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Variation in health visiting contacts for children in England: cross-sectional analysis of the 2–2½ year review using administrative data (Community Services Dataset, CSDS)

Fraser, Caroline, Harron, Katie, Barlow, Jane, Bennett, Samantha, Woods, Geoffrey, Shand, Jenny, Kendall, Sally, Woodman, Jenny (2022) Variation in health visiting contacts for children in England: cross-sectional analysis of the 2–2½ year review using administrative data (Community Services Dataset, CSDS). BMJ Open, 12 (2). Article Number e053884. ISSN 2044-6055. (doi:10.1136/bmjopen-2021-053884) (KAR id:98265)

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Objective: The 2–2½ year universal health visiting review in England is a key time point for assessing child development and promoting school readiness. We aimed to ascertain which children were least likely to receive their 2–2½ year review and whether there were additional non-mandated contacts for children who missed this review.

Design, setting, participants: Cross-sectional analysis of the 2–2½ year review and additional health visiting contacts for 181 130 children aged 2 in England 2018/2019, stratified by ethnicity, deprivation, safeguarding vulnerability indicator and Looked After Child status.

Analysis: We used data from 33 local authorities submitting highly complete data on health visiting contacts to the Community Services Dataset. We calculated the percentage of children with a recorded 2–2½ year review and/or any additional health visiting contacts and average number of contacts, by child characteristic.

Results: The most deprived children were slightly less likely to receive a 2–2½ year review than the least deprived children (72% vs 78%) and Looked After Children much less likely, compared with other children (44% vs 69%). When all additional contacts were included, the pattern was reversed (deprivation) or disappeared (Looked After children). A substantial proportion of all children (24%), children with a ‘safeguarding vulnerability’ (22%) and Looked After children (29%) did not have a record of either a 2–2½ year review or any other face-to-face contact in the year.

Conclusions: A substantial minority of children aged 2 with known vulnerabilities did not see the health visiting team at all in the year. Some higher need children (eg, deprived and Looked After) appeared to be seeing the health visiting team but not receiving their mandated health review. Further work is needed to establish the reasons for this, and potential solutions. There is an urgent need to improve the quality of national health visiting data.

Item Type: Article
DOI/Identification number: 10.1136/bmjopen-2021-053884
Subjects: H Social Sciences
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Depositing User: George Austin-Coskry
Date Deposited: 23 Nov 2022 10:51 UTC
Last Modified: 24 Nov 2022 12:39 UTC
Resource URI: (The current URI for this page, for reference purposes)
Harron, Katie:
Kendall, Sally:
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