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

4-5 year review

Reviews provided each month

The 4-5 year review was intended to be provided from April 2020 (for children born from 1 April 2016 onwards: that is, from the intended date of UHVP implementation). In practice, a number of health boards introduced this review early, from April 2017 (see Figure 16).

There was a peak of 2,799 reviews delivered in May 2018, but in the financial year 2018/19 the mean number of reviews delivered in a month was 1,685. As seen in the other reviews the trough in December 2018 may be due to staff holidays and fewer working days in the month as well as other factors. However, it should be borne in mind that the review was not originally intended to be delivered before April 2020.

Overall coverage

As can be observed in Figure 17, the overall coverage of this review in the early implementation phase was very low: it reached a peak of 63.5% for children born in March 2015, the cohort for whom NHS Greater Glasgow and Clyde and NHS Lothian introduced the review, and exceeded 40% for cohorts born in the following eight months. However, as stated above, the original intention was to introduce the review on 1 April 2020 (so that children born after the date of intended implementation of the UHVP would be eligible for the review). Therefore this data should be used with caution and viewed as experimental data until the 4-5 year review is bedded into practice. It is also likely that some health boards may aim to deliver this review at certain points in the academic year so there may be an element of 'queuing' in the coverage data.

Coverage stratified by SIMD quintile

As with the 27-30 month data, we refer readers to the PHS published tables to explore coverage for the 4-5 year review (Child Health Pre-School Review Coverage Statistics). For reasons described in the section above, coverage of this review was very low for children receiving reviews between April 2017 and March 2019.

Coverage varied between SIMD quintiles in these two years, with no stable pattern seen between the groups. In 2018/19 (when the last cohort of children in this study were turning 4-5 years), coverage was highest in SIMD quintiles 3 and 4 (41.1% and 41.6% respectively), and lowest among children in the least deprived quintile (35.1%); 37.2% children in the most deprived group received a 4-5 year review.