Statistical commentary: health visitor service delivery metrics, quarter 1, 2017 to 2018
Updated 28 November 2018
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This publication is available at https://www.gov.uk/government/publications/health-visitor-service-delivery-metrics-2017-to-2018/statistical-commentary-health-visitor-service-delivery-metrics-quarter-1-2017-to-2018
This statistical commentary should be considered alongside the 2017 to 2018 Quarter 1 Health Visitor Service Delivery Metrics statistical release
Please treat the figures contained in this report with caution.
Where totals are presented for England and Public Health England (PHE) centres, these are aggregate totals of the areas that submitted information and passed initial validation (see the section ‘Validation rules’ below for further details).
Where no reference to a particular quarter is mentioned it should be assumed that the data refers Quarter 1 2017 to 2018.
1. Main findings
| Indicator | Quarter 1 England value | Quarter 2 England value | Quarter 3 England value | Quarter 4 England value | 2017 to 2018 England value |
|---|---|---|---|---|---|
| C2: New Birth Visits (NBVs) completed within 14 days (%) | 86.4% (86.2 to 86.5) | ||||
| C3: New Birth Visits (NBVs) completed after 14 days (%) | 11.1% (11.0 to 11.3) | ||||
| C8i: 6 to 8 week reviews completed (%) | 81.5% (81.3 to 81.7) | ||||
| C4: 12-month reviews completed by the time the child turned 12 months (%) | 74.6% (74.4 to 74.8) | ||||
| C5: 12-month reviews completed by the time the child turned 15 months (%) | 82.6% (82.4 to 82.8) | ||||
| C6i: 2 to 2.5 year reviews completed (%) | 75.7% (75.5 to 76.0) | ||||
| C6ii: 2 to 2.5 year reviews completed using ASQ-3 (%) | 91.2% (91.0 to 91.4) |
Percentages are based on local authorities that made submissions and passed initial validation. Confidence intervals are shown in brackets.
2. Background
In October 2015, the responsibility for commissioning children’s public health for the 0 to 5 years’ population transferred from NHS England to local authorities. To support this transfer, PHE established an interim data collection for a number of main performance indicators associated with these services, which it is critical to monitor and report. The strategic reporting solution hosted by NHS Digital, the Community Services Dataset (formerly the Children and Young People’s Health Services Dataset), is collecting relevant data items directly from providers’ systems and in time will take on reporting of these indicators.
The health visiting information in this publication has been obtained via the interim reporting system. It was submitted to PHE by local authorities on a voluntary basis. It covers Quarter 1 of 2017 to 2018, which is the ninth reporting period. The full data can be found in the 2017 to 2018 Quarter 1 Health Visitor Service Delivery Metrics statistical release.
The health visiting service leads on the delivery of the Healthy Child Programme (HCP), which was set up to improve the health and wellbeing of children aged 0 to 5 years. This is achieved through health and development reviews, health promotion, parenting support and screening and immunisation programmes.
The health visiting service consists of specialist community public health nurses and teams who provide expert information, assessments and interventions for babies, children and families, including first time mothers and fathers with complex needs.
The health visitor service delivery metrics currently cover the antenatal contact, new birth visit, the 6 to 8 week review, the 12-month review and the 2 to 2.5 year review and report on the following metrics.
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C1: Number of mothers who received a first face-to-face antenatal contact with a health visitor at 28 weeks or above.
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C2: Percentage of New Birth Visits (NBVs) completed within 14 days.
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C3: Percentage of New Birth Visits (NBVs) completed after 14 days.
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C8i: Percentage of 6 to 8 week reviews completed.
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C4: Percentage of 12-month development reviews completed by the time the child turned 12 months.
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C5: Percentage of 12-month development reviews completed by the time the child turned 15 months.
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C6i: Percentage of 2 to 2.5 year reviews completed.
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C6ii: Percentage of 2 to 2½ year reviews completed using Ages and Stages Questionnaire (ASQ-3).
These metrics are presented as management information and are reported by local authority, PHE centre and England level.
3. Data collection method
An interim reporting system is hosted on the Local Government Association (LGA) website to collect the data on health visiting indicators. The reporting window for Quarter 1 and Quarter 2 data was 20 November to 15 December 2017.
To support local authorities in submitting data, detailed guidance was circulated to explain how analysts and commissioners in local authorities should submit health visiting indicators. A dedicated mailbox [email protected] was also in place to respond to questions and comments.
Once the collection window closes the data received is centrally collated, validated and reported. This process will be repeated quarterly.
4. Data quality
The following data relates to Quarter 1, 2017 to 2018.
A total of 145 reporting local authorities submitted a return for the interim reporting system for Quarter 1, 2017 to 2018. The 5 local authorities that did not submit data are Kirklees, Middlesbrough, Newham, Nottinghamshire, and Sefton.
5. Validation rules
A set of validation rules was applied to each health visiting metric.
| Validation stage | Definition |
|---|---|
| Stage 1 | Indicator numerator and denominator are integers, and numerator <= denominator. |
| Stage 2 for all indicators other than C6ii | Indicator denominator is within 20% of the resident population of the relevant age (0 years for new baby visits and 6 to 8 week reviews, 1 year for 12 month-reviews, and 2 years for 2.5 year reviews). The annual figures are divided by 4 to provide quarterly estimates. |
| Stage 2 for indicator C6ii | Indicator denominator is within 20% of the numerator for indicator C6i. |
Each local authority has to pass both stages 1 and 2 in order for its values to be shown.
The values for areas that did not pass stage 1 validation are excluded from their respective PHE centre and the England aggregated calculations.
A comprehensive breakdown of the results following the application of the validation can be found in the 2017 to 2018 Quarter 1 Health Visitor Service Delivery Metrics statistical release.
6. Summary of Quarter 1 data
6.1 Indicator C1: Number of mothers who received a first face-to-face antenatal contact with a health visitor
This is unable to be collected as a percentage due to the difficulties in defining an adequate denominator.
One local authority was unable to provide a number for this metric (put ‘DK’ don’t know).
Based on the 144 local authorities that did provide a value (including 3 that reported ‘0’ zero), there were 63,384 antenatal contacts nationally in Quarter 1, 2017 to 2018.
This compares to 74,423 in Quarter 1, 2016 to 2017 (based on the final figures published in November 2017).
6.2 Indicators C2 and C3: Percentage of births that received a face-to-face new birth visit (C2: within 14 days and C3: after 14 days)
New birth visits should ideally occur within 14 days; however, it is accepted that in some circumstances this is not possible.
The aggregate percentage of new birth visits within 14 days (indicator C2) for England for Quarter 1 is 86.4% (with confidence intervals of 86.2% to 86.5%). This is lower than Quarter 1, 2016 to 2017, based on the final figures published in November 2017.
The aggregate percentage of new birth visits after 14 days (indicator C3) for England for Quarter 1 is 11.1% (with confidence intervals of 11.0% to 11.3%). This is higher than Quarter 1 for 2016 to 2017, based on the final figures published in November 2017.
The aggregate percentage of new birth visits within or after 14 days (indicator C2+C3) for England for Quarter 1 is 97.5% (with confidence intervals of 97.4% to 97.6%).
Values for percentages of new birth visits within 14 days could be published for all PHE centres for Quarter 1 (these were aggregates of ‘valid’ local authorities in each centre). Values ranged from 80.0% to 90.6%.
Values for percentages of new birth visits after 14 days could be published for all PHE centres. These ranged from 6.2% to 17.2%.
The percentage of babies who received a new birth visit within 14 days could be published for 140 local authorities who passed additional validation. Values ranged from 25.1% to 99.3%, with the majority (119) reporting between 80% and 100%.
The percentage of babies who received a new birth visit after 14 days could be published for 140 local authorities who passed additional validation. Values ranged from 0.4% to 72.6%.
6.3 Indicator C8i: Percentage of children who received a 6 to 8 week review by 8 weeks
The aggregate percentage of infants receiving a 6 to 8 week review for England for Quarter 1 based on 140 local authorities passing initial validation is 81.5% (with confidence intervals of 81.3% to 81.7%). This is the same as Quarter 1, 2016 to 2017, based on the final figures published in November 2017.
Values for the percentage of children who received a 6 to 8 week review by 8 weeks could be published for all PHE centres for Quarter 1 (again these were aggregates of ‘valid’ local authorities in each centre). These ranged from 56.6% to 91.7%, with all but one of the centres achieving over 80%.
Values for the percentage of children who received a 6 to 8 week review by 8 weeks could be published for 134 local authorities who passed additional validation. Values ranged from 3.3% to 100%, with the majority (98) reporting between 80% and 100%
6.4 Indicator C4: Percentage of children who received a 12-month review by 12 months
The aggregate percentage of children receiving a 12-month review by 12 months of age for England for Quarter 1 based on 145 local authorities passing initial validation is 74.6% (with confidence intervals of 74.4% to 74.8%). This is higher than Quarter 1, 2016 to 2017, based on the final figures published in November 2017.
Values for completed reviews within 12 months could be published for all PHE centres for Quarter 1 (again, these were aggregates of ‘valid’ local authorities in each centre). These ranged from 54.2% to 86.9%. Only three of the 9 centres achieved over 80%.
Values for the percentage of children who received a 12-month review by 12 months could be published for 144 local authorities who passed additional validation. Values ranged from 1.4% to 100%, with the majority (80) reporting between 80% and 100%.
6.5 Indicator C5: Percentage of children who received a 12-month review by 15 months
The aggregate percentage of children receiving a 12-month review by 15 months of age for England for Quarter 1 based on 144 local authorities passing initial validation is 82.6% (with confidence intervals of 82.4% to 82.8%). This is higher than Quarter 1, 2016 to 2017, based on the final figures published in November 2017.
Values for completed reviews within 15 months could be published for all PHE centres for Quarter 1 (again these were aggregates of ‘valid’ local authorities in each centre). These ranged from 66.2% to 95.6%, with 8 of the 9 centres achieving over 80%.
The percentage of children who received a 12-month review by the age of 15 months could be published for 140 local authorities who passed additional validation. Values ranged from 0.1% to 100%, with the majority (102) reporting between 80% and 100%.
6.6 Indicator C6i: Percentage of children who received a 2 to 2½ year review by 2½ years
The aggregate percentage of children receiving a 2 to 2.5 year review by the age of 2.5 for England for Quarter 1 based on 145 local authorities passing initial validation is 75.7% (with confidence intervals of 75.5 to 76.0%). This is lower than Quarter 1, 2016 to 2017, based on the final figures published in November 2017.
Values for the percentage of children who received a 2 to 2.5 year review by 2.5 years could be published for all PHE centres for Quarter 1 (again these were aggregates of ‘valid’ local authorities in each centre). These ranged from 61.2% to 88.8%, with only 4 of the 9 centres achieving over 80%.
The percentage of children who received a 2 to 2½ year review by 2.5 years could be published for 138 local authorities who passed additional validation. Values ranged from 14.1 % to 98.2%, with the majority (78) reporting between 80% and 100%.
6.7 Indicator C6ii: Percentage of children who received a 2 to 2.5 year review using Ages and Stages Questionnaire (ASQ-3)
The aggregate percentage of children receiving a 2 to 2.5 year review which used ASQ-3 for England for Quarter 1 based on 137 local authorities passing initial validation is 91.2% (with confidence intervals of 91.0% to 91.4%). This is higher than Quarter 1, 2016 to 2017, based on the final figures published in November 2017.
Values for completed 2 to 2.5 year reviews using ASQ-3 could be published for all PHE centres for Quarter 1 (again these were aggregates of ‘valid’ local authorities in each centre). These ranged from 79.1% to 95.7%, with 8 of the 9 centres achieving over 80%.
The percentage of children who received a 2 to 2.5 year review using ASQ-3 could be published for 121 local authorities who passed additional validation. Values ranged from 18.0% to 100%, with the majority (109) reporting between 80% and 100%.
7. Data quality notes
When making a submission, local authorities have the opportunity to enter comments in a free text box to explain any issues with reporting. During the Quarter 1 submission, comments were received from 12 local authorities, of collective interest:
A total of 8 local authorities reported they knew, or suspected, that they had made an incomplete submission. This may include receiving confirmation of nil returns from neighbouring authorities.
A total of 9 local authorities reported that recent migration to a new Child Health Information System or problems with their existing system had impacted on their ability to submit, or on the short-term reliability of the figures.