The impact on children and parents / carers of adding a 3-4 month health visit in Rotherham
Evaluation completed October 2025
Rotherham HCP evaluation_NIHR report Oct2025 (pdf, 45 pages. Opens in new window)
Presentation delivered by Nathan Davies, taken from the Local Government Associations public health lunch and learn session recorded 2 July 2026
At a glance
The Healthy Child programme (HCP) is the UK Government’s national framework for improving the health and wellbeing of children. It includes 5 statutory health and wellbeing reviews delivered from pregnancy up until the child is 2 years old. A Public Health England review suggested that the gap between the 6-8 week and 1 year visit is too long and families may benefit from an additional visit at 3-4 months. Rotherham decided to include a 3-4 month visit alongside the 5 mandated reviews and rolled this offer out to all families in 2024.
PHIRST Light evaluated the impact of the additional 3-4 month visit using information already collected by the council to examine if uptake of the visit was affected by factors such as ethnicity and deprivation level. They conducted interviews and focus groups with parents and staff delivering the visit and council representatives to gather their views. They also looked at developmental data of infants.
What does the evaluation mean for Local Government?
This evaluation investigated the impacts of including an additional interaction with a health visitor or nursery nurse when infants are aged 3-4 months in Rotherham. It provided valuable insights for Rotherham Metropolitan Borough Council about the accessibility and reach of the additional visit and differences between families that chose to engage or not engage with the visit. It provided the council with qualitative feedback from parents and staff on their experiences, as well as potential impacts on child development. It is relevant to other local authorities and Healthy Child Programme (HCP) providers interested in improving their HCP, particularly if considering additional non-mandatory visits.
The evaluation findings were used in Rotherham to support the continuation of the 3-4 month visit for an additional 2 years.
How are the public involved in the evaluation?
PHIRST Light have established an overarching Public Advisory Group (PAG) comprising members of the public and local authority service users. All Patient and Public Involvement (PPI) activities are monitored by the PAG. With the guidance of the PAG, we have formed a Rotherham-specific PPI group to advise on and assist with the evaluation design and delivery.
The Rotherham PPI group comprises local parents and carers who were identified through an existing parent voices group and snowball recruitment. They will co-produce recruitment strategies and materials that are accessible and inclusive, including wording of topic guides and community settings for recruitment, alongside developing dissemination plans. Members of the PPI group have already been included as key stakeholders during the proposal development, ensuring lived experience voices inform the evaluation strategy.
Evaluation details
The first 1000 days of a child’s life are vitally important for mental, physical and social development. The Healthy Child Programme (HCP) is an initiative developed by the UK Government which seeks to reach every child in the country. It is a key way to promote healthy child development. Local authorities spend over £850 million on HCP delivery each year. It is important to make best use of this money and empower the skilled professional cohort of health visitors and supporting professions.
As part of the HCP in Rotherham, parents and carers of new babies meet with health visitors at defined timepoints. Since January 2024, an additional 3–4-month visit has been added to the usual schedule, shown below.
- pre-birth (28-32 weeks of pregnancy)
- new baby (10-14 days old)
- 6–8 weeks
- 1 year
- 2–2.5 years.
At this visit, professionals (health visitors or nursery nurses) use a standard questionnaire (Ages and Stages Questionnaire-3) to check a baby’s development, give advice on breastfeeding and weaning, and assess parental confidence in parenting and their mental health. Research suggests these visits can help prevent problems later and that parents often find them helpful.
We will evaluate the impact of Rotherham’s additional visit. We will compare data from families before the visit was available with data from families who could have the visit. We will look at why some parents and carers accept this additional visit, and some do not. We will look for differences between these groups on measures such as:
- parent confidence
- knowledge of child development
- safety practices
- child development at 12 months or 2–2.5 years
- breastfeeding rates
- vaccination uptake
- awareness of support families can access.
We will interview parents and carers who did not take up the extra visit to learn about their experiences. We will also interview healthcare professionals. We will combine the numerical data and parent/professional views to determine any benefits or drawbacks of adding a universal 3-4 month visit. This evaluation will help to inform future decisions on whether the visit should continue as a permanent part of the local health visiting schedule. This will also be of relevance to other local authorities and national decision-makers involved with the Healthy Child Programme.
Local Government / Partner(s)
Rotherham Metropolitan Borough Council
PHIRST Light Research Team
University of Nottingham: Professor Elizabeth Orton, Professor Denise Kendrick, Dr Jessica Jackson, Professor Jo Leonardi-Bee, Miriam Avery, Dr Holly Knight, Nathan Davies
University of Lincoln: Dr Hayden Bird
Public Advisory Group Members: Pam Rees and Marie McDevitt
All PHIRST Light team members contribute to every evaluation.
NIHR Funding Award: NIHR165970
Photo by Bonnie Kittle on Unsplash