‘All the changes drain the life out of you’: a qualitative study of variation in health visiting across three local areas in England

Background: Health visiting is a universal service aimed at improving child health and school readiness for under-5s. Understanding how services are experienced locally is needed to inform service improvements across England. Aims: To explore differences in professionals' and parents' experiences of the role and support delivered by health visiting services in their local area. Methods: In three sites across England, the authors conducted qualitative interviews with 14 health visiting professionals and parents. Findings: Three themes emerged: a service under pressure, encapsulating how health visiting was influenced by pressures in other health and social care services; perceived purpose of health visiting, capturing participant experiences of key performance indicators and availability of services; and that staff members are human too, describing the impact of commissioning and service structures on them. Conclusions: Perceived purpose of health visiting and commissioning structures should be considered when evaluating and monitoring health visiting services.