England’s early years health visitor reviews edge higher, but access remains uneven
England’s latest health visitor service delivery metrics show modest gains across most mandated post-birth reviews in 2025 to 2026, with every measured review now above 80% coverage. The pattern is encouraging on paper, yet the distribution tells a more complicated story: regional performance still varies sharply, and some local councils sit far outside the national average.
The data cover the universal health and development reviews that are intended to reach families during pregnancy and the first two and a half years of life. In practical terms, these contacts are meant to do more than tick a service box. They are the system’s earliest structured opportunity to identify feeding problems, developmental delay, parental mental health concerns, safeguarding issues, and social vulnerability before problems harden into longer-term difficulty.
One figure stands out immediately. Coverage for the new birth health and development review fell slightly in one sense of timing but still rose in overall national performance when measured within 14 days of birth.
New birth review coverage improved nationally, with wide local spread
In 2025 to 2026, 85.5% of infants received their new birth health and development review within 14 days of birth, up from the previous year. Among English regions, the West Midlands recorded the lowest coverage at 81.2%, while the North East reached 91.6%. Across local councils where a value could be calculated, coverage ranged from 1.6% to 98.8%.
Those extremes point to a delivery system that is not yet behaving uniformly. The newborn period is when a health visitor visit can detect jaundice concerns, feeding difficulties, postnatal depression, unsafe home circumstances, and early concerns about infant thriving. Delays in that window matter because a short interval after discharge is often when families are least visible to formal services and most dependent on rapid, proactive outreach.
A strikingly high proportion of councils reached over 90% when all new birth reviews were counted, including those completed outside the 14-day window. Even so, the sharp spread in timely completion suggests that access, workforce capacity, local pathways, and recording practices are still shaping who gets seen when it matters most.
Six-to-eight-week contacts gained ground, led by the North East
The 6-to-8-week review also improved. National coverage reached 86.5% within 8 weeks, compared with 85.1% in 2024 to 2025. Regionally, performance ranged from 77.3% in Yorkshire and the Humber to 91.9% in the North East. Local council coverage, where calculable, stretched from 10.1% to 98.8%.
This review sits at a clinically important point in infancy. Families are moving beyond the immediate postnatal period, but feeding, growth, maternal recovery, sleep, and family functioning often remain unsettled. The review is also a chance to identify infants whose developmental or social needs are already becoming visible, before they are missed in the churn of routine care. A service that reaches more than eight in ten families is doing important work; a service that leaves some areas far behind risks embedding inequalities early in life.
The 12-month review reached more than nine in ten children
At 12 months, coverage rose again. In 2025 to 2026, 90.4% of children received their 12-month health and development review by 15 months, up from 88.4% the year before. Among regions with calculable values, London had the lowest coverage at 84.3%, and the North East had the highest at 95.1%. Local council coverage ranged from 60.8% to 99.0%.
By this age, the review has a different clinical purpose. It becomes less about immediate postnatal adaptation and more about developmental surveillance, behaviour, communication, growth, and family support. The gap between the best and worst performing areas remains wide enough to raise questions about workload, referral pathways, and whether the most vulnerable families are being reached consistently. Children with emerging developmental concerns often do not present neatly; they are found through repeated, systematic contact, not by chance.
Two-and-a-half-year review and ASQ-3 completion rose together
The 2-to-2-and-a-half-year review reached 81.3% of children in 2025 to 2026, up from 80.8% in the previous year. Completion of the Ages and Stages Questionnaires Third Edition (ASQ-3) alongside that review also improved, rising from 93.9% to 95.0%.
This later review carries particular developmental value. By two to two and a half years, concerns about language, social communication, motor development, and broader school-readiness markers can become more visible. The higher ASQ-3 completion rate is meaningful because structured parent-completed screening supports more consistent detection of children who may need follow-up, referral, or enhanced support. Nationally, region-level coverage ranged from 70.8% in the East of England to 90.8% in the North East, while local council values ranged from 27.5% to 100%.
Local variation points to delivery and data-quality problems at once
The publication’s own framing makes the caution plain: these figures come from a voluntary data collection with incomplete coverage, and aggregate values depend on local councils that supplied data meeting validation criteria. In other words, the numbers reflect both service delivery and the quality of the underlying reporting system.
This is not a minor technicality. When coverage appears low in a particular council, the explanation may include genuine access gaps, but it may also include incomplete submission, inconsistent coding, or local service pathways that do not map cleanly onto the metrics. The publication also notes that health and development reviews may be targeted toward children most likely to need additional support, including those in deprived areas and children known to be vulnerable because of family or other circumstances. Such targeting can depress apparent coverage while still representing appropriate clinical prioritisation.
The longer-term plan is to use the Community Services Data Set as the basis for these metrics once data quality is strong enough. Until then, interpretation requires restraint. The figures are useful, but they are not a perfect mirror of service performance across England.
Early years surveillance is improving, but equity remains the unresolved problem
The most important clinical message from the 2025 to 2026 update is not that coverage is uniformly high. It is that England is moving upward while still tolerating large geographic variation in early years contact. For families, that variation can determine whether a concern is identified promptly or whether it drifts beyond the window when intervention is simplest.
The service model itself is clear enough: five universal reviews in pregnancy and early childhood, ideally delivered face to face with a health visitor or under their supervision. The implementation is less uniform. Some regions are consistently near the top of the distribution, while some councils remain far below national norms. The next test is whether better data infrastructure can separate genuine service shortfalls from reporting artefact, and whether local systems can narrow the gap without weakening outreach to the children most likely to need help.