Realist Review: Health visiting in light Of the COVID-19 Pandemic Experience (RReHOPE)

Research question How can the organisation and delivery of health visiting services in the UK be improved in light of COVID-19 pandemic, to provide equitable, effective and efficient services for young children and their families? Background Health visiting services are an essential part of the UK'Äôs support structure for young children, helping to ensure every child has the best start in life. Whilst child health programmes share the same goals, there are different government policies across the four nations of the UK and competing opinions about how services are best organised and delivered. There is a paucity of research about both organisational arrangements and about how health visitors practise in order to achieve the best outcomes. COVID-19 tested health visiting services in profound ways. Services rapidly adapted in response to the situation, with many providers developing innovative ways to ensure families continued to receive support through extraordinary 'Äòlockdowns'Äô. Some innovations will have worked better for some people, in some contexts, than others. Furthermore, the impact of the pandemic on families and young children has been far-reaching and uneven, with important implications for post-pandemic health visiting services. There has been lots of data published since the start of the pandemic, but there is a need to synthesise this to understand how the organisation and delivery of health visiting services can be improved for a stronger post-pandemic recovery. Methods We will undertake a realist review of the literature relating to health visiting services during the COVID-19 pandemic since March 2020. We have chosen a realist review because health visiting services are a complex intervention and the impact of the pandemic will have been different for different people in different contexts. We will follow Pawson'Äôs five iterative stages, namely: 1) locate existing theories; 2) search for evidence; 3) article selection; 4) extract and organise data; and 5) synthesise evidence and draw conclusions. We will recruit a stakeholder group of individuals, organisations or communities that are representatives, in different parts of the UK, of patients and the public, providers, commissioners, policy-makers, researchers and policy advocates. This group will advise and give us feedback throughout the project. Our review, which will follow the RAMESES quality standards, will last 18 months from June 2022, by which time we expect there to be a considerable body of evidence to include and synthesise. It will consider the differences in policy and service delivery across the UK and analyse, where possible, the differences in impact across the four constituent countries. Impact Our findings will be used to provide recommendations for improving the organisation and delivery of ongoing post-pandemic recovery of health visiting services in different settings, for different groups. We will collaborate closely with the Institute of Health Visiting (iHV) and our stakeholder group to ensure our findings are developed into a range of outputs suitable for a variety of audiences. These will include academic papers, a 'how to' publication and user-friendly summaries. Our stakeholder group, as individuals and organisations who are interested in the messages arising from our work, will help amplify our message, getting our research to different members of the policy and practice community in different ways.