Understanding Variation in Health Visiting

This Blog has been written by Amanda Clery together with Emily and Claire, members of a parents group Amanda has been working with. This blog post offers reflections on a long-term, collaborative public engagement group to support research into understanding variation in health visiting, as part of Amanda’s PhD at UCL Institute of Child Health.

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Engagement in health visiting research: reflections from our parent group.

What was the research looking at?

Health visiting in England is provided to all families with children under 5 years old, designed to improve child health outcomes and reduce inequalities. Each of the 150 local authorities across England are responsible for delivering their own health visiting services, which means they can be different for families living in different areas. Not much is known about how this affects delivery of services to families. So, the aim of this research was to explore which children receive more or less health visiting and why this variation exists.

What did the public engagement look like?

The group was created to provide an opportunity for collaboration between the research project and parents impacted by the research. Firstly, this was important to make sure that the research stayed relevant and important to parents who have current, first-hand experience of the health visiting service. Secondly, it was a chance for parents to learn more about the service and share their personal perspectives on the research.
The first meeting took place in September 2021 and our final session was in November 2023. Over the 2-year period, we met 6 times, around every 4-6 months. Most of these sessions took place online except for one which was held in-person at UCL in July 2022. Each session had a different focus including: discussing personal experiences, planning the research, and sharing and interpreting research findings.

Who was part of the group?

Parents from across England were part of the group, and up to 7 joined sessions over the 2 years, as well as Amanda leading the sessions. All the parents had experience of the health visiting service before joining the group. For some, this was the first time engaging in research, while others had some previous experiences of research. All had chosen to join because they felt it was relevant to their personal experience which they wanted to share and because they wanted to hear about other parents’ experiences too.

What are our reflections on the experience?

Everyone really enjoyed the experience, felt seen and had their voices heard, and appreciated the fun and relaxed environment in the group. By meeting multiple times over a long period, we could build relationships, confidence, and respect within the group. We also learnt a lot about health visiting, from what the service is supposed to offer, to seeing the differences across England in what people receive. This is something parents plan to take away and share their new knowledge with friends, and Amanda incorporated these perspectives and reactions into the project. The group appreciated the flexibility of the sessions: we planned them for when suited most people and the sessions usually did not need any preparation beforehand. We also generally felt that the number of sessions was not too much of a burden on everyone’s time.

Did we have any challenges?

The nature of the research meant that everyone in the group all had different experiences of health visiting. For some, this made them feel grateful for the service that they received, but for others this felt bittersweet, when they wished they had received more. Some of us also felt angry that health visiting was not always there to support families. Everyone was so patient and understanding, so even though we all had different feelings, the group was a space where conversations were open and honest.

This type of long-term engagement also comes with its challenges. Some of us enjoyed the commitment, while for others it felt a bit too much. So, some of us will take a break from research involvement for now, while others are keen to do more!