Sefton's health visiting landscape: Pioneering solutions for community wellbeing

In Sefton, the provider Mersey Care's health visiting services have embarked on an evolving journey, to address deep rooted challenges such as poverty, health inequalities and logistical complexities of service delivery across a diverse borough.

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Through strategic collaborations and a commitment to workforce development, Mersey Care has redefined what it means to provide comprehensive and responsive health visiting services. 

The challenge

Sefton's health visiting services, provided by Mersey Care, faced a variety of complex challenges including significant poverty, health inequalities, and the logistical complexities of delivering services across a geographically diverse area. 

The council’s scrutiny under an Ofsted improvement plan added focus to enhance service quality and outcomes for children, young people and families. Additionally, the need for innovative public health interventions, such as safe sleep practices, and the adaptation to changing demographics in areas like Formby, where new housing developments altered the community's needs, underscored the demand for a responsive and flexible health visiting service.

The solution

The health visiting services in Sefton are being proactively integrated within family wellbeing centres through co-locating health visiting and wellbeing teams. This is  enhancing access to a broad range of support services for families. 

Mersey Care has also developed an enhanced model of health visiting in Sefton that provides additional support to families meeting certain criteria. This targeted approach ensures that vulnerable families receive the intensive support necessary to address complex needs.

In its commitment to actively address some local and national public health issues Mersey Care, following a successful Safe Sleep Pilot in Liverpool and Wirral, has partnered with Merseyside Police to try and reduce the local incidence of sudden infant death syndrome and improve safe sleep outcomes. In this new joint venture, the police pick up potential issues regarding safe sleep practices and notify health visiting teams directly through an app. Any identified unsafe sleep practices are picked up by health visitors who follow up, clinically assess the situation and provide relevant support as appropriate. 

To further embed safe sleep messaging and overcome challenges faced in difficult conversations, Mersey Care developed a training package in the form of a simulation video in partnership with Liverpool John Moores University. The training package allows staff to deliver training around safe sleep in a different and more engaging way. Mersey Care is also aiming to tackle the widespread issue of poor dental health amongst children by introducing dental health packs at the three-month review for the whole family. These contain the tools and knowledge needed for early dental care to promote good oral health. 

Mersey Care is also making significant strides in improving mental health outcomes for the family unit through a number of initiatives. Through BABS (Building Attachments and Bond Services), a specialist parent-infant mental health support provision in Sefton, parents or carers and their infants can access targeted interventions to help cope with mental health and related struggles with becoming new parents. There is also an antenatal programme in partnership with parents and specialist services, focusing on early intervention and support as well as an enhanced model of health visiting for families meeting specific criteria. 

Recognising the unique needs of fathers and their contribution to family health, the BABS service is also piloting a fathers engagement worker to support families within the universal service to access support resources across the local partnership. There is also additional support for fathers through Dad Pad, an app for new dads, partners and parents that hosts a variety of resources to help develop mindset, confidence and skills needed to meet babies’ physical and emotional needs.

There is a comprehensive breastfeeding support offer in Sefton delivered by a skill mix of staff and senior leaders. The workforce is being prepared across the local partnership in Sefton for UNICEF gold accreditation. A focus on workforce development and policy will ensure the service can meet evolving community needs. In addition, Mersey Care’s "grow your own" approach and clear progress pathway to nurse training, including the exploration of the Trainee Nurse Associate (TNA) route, aims to bolster the skill mix within health visiting teams.

The impact

The strategic partnership with Merseyside Police has begun to show promise in enhancing safe sleep practices, with expectations of replicating the very successful outcomes seen in Liverpool. The introduction of dental health packs and the focus on early dental health education aims to improve long-term dental health outcomes. Additionally, the realignment of service areas and the development of a more responsive workforce model are expected to ensure services meet the evolving needs of Sefton's communities.

How is the new approach being sustained?

Though impact evaluations are a work in progress, Mersey Care is committed to developing more comprehensive outcome frameworks and have a schedule of audits to understand the impact of current provisions which will support the long-term sustainability and development of its offers. To improve current practices around clinical record keeping and enhance outcome measures and analyses, a new role has been developed for a clinical systems nurse. 

Mersey Care are keen to enhance digital integration and extract system-based information to develop impact evaluations and more regular data analysis so that their interventions continue to be targeted and effective. 

There is also active, ongoing workforce development and the strategic use of digital tools support the adaptability and responsiveness of the service.

Lessons learned

  • Partnership work and community integration is critical in improving family outcomes.
  • A fair culture promoting ‘what’ went wrong rather than focusing on ‘who’ creates effective working relationships.
  • Creating a space for ‘failure is a learning experience’ contributes to an enhanced learning and development environment.
  • Supportive staff and senior leadership contribute to greater workforce retention.
  • Having clear development pathways and encouraging career progression through alternative training routes helps build and sustain the future workforce.


Maria Sumner - [email protected]

Clinical Service Manager - Children’s & Young People, Families

Vicki Culley - [email protected] 

Health Visitor Team Manager - Feel Good Health visiting Team