Universal Health Visiting Pathway evaluation - phase 1: main report - primary research with health visitors and parents and case note review

The Universal Health Visiting Pathway was introduced in Scotland in 2015 to refocus the approach to health visiting. This is the first report of 4 that provides findings of the National Evaluation of Health Visiting. It focuses on primary research with health visitors and parents and case note review.

6. Overall satisfaction with health visiting service

Around two thirds of parents (69%) were satisfied with the health visiting service they had received before lockdown started in March 2020, with 37% saying they were very satisfied and 32% fairly satisfied. Just over one in ten parents (12%) were dissatisfied with the service they had received (7% ‘fairly’ and 4% ‘very’) while 18% were neither satisfied or dissatisfied and 2% said they did not know.

Satisfaction with the health visiting service declined with the age of the child – the proportion ‘very satisfied’ fell from 52% among those answering for a child aged one or younger, to 39-40% among parents of 2 and 3 year-olds, and 26% of parents of 4 or 5 year olds. There were no significant variations overall by the age of the parent, area deprivation, Health Board region, household income or the number of other children in the household.

Importance of health visitors to families

In the qualitative research, when parents were asked to mention the most important aspect of having a health visitor, majority of them highlighted receiving support and reassurance from health visitors and overall accessibility as the most important. Others also mentioned home visiting and the role health visitors play in helping to monitor their children’s weight and development.

Support and reassurance from health visitors

Almost all parents mentioned that receiving reassurance is one of the most important aspects of having a health visitor. They felt that the support health visitors provide to them and their children is invaluable. Many parents also felt this was a secure and non-judgemental source of support.

I think just having that reassurance and knowing that you've got someone there that you can access easily and quickly. And there's not going to be any drama or any issue and or any judgement. I think it's just that feeling of security that you've got someone there that's accessible. So, I will say that’s my big one (Parent, three children).

I think it’s knowing that there’s somebody there like whenever you need them that’s always going to give you the right advice (Parent, two children).

I think it’s probably somebody to go to if you’re not sure what to do. I think every, sort of, every month when they’re younger in age has different challenges with it, or new things that you’re not expecting, perhaps, so I guess, a bit of a sounding board, somebody to talk to and ask them if things are normal – a bit of reassurance that what you’re doing is the right thing (Parent, two children).

Accessibility (first port of call):

Another important aspect of having a health visitor that most parents mentioned was about accessibility and availability. They explained that being able to easily contact their health visitor was very important to them, especially when other health facilities and professionals were difficult to reach. They explained further that health visitors are not only accessible, but they also provide knowledgeable advice. Many mentioned that without the health visitor they would have visited their GPs more frequently, placing an additional strain of this service.

Just having them there. Just on the end of the phone just to ask questions. The doctor’s surgery here is particularly stretched, the town is just growing phenomenally. It’s so difficult to get an appointment, so between the health visiting team and the pharmacists it’s, kind of…those are my ports of call before I would actually go to the doctor. I think it’s just knowing someone’s there and having them on the end of the phone. That I don’t need to wait for an appointment, that I can just phone and leave a message and they will get back to me. Just, it does me the world of good, just to kind of have that security and knowing that’s there. And that she knows me; that I don’t need to explain things, like from scratch every time. That she knows me and she knows the children (Parent, two children).

I think having a central source of information and having easy access to them so that you don’t feel like you’re having to waste a doctor’s time asking them niggly questions about why isn’t my child sleeping, how much milk should they be drinking at this point, what kinds of foods can I feed them, when I’m weaning (Parent, three children).

Yeah, I think, that’s the best thing, yeah you know, it would have been very hard without her, I think you know, we would have just, I think, to have not had a health visitor would have been a nightmare, I think, we would have always been at the doctors every week, I think you know, there’s a problem with this, there’s a problem with this (Parent, first time).

Monitoring child weight

Monitoring of the child’s weight was also commonly discussed by parents. They mentioned that knowing from the health visitor how much their baby weighs was important to them and often provided positive feedback or assurance regarding their child’s development which they found encouraging.

For me, I think it’s keeping an eye on my baby’s weight. So, I know she’s, sort of, growing and developing and thriving and, sort of, having that line of advice there when needed (Parent, first time).

I think for me, that’s probably the best bit about it, I actually quite look forward to the visits, I really look forward to knowing how much my son has grown, how much weight he’s put on and basically to get that affirmation that you’re doing a good job (Parent, first time).

Home visits

Some parents also highlighted that the most important element of having a health visitor is the opportunity available for the health visitor to visit them in their home. Parents said not getting dressed to go elsewhere to see the health visitor was convenient for them, and this was mostly highlighted by first time parents.

I think it’s just knowing that somebody professional is coming round to your home. So, you don’t need to leave the house, you don’t need to get dressed, you don’t need to, you know, venture outside if you’re not ready. And it’s…so, coming to your home is really important (Parent, first time).

Her coming here is brilliant. Us not having to go out, you know…for her coming to the house, you know…And she just comes in, you know, she knocks and just comes in and hello, you know (Parent, first time).


Email: Justine.menzies@gov.scot

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