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Publication - Research and analysis

Universal Health Visiting Pathway evaluation: phase 1 report - routine data analysis - implementation and delivery

Published
23 June 2022
From
Director-General Education and Justice
Directorate
Children and Families Directorate, +1 more … Chief Nursing Officer Directorate
Part of
Children and families, Health and social care
ISBN
9781804356456

The Universal Health Visiting Pathway was introduced in Scotland in 2015 to refocus the approach to health visiting in Scotland. This is the final report of four that provides findings about the implementation and delivery of the pathway as part of the national evaluation of Health Visiting.

View supporting documents Supporting documents

First visit

Reviews provided each month

Over the course of 8.25 years, almost 446,400 first visits were recorded, averaging just over 4,500 visits per month (Figure 5). Some fluctuation is apparent, and there is a slight downward trend over the course of the period: the monthly average for the first two years (January 2011 to February 2013) is about 4,725 reviews, then 4,550 reviews per month (March 2013 to February 2016), and 4,310 reviews per month (March 2016 to March 2019). However, this downward trend can be seen to mirror the number of live births each month (Figure 1).

Overall coverage

Mean coverage for this review over the time period is 98.1%. Although Figure 6 shows some months have lower coverage, this never drops below 96%. Since this usually falls for births in December or January, it is probably attributable to staff holidays over the festive period.

Figure 5 Number of first visits that were provided each month in Scotland, from January 2011 to March 2019
Line chart showing the number of first visits that were delivered each month in Scotland from January 2011 to March 2019. The line chart shows that on average between 4,000 and 5,000 first visits are conducted each month.
Figure 6 Overall coverage of first visit for babies born in Scotland between 1 January 2011 and 31 March 2019
Line chart showing the percentage of babies born each month between 1 January 2011 and 31 March 2019 that received their first visit on average over 90% of all children review their first visit over the time period.

Coverage of first visit stratified by SIMD quintile

Annual coverage of the first visit stratified by SIMD quintile is displayed in Figure 7. The average annual coverage is 98% for each SIMD quintile. The lowest coverage is 97.5% (SIMD 1, SIMD 3 and SIMD 5 for babies born in 2011/12 and SIMD 5 in 2015/16); the highest is 98.6% (SIMD 3 for babies born in 2013/14) (see Table 3 below). Thus coverage does not vary systematically by SIMD for this review.

Comparison of first visit coverage between SIMD 1 and SIMD 5

A comparison of the difference in coverage – both absolute and relative – for the health visitor's first visit to babies living in the most and least deprived areas is presented in Table 3. As can be observed, for six of the eight birth cohorts, the 95% confidence intervals (95% CI) for the absolute difference between least and most deprived quintiles include 1, thereby demonstrating that there is no significant difference between the coverage for the two quintiles in these years.

Figure 7 Coverage of first visit for babies born in Scotland during financial years 2011/12 to 2018/19, stratified by SIMD
Line chart showing the percentage of babies born each month between 1 January 2011 and 31 March 2019 that received their first visit, with a line for each of the 5 quintiles of the Scottish Index of Multiple Deprivation (SIMD) (SMID 1 being the most deprived and SMID 5 being the least deprived). The chart shows that there is no noticeable difference in the portion of children that reivew their first visit by SIMD quintile.

Notes to Figures 5-7

1. The first visit should be delivered by the time the baby is 14 days old. However, in certain instances, it may be delayed; for example, for sick children in neonatal care. Therefore some 'late' reviews will be expected (and are clinically appropriate).

2. The review is deliverable from January 2011 and should therefore be delivered to all children born from January 2011 onwards.

3. Overall coverage = Number of children born in month with subsequent record of a health visitor first visit on CHSP-PS (by May 2020) / Number of children born in month.

4. Coverage of SIMD 1 reviews = Number of children born in financial year in SIMD 1 area with subsequent record of a health visitor first visit on CHSP-PS (by May 2020) / Number of children born in financial year in SIMD 1 area.

Source for Figures 5-7

The source for all child health data is CHSP-PreSchool May 2020, Public Health Scotland. The source for births data is NRS.

Table 3 A comparison of the difference (absolute and relative) in coverage for the health visitor's first visit to babies living in least deprived and most deprived locations
Birth cohort (i.e. births occurring in financial year ending March 20XX) Coverage of first visit (%) Absolute difference in coverage (SIMD 5 – SIMD 1) Absolute difference in coverage: 95% CI Relative difference in coverage (SIMD 5 / SIMD 1)
SIMD 1 SIMD 2 SIMD 3 SIMD 4 SIMD 5
March 2012 97.53 97.63 97.46 97.70 97.47 -0.06 -0.476 to 0.352 0.9994
March 2013 97.73 97.98 97.88 98.06 98.01 0.28 -0.107 to 0.662 1.0028
March 2014 98.18 98.42 98.60 98.13 98.29 0.11 -0.243 to 0.471 1.0012
March 2015 98.06 98.30 98.49 98.26 98.34 0.29 -0.064 to 0.637 1.0029
March 2016 97.60 97.80 97.97 98.00 97.50 -0.10 -0.515 to 0.310 0.9989
March 2017 98.17 98.26 98.01 98.13 98.12 -0.05 -0.415 to 0.316 0.9995
March 2018 97.94 98.44 98.30 98.14 98.35 0.42 0.045 to 0.786 1.0042
March 2019 97.80 98.19 97.84 98.20 98.25 0.45 0.065 to 0.841 1.0046

Source:

The source for all child health data is CHSP-PreSchool May 2020, Public Health Scotland. The source for births data is NRS.

Contact

Email: justine.menzies@gov.scot

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