Health visiting assessment—unpacking critical attributes in health visitor needs assessment practice: A case study

Background Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. Objectives The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. Design A case study design informed by a constructivist methodology was used to examine health visitors’ professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. Settings The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Methods and participants Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. Results/conclusions The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors’ assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.