Realist Review: Health visiting in light Of the COVID-19 Pandemic Experience (RReHOPE)

This research is about learning lessons from the delivery of health visiting services during the COVID -19 pandemic in the UK. Health visiting services are a core part of child health programmes for children aged 0 to 5. They help to ensure every child has the best start in life. Health visiting is unique because it includes home visits and reaches all new babies and their families. Health visitors work in partnership with parents and other health and social care workers to:

•help protect babies and young children from harm, •support and promote good health and development, and •identify concerns early and to ensure families get the support they need.

Health visiting services are organised and delivered differently across the UK, but the ultimate goal is the same: to improve outcomes for children. The COVID-19 pandemic that hit the UK in early 2020 placed a huge burden on health visiting services. Initially, the support they were able to provide families was substantially scaled back. At the same time, many young children and families faced increasing pressures due to indirect impacts of the pandemic. In many places, health visitors and families adapted, and services were provided just as well in new creative and different ways. It is vital that we find ways to build on the best of what has happened. We will learn lessons about the positive and negative impacts of the COVID-19 pandemic on health visiting services so we can recommend improvements to how they can be organised and delivered in the future. This in turn will help health visitors and others to deliver the best possible support to babies, young children and their families.

How do we plan to do it? Lots of studies have described some of the changes and areas of impact – some ‘good’, some ‘bad’ - during the pandemic. They have looked at the effects on children and families, service providers, and service delivery in different places. However, there is a real need to pull this learning together to find out what affect COVID-19 has had for who, in what circumstances, how and why. We plan to carry out a review of the evidence on the impact on health visiting services. We will use an approach called realist review. This involves looking at many different kinds of evidence to learn more about how services, service providers and service users have been affected by the pandemic. It is a type of evidence review that can deal with and make sense of all the differences we expect to find in the studies we include. It also involves speaking to stakeholders (health visitors, service managers, policy makers, charities, professional bodies, and parents) and involving their views in interpreting the findings.

What will the result be? We will use the findings of our review to provide recommendations to organisations who plan and deliver health visiting services, so they can organise and deliver the services better, for example more efficiently, effectively and fairly. We will work closely with the Institute of Health Visiting and other stakeholders to ensure our findings make sense and we develop suitable and accessible materials for all involved. Our review will be valuable because it will look across the whole of the UK so that people in England, Wales, Scotland and Northern Ireland can learn from each other’s experiences about what improvements might be possible.