A five-year roadmap called Researching Effective Approaches for Children (REACH) has been published today to find out what works to prevent domestic abuse and support child victims. This plan has been produced by Foundations, What Works Centre for Children & Families, who provide answers and practical solutions that empower decision makers to improve policy and practice on family support. The plan shares some sobering statistics and highlights how five million children are affected by domestic abuse in the UK, with the social and economic cost standing at £74 billion a year.

The ambitious plan sets out for the UK to become the first country in the world with a set of proven approaches to prevent domestic abuse and support child victims. The document highlights the lack of knowledge about what works to prevent domestic abuse and support child victims, and the need for rigorous evaluation of programmes and services to determine their effectiveness in improving outcomes.

The REACH plan is underpinned by four principles:

  1. To work alongside services to prepare for impact evaluation. They will not evaluate services before they are ready.
  2. Rigorous impact evaluation – to prove that something works to improve outcomes for children.
  3. Testing approaches across the spectrum, from prevention through to helping children recover. This could include prevention and identification services such as health visiting.
  4. Ensuring that victims and survivors are fully engaged in REACH.

The REACH plan is tightly focused on the end goal of finding results from robust impact evaluation. The plan sets out the following four stages to identify and evaluate promising programmes, with the goal of taking around 20 programmes through to full-scale impact evaluation:

  • Stage 1: Finding the best bets. Estimated number of programmes: 80
  • Stage 2: Groundwork for evaluation. Estimated number of programmes: 50
  • Stage 3: Initial testing Estimated number of programmes: 30
  • Stage 4: Full impact evaluation. Estimated number of programmes: 20

Each stage of this plan will help the service providers they work with to strengthen their services and increase their readiness for evaluation, as well as enable identification of the strongest delivery models that are ready to be evaluated for impact. ​

The implementation of the REACH plan requires an investment of £75 million over five years, which the document highlights is around 0.1% of the estimated £74 billion annual social and economic cost of domestic abuse.

The success of the REACH plan relies on collaboration and engagement with service providers, victims, and survivors of domestic abuse. ​ It emphasises the importance of involving victims and survivors in decision-making and ensuring their experiences and expertise inform the evaluation process. ​ Additionally, partnerships with research funders, trusts, and foundations are sought to support the plan’s implementation.

To read more about the plan and how you can get involved – click here.

Update 5 October: the call for applications is now closed as we progress towards delivery of the sessions. We have received high interest from organisations across the country. There will be a further call for interest to participate in Phase 2 (to be delivered Jan – March 2021) at the end of November 2020.


We are thrilled to share that RCN Foundation has awarded funding to enable us to develop and deliver a programme of brand-new virtual support sessions to health visiting staff.



Our emotional wellbeing at work support sessions are for small groups of health visitors (HVs) and HV staff working in the community.

Recent research has highlighted the impact of COVID-19 on the wellbeing and mental health of health visiting staff:

  • 68% of respondents reported stress levels at work have increased over the past year
  • Of these 37% reported they would leave their posts if they could

“The impact of working during the COVID-19 pandemic on staff wellbeing cannot be underestimated – a proactive plan is needed to ensure staff have the right support during the restoration of services and to create high quality workplaces for all staff in the future”.

Conti & Dow, Sept 2020The impacts of COVID-19 on Health Visiting in England 

“Health and wellbeing of (health visitors) are essential to the quality of care they can provide for people and communities, affecting their compassion, professionalism and effectiveness”.

The Kings Fund, Sept 2020 – The Courage of Compassion: Supporting nurses and midwives to deliver high quality care

Who are the support sessions for?

We invite applications for places from health visiting services from across the UK nations, on behalf of their practitioners, who will be representative of the whole health visiting workforce regardless of grade or rank, gender/sex, race/ethnicity etc. Ours is an inclusive approach with an aim to acknowledge and meet everyone’s individual needs, using a sensitive approach to ensure the sessions are accessible to all.

What is the aim of the support sessions?

The overarching aim is to create a bespoke programme co-produced with health visiting teams to meet the needs for emotional wellbeing of the workforce at this current time – through provision of:

  • A safe forum for practitioners to acknowledge and reflect confidentially on pressures created by the ongoing pandemic and to explore any impact on emotional wellbeing at work
  • Protected time for practitioners to explore new approaches to promote reflection on practice and to develop skills in sharing thoughts and feelings via innovative virtual group formats
  • Space for practitioners to consider a range of innovative strategies that may be helpful in promoting emotional wellbeing at work
  • The opportunity for practitioners to devise and review their own personal action plans to support their emotional wellbeing at work

What is included in the support sessions?

The support sessions are a series of 6 innovative workshop-based interactive discussion group sessions. The content of the workshops and discussions will be person-centred and participant-driven but may include:

  • appreciative enquiry strengths-based discussions
  • solution-focused coaching methods
  • emotional containment or restorative supervision styles (e.g. Wallbank, 2016)
  • the use of mentalising stances (e.g. Fonaghy et al)
  • the sharing of emotional wellbeing strategies (e.g King, 2016)


  1. The virtual emotional wellbeing at work sessions provided by the iHV do not replace an organisation’s responsibility for the provision of safeguarding and managerial supervision.
  2. The sessions are underpinned by robust governance processes with protocols in place for managing confidentiality, with an escalation process to flag concerns and enable further discussion outside the group should this be required.

What is the commitment to the support sessions?

We are looking for organisations wishing to offer the opportunity to 5 practitioners who will attend an online programme of 6 x 2-hour emotional wellbeing workshop sessions on a Wednesday or Thursday.

Participants must be willing to commit to attending all sessions and be supported by their managers to prioritise their attendance. They need a private space and access to the Zoom platform.

Each workshop will be delivered virtually by iHV expert facilitators to a small group of up to 10 total participants, providing the opportunity for high quality sharing and learning with and from each other.

Participants will share useful strategies learned with their colleagues and provide feedback to shape future sessions and support evaluation of the programme.


  • Wednesdays – am or pm
  • Thursdays – am

Starting week commencing 19th October 2020 – time of session to be confirmed on approval of participation

Length of programme: A total of 6 support sessions will be provided to each participant – October 2020 – January 2021

Location: Zoom platform (secure password-enabled sessions sent directly to participants)


  • We can offer this opportunity free of charge to organisations wishing to take advantage of this programme due to the grant funding kindly provided to iHV by RCN Foundation.
  • Please note that delivering these sessions is not without cost and we do ask for participants able to commit to attending their place/sessions offered for this limited opportunity.

Calls for expressions of interest in your organisation participating are now closed.

Update 5 October: the call for applications is now closed as we progress towards delivery of the sessions. We have received high interest from organisations across the country. There will be a further call for interest to participate in Phase 2 (to be delivered Jan – March 2021) at the end of November 2020.


The Institute of Health Visiting (iHV) has published “Making History: health visiting during COVID-19”, a collection of case studies which presents a window into the working lives of health visitors and families navigating the ups and downs of the COVID-19 pandemic.


In these unprecedented times, the world “locked down”. Yet life continued, babies kept being born and the normal struggles of parenthood became amplified for many.

Whilst some families enjoyed the relative peace of an enforced slower pace of life; most families were negatively impacted by lockdown and home was not a safe place for some, with rates of domestic violence and abuse, mental health problems and safeguarding concerns quickly becoming a source of concern.

The case studies, family stories and creative pieces contained within “Making History: Health visiting during COVID-19” capture the pace and scale of change as health visiting services adapted to working during “lockdown”.

Alison Morton, Director of Policy at the Institute of Health Visiting, commented:

“It has taken a global public health pandemic to shine a spotlight on the importance of the health visiting service.

“Parents reached out to health visitors for support as many other sources of support were no longer available. Health visitors are Specialist Community Public Health Nurses providing a vital “safety net” for babies, young children and their families whose needs can easily be hidden from sight. Their specialist public health skills, supporting babies, young children and their families during the biggest public health emergency in living memory, have been needed more than ever.”

Health visitors have risen to this challenge with professionalism and autonomy, flexing and developing innovative service “workarounds” to ensure that families receive the best possible support. Different areas have responded in different ways, many introducing “virtual contacts” instead of face-to-face, as well as rapidly responding to urgent needs to support families using Personal Protective Equipment.

Councillor Ian Hudspeth, Chairman of the Local Government Association Community Wellbeing Board, commented:

“Councils are incredibly proud of how their public health workforce has responded over the last 6 months. This report is testimony to the commitment and resilience of health visitors and illustrates the pivotal role they play in ensuring children and families get the support they need in challenging times.

“In the upcoming Spending Review, we are asking the Government to reverse the £700 million of public health reductions, to enable councils to strengthen this workforce and ensure we can continue to support families when they need us most.”

Alison Morton concluded:

“We need to learn from COVID-19 and the experiences of families and health visitors to ensure that the health visiting service is strengthened and fit to face the challenges that lie ahead as we adapt to living with the virus for the foreseeable future. The challenges that we face are not insurmountable – individually and collectively we have the ability to put things right. But this requires bold action to make the difference – there is no time to waste, the time to act is now.”


Our recommendations for restoration of the health visiting service are:

  • Health visiting services should be reinstated (where they have not been) as a matter of urgency as a vital support and safety-net for children, with appropriate measures put in place, including the use of PPE, to reduce the spread of the virus.
  • Health visiting services must be fully prepared for any future waves of COVID-19. NHS England should revise the Community Prioritisation Plan (for phase one pandemic management) and develop clear messages on the importance of continuation of the service to ensure the needs of children are prioritised. This should include removing wording on the redeployment of health visitors.
  • A clear workforce plan is needed to ensure that the service has sufficient surge capacity to manage the backlog of missed appointments, as well as demand for support due to the secondary impacts of the pandemic.
  • An evaluation of the use of virtual, non-face-to-face service delivery methods is urgently needed to determine their effectiveness for identification of vulnerabilities and risks, impact on child and family outcomes and reducing inequalities to inform future digital change.
  • A cross-government strategy is needed to reduce inequalities and “level-up” our society – this will require investment to strengthen the health visiting service which plays a crucial role in the early identification and support of the most disadvantaged families.
  • The impact of working during the COVID-19 pandemic on staff wellbeing cannot be underestimated – a proactive plan is needed to ensure staff have the right support during the restoration of services and to create high quality workplaces for all staff in the future

This week is World Breastfeeding Week 2020, running from 1-7 August. The week aims to raise awareness of the links between good nutrition, food security, poverty reduction and breastfeeding, and galvanise action to increase breastfeeding rates.

2020 has brought new challenges as infant feeding support services have needed to quickly adapt to the restrictions of COVID-19 lockdown and physical distancing. However,  these conditions have also provided the opportunity for services to innovate and work together to ensure that women and babies receive the support that they need to successfully breastfeed.

We are delighted to be able to showcase the innovative work of the health visiting infant feeding service in Devon led by Gail Barker, Infant Feeding Coordinator Devon Public Health Nursing. This peer-reviewed case study has been selected for inclusion as part of our “Making History: Health Visiting during COVID-19” collection of case studies due to be published later this month.


Gail’s case study presents 12 learning points that contain a wealth of transferable tips gathered by the health visiting service in Devon during the first 12 weeks of the implementation of their adapted support service. Their experiences will resonate with others facing similar challenges which Gail outlines, “Staff were scared, families vulnerable. We needed to continue to keep everyone, families and staff alike safe, informed and supported with infant feeding challenges. We needed to be able to assess latch, build peer relationships, support growth and development, promote, protect and support breastfeeding, all whilst working in an integrated manner with our partners and parents”.

Commenting on the importance of supporting breastfeeding during these challenging times, Gail Barker said:

“Improving the UK’s breastfeeding rates is acknowledged as a key factor in improving the health of a population. Through being able to continue to support infant feeding via video teleconferencing at such a challenging time, we were able to support and promote the health of each baby and mother supported by our service. We know that infant feeding supports not only the building of close and loving relationships, which in turn promotes mental health of both mother and baby (Unicef, 2019), but it also has significant health impacts and reduces health inequalities (Victora et al 2016). At this time of COVID-19, it has never been more important to focus on children in view of these considerations for now and for the future, not just in the UK, but globally”.

Please see further resources and blogs to support breastfeeding during COVID-19:

Download iHV Parent Tips: Supporting breastfeeding during COVID-19

Read Dr Alison Spiro’s Voices blog published during England’s breastfeeding awareness week in June 2020 – Breastfeeding during the COVID-19 crisis

We recently asked health visitors across the UK what the big issues were for them under the COVID-19 pandemic.  We have used the responses very proactively with government to provide a window into health visiting practice in April 2020 and the support that the profession needs.

One issue came up very frequently: redeployment and its impact on the service and on health visitors themselves. We have sought national advice from NHS England and NHS Improvement who are leading the COVID-19 response on their views regarding safe levels of redeployment. They are very clear that any redeployment decisions should be based on careful workforce modelling and risk assessment.

We hope that the attached document based on health visitor responses will be helpful where redeployment decisions need to be challenged.  We have also included information on sources of support for practitioners during this difficult time – some places to find personal support

PANDAS FOUNDATION Pre and Postnatal Depression Advice and Support – committed to continuous support for all parents from conception through to birth and beyond. They aim to ensure that the NHS are supported by us through their perinatal mental health charity.

PANDAS FOUNDATION are committed to supporting every parent and their network for their continued well being during and beyond the Coronavirus.

PANDAS want to support the NHS and release some of the burden and backlog from a mental health patient perspective.

  • A reminder that they are operating their helpline FREE from all UK landlines and mobile phones. Available Monday – Sunday 9am-8pm – 0808 1961 776.
  • They also offer their free email support service with a response within 72 hours [email protected].

Whilst respecting the government advice in relation to support groups, they have made the decision to pause the face to face groups. These will re-commence once they have been advised that its safe to do so.

Whilst they cannot give medical advice, they are here, business as usual with eager and supportive trained volunteers ready to offer hope and empathy. Please do use their services when considering your mental health to ease the stress from the NHS as much as possible.

PANDAS Foundation are anticipating an increase in calls and support offered for support services. Whilst their services remain free, they are reliant on donations to keep going. If you would like to donate please contact [email protected] for interesting (house-bound) ideas and suggestions for fundraising, with your child’s input.

iHV welcomes the NSPCC ‘Fight for a Fair Start’ campaign – calling on Government to ensure all new parents receive a minimum of five face-to-face visits from the same health visitor.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

The Institute of Health Visiting welcomes the NSPCC Fight for a Fair Start campaign and its call to strengthen the essential support that health visitors should be offering to all families during the first years of their baby’s life.

The reduction in universal contacts by health visitors following the loss of one in four health visitors over the past 4 years, often accompanied by fragmenting of continuity of care, means that there may be a generation of children and new families with emotional health needs which are going unrecognised. Indeed, the Children’s Commissioner has already expressed her concern regarding hidden children, those with significant needs who may not be sufficiently well known to services. We are aware that the number of referrals to child mental health services has doubled over the past few years and this can only be set to increase further unless there is new investment into supporting new families.

Implementation of the new green paper on public health (Advancing our health: prevention in the 2020s) would seem to provide an impetus for reinvestment. We hope that the Treasury will take that opportunity using the next Spending Review before even more children’s lives are affected.

One in four families across England are missing out on vital health visits as their baby reaches their first birthday, increasing the risk of mental health issues with the parents going undetected. Data from Public Health England for 2017/18 has also revealed that these 12 month visits drop to around one in two for families living in London.

In addition, further NSPCC research highlights that antenatal visits are particularly inconsistent, with an estimated 38% of families not receiving a health visit before the mother gives birth.

The transfer of budgetary responsibility for health visiting services from the NHS to local authority public health in 2015 has coincided with a significant reduction in the public health budget and workforce numbers.

There has been a 26% fall in health visitors employed by the NHS operating nationwide between 2015 and 2019, with almost half of those still in the service working with caseloads of more than 400 children each. The Institute of Health Visiting recommends a maximum of one health visitor to every 250 children to ensure a safe service is delivered.

In response the NSPCC is launching a national campaign Fight for a Fair Start’, and is calling on the Government to ensure all parents receive a minimum of five face-to-face visits undertaken by a consistent health visitor.

The NSPCC is inviting people to join the campaign by raising their voice and signing the Fight for a Fair Start petition.


Yesterday there was a debate in Parliament on the First 1001 Critcal Days – the motion relating to the Inter-Ministerial Group on Early Years Family Support, opened by Andrea Leadsom MP.

We are delighted that health visiting got mentioned on a number of occasions. The work of the iHV and Cheryll got a particular mention by Tim Loughton (and a well deserved hear-hear for her tireless work to promote all the work that health visitors do- starting at 17:10:30 ) – with Tim also quoting from our statement.

Prior to the debate, iHV sent a position statement and briefing paper to several Ministers and MPs providing information and background on the services that health visitors are able to offer, and that have seriously disintegrated since 2015 and are now at tipping point – affecting the lives of generations of children.


Cavell Nurses’ Trust, a national charity giving money and support to nurses, midwives, health visitors and HCAs facing hardship, is carrying out research to find out more about the extent of hardship in the nursing profession. The results will help the charity to develop its service and be here for more of the deserving people that need its support.

As part of the research, the charity is looking for as many nurses, midwives, health visitors and HCAs as possible to complete a short survey and for the chance to win a £250 shopping spree!

The survey is live at: www.marketingmeans.co.uk/Cavell2016b.  It takes about 10 minutes to complete.

The survey closes on 19 August 2016. All responses will help Cavell Nurses’Trust to support more nurses, midwives and healthcare assistants.

Everyone who completes the survey will also be entered into a prize draw to win one of four £250 high street shopping vouchers.