Long-awaited government data published today has provided the clearest picture yet of the health visiting workforce in England, confirming significant workforce losses, wide variation in provision, and growing pressures on services supporting babies, children and families.
Today, the Department of Health and Social Care published its Children’s public health nursing: workforce and activity report, 2025, providing a new national overview of the children’s public health nursing workforce and delivery of the Healthy Child Programme across England. The report estimates a national workforce of 6,909 whole-time equivalent (WTE) specialist community public health nurse (SCPHN) health visitors, within a wider health visiting workforce of 14,126 WTE staff.
The Institute of Health Visiting (iHV) welcomes the publication which represents an important step forward for transparency and accountability.
For many years, the absence of robust national workforce data has made it difficult to build a comprehensive picture of workforce capacity across health visiting services. The iHV has consistently called for better workforce intelligence, arguing that a lack of transparent national data risked obscuring the scale of the workforce challenges facing services and the consequences for babies, children and families – and delayed any action to addressing these issues.
Today’s publication provides an important benchmark from which progress can be measured and services rebuilt. Crucially, it also validates concerns that the iHV has been raising for many years about the sustained erosion of the health visiting workforce.
Published data confirm decade-long workforce decline
The newly published government data confirm a picture that the iHV has been warning about for years.
Drilling into the data, and comparing the latest uncorrected actual published workforce figures with the last comparable government data collection from 2015, shows that the number of health visitors in England has fallen from 11,192 in 2015 to 6,649 in 2025, representing a loss of 4,543 health visitors over the past decade.
While the new report estimates a national workforce of 6,909 WTE health visitors after adjusting for six local authorities that did not submit returns, the published workforce counts nevertheless demonstrate a dramatic 41% reduction in the number of qualified health visitors since 2015.
The findings closely align with the workforce trends previously highlighted by the iHV and reinforce longstanding concerns about the ability of services to meet increasing levels of need with a significantly smaller workforce.
A postcode lottery of support
The report also reveals substantial variation in health visitor provision across England.
Nationally, there are 2.2 WTE health visitors per 1,000 children aged 0 to 5 years, but local authority rates range from 0.9 to 4.9 health visitors per 1,000 children, more than a five-fold difference between the lowest and highest staffed areas.
For families, this means access to health visiting support can vary significantly depending on where they live.
The data also highlights the scale of variation in health visitor caseloads. Average caseloads stand at 454 children per health visitor, but average caseloads range from 204 to 1,111 children across different areas of England.
Such variation has a direct impact on the quality and consistency of support available to families. Health visitors carrying very large caseloads have less time to spend with each family, fewer opportunities to build trusted relationships, and reduced capacity to provide the preventative and early intervention support that is at the heart of the Healthy Child Programme.
The iHV is particularly concerned that, in some areas, service models and workforce shortages mean that families may never see a qualified health visitor. While wider skill mix teams make an important contribution, all families should be able to access the specialist expertise of a qualified health visitor when needed.
Demand remains high
Despite workforce reductions, demand for health visiting support remains substantial.
The report shows that more than 2 million statutory health and development reviews were delivered during 2025, including around 194,000 antenatal reviews, 473,000 new birth visits, 448,000 six-to-eight-week reviews, 474,000 one-year reviews, and 442,000 reviews at age two to two-and-a-half years. These figures also do not take account of the hundreds of thousands of other contacts that health visitors and their teams have with families, including targeted and specialist packages of support for a range of public health priorities.
These figures illustrate both the reach and importance of health visiting services and the challenge of maintaining high-quality support with a significantly reduced workforce.
Commenting on the data, Alison Morton OBE, iHV CEO, said:
“We warmly welcome the publication of this long-awaited workforce data. Greater transparency is essential and this report provides an important benchmark from which to rebuild the health visiting workforce.
“For too long, the absence of robust national workforce data has been a stumbling block to understanding the full scale of the challenge facing health visiting services. We have consistently called for better workforce intelligence because without transparency it is difficult to drive the action needed to address workforce shortages.
“These findings confirm the picture that the Institute of Health Visiting has been highlighting for many years – put simply, there are not enough health visitors to meet the scale of need and deliver the Healthy Child Programme as intended.”
Alison continued:
“Particularly concerning is the huge variation in workforce capacity across England. While the average caseload is 454 children, some health visitors are responsible for more than 1,100 children (and as this is aggregate data, we know that for individual health visitors this is even higher in some localities). That inevitably affects the amount of time they can spend with families and the support they can provide.
“A child’s access to support should not depend on their postcode, yet today’s figures reveal major differences between local areas. In some places, families may never see a qualified health visitor despite the recognised value of their specialist expertise.
“This matters because health visiting is a vital safety-net and one of our most important preventative services – the only service that proactively and systematically reaches babies, young children and their families during the crucial earliest years of life. Health visitors build trusted relationships with families, identify concerns early, support infant development, strengthen parent-child relationships, safeguard children, and help reduce health inequalities.”
Alison concluded:
“Today’s publication provides welcome transparency and confirms concerns that we have raised for many years about the impact of workforce shortages on babies, children and families.
“The evidence is now clear. The question now is: where is the plan to fix it?
“We need a clear, fully funded national workforce strategy, with ring-fenced funding, to rebuild health visiting services, tackle unwarranted variation, and ensure that every baby, child and family can access the support they need, regardless of where they live.”









