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

Conclusion

This Phase 1 evaluation of the UHVP has highlighted implementation and delivery processes of the UHVP, as well as some short (process) and medium-term outcomes that the pathway is achieving as outlined in the logic model (appendix 2).

All Health Boards in Scotland are now delivering the UHVP, which means all families are largely receiving core visits and many are receiving additional visits when required. While the roll out of the pathway has varied across Scotland, the Scottish Government aim to deliver the pathway by January 2020 has been met.

Health visitors feel confident in their knowledge and skills to deliver the UHVP. They also feel supported by their supervisory teams and colleagues. It was clear from both parents and health visitors that the frequency of visits embedded within the pathway enhance the building of positive and trusting relationships. This is important because it offers parents the opportunity to contact health visitors when they have concerns and almost all health visitors felt that the pathway facilitates the early identification of strengths and concerns of children and parents.

A significant proportion of health visitors felt the pathway offered the opportunity to discuss and support parents on various topics, including child wellbeing, safety and attachment. Discussion of these issues can improve parents understanding and influence their choices and behaviour. For example, the vast majority (89%) of parents in the survey said they knew a great deal or a fair amount about the impact on children of parents smoking, drinking alcohol or using drugs. Similarly, 89% of parents felt they knew a great deal or a fair amount about how to support their child’s physical health and development with half of parents (49%) saying that they knew a great deal about this. The source of their knowledge on these issues was often attributed to the health visitor.

There were differences by deprivation in terms of the information parents received from health visitors. The survey highlighted that parents living in the most deprived areas of Scotland are most likely to report having received a great deal or a fair amount of information from their health visitor on some of the topics covered. This finding, therefore, suggests that those living in the most deprived areas in Scotland are being offered or are accessing more support on such issues. It is difficult to ascertain from the survey, qualitative research and case note review data how the information parents receive actually impacts on their behaviour, however, the outcomes evaluation particularly within the second phase of this evaluation will likely provide further insight into this and some of the other findings presented in this report.