Every child deserves the very best start in life and health visitors play a crucial role in achieving this ambition. Public Health England (PHE) has started a process of refreshing the so called 4–5–6 model for health visiting and the healthy child programme. To feed into this robustly, the Institute of Health Visiting (iHV) consulted its members, as well as mums and other stakeholders, and went to the evidence to determine what its own position should be on necessary changes to these important national initiatives.