We recognise that there is unwarranted regional variation in the quality of health-visiting services and addressing this is an active priority. The latest published annual health visitor service delivery metrics for 2024 to 2025 show less variation in performance for the 2 to 2- and-a-half year review across local authorities compared to the 2023 to 2024 data quoted in the committee’s report. In fact, the overall uptake of this review is at its highest level in recent years (80.8% in 2024 to 2025) and is above pre-pandemic levels of delivery. Through its regional public health teams, DHSC has already been carrying out rapid performance improvement activity with local authorities to improve uptake and quality of the 2 to 2-and-a-half year review, as part of the government’s commitment for 75% of children to be achieving a good level of development at the age of 5 by 2028. We have also looked to ensure that delivery and reporting of the review takes place within the recommended timescales required for inclusion in national data sets. To ensure continued strengthening of service quality and to promote consistency across the country, we have recently refreshed the healthy child programme guidance, which sets requirements for the commissioning and delivery of health-visiting services to make it clearer and reduce variation. Local authorities’ vital public health work is reflected in the Local Outcomes Framework (LOF), which signals the priority outcomes the government expects local authorities, working with local partners, to deliver over the spending review period. This includes important child health outcomes, which DHSC will monitor. DHSC also carries out assurance of local authorities’ public health grants and has also set the expectation that from this year every local authority will undergo an external peer review every 5 years. This will help each local authority develop a comprehensive, evidence-based understanding of its strengths and challenges. The peer reviews will be complemented by a programme of improvement support to help local authorities improve public health services and adopt best practice. It will also give local authorities better access to expert support to help build their capabilities and improve health outcomes locally. We have also launched a quality improvement partnership forum to support roll out of best practice for the healthy child programme, including health visiting.