ‘new wheel’ when faced with a complex set of problems across society, I strongly believe that the health visiting service provides a crucial part of the ‘solution’ for a number of government departments who fund late intervention.  Crucially, the evidence highlights the key role that the health visiting service plays in leading the delivery of the Healthy Child Programme (0-5 years), in partnership with a wide range of other agencies. I look forward to working with health visitors throughout the country and partners working in maternity and early years, as well as government departments, to strengthen the health visiting service and ensure that every child truly does have the ‘Best Start in Life’.”

We are delighted to share 2 new opportunities with iHV:

  • Director of Policy and Quality
  • iHV Practice Development Lead

Director of Policy and Quality

The iHV is seeking to appoint its first Director to take responsibility for the further development of our policy and quality functions, whilst supporting the Executive Director and wider team activity.

The successful applicant will be educated to Doctoral level, or equivalent academic/professional leadership experience, and will have a strong track record of leading policy and quality initiatives, as well as of budgetary management and contracting.

Applications close: 9.00 am, Monday 14 January 2019

Interviews: Tuesday 22 January 2019 (please hold this date in your diary if applying)

For further information or an informal conversation about this post please contact Dr Cheryll Adams, [email protected]

 

iHV Practice Development Lead

The iHV is seeking to appoint a lead officer for practice development, working across the whole organisation and with the expectation that one day a week will be allocated to supporting iHV training functions.

The postholder, will have minimum of a master’s degree and a strong education and practice development background.

Applications close: 9:00am Friday 11 January 2019 

Interviews: afternoon on Monday 21 January 2019 (please hold this time in your diary if applying)

For further information or an informal conversation about this post please contact Dr Cheryll Adams [email protected]