Health visiting is in crisis

I’m sure I don’t need to tell you of the value of health visitors (HVs). Many of you will have had personal experience of their great work and the support they have given to the families you come into contact with.

Paediatricians such as myself see the health visitor role as crucial to children, families and paediatricians. Health visitors act as a frontline defence against multiple child health problems – from providing advice to parents on nutrition and feeding, to early identification of risk factors for serious illness, advising on vaccinations and identifying vulnerable children.

Health visitors are nurses or midwives trained in community public health who work with families with new babies, offering support and advice from before birth until the child starts school. Families usually receive several home visits from late pregnancy through to a developmental assessment when the child turns two. Sometimes, families are invited to groups, clinics and networks. So, what’s been happening to this invaluable service under Covid-19?

Lockdown was inevitably going to make family visits difficult – but all the more so when many health visitors (35 per cent) had no personal protective equipment, according to a survey published by University College London.

And just when their work has been more important than ever, many HVs were – often needlessly – redeployed away from children and families. Of the 663 HVs in England who responded, 41 per cent of those in teams that lost staff had between six and 50 members redeployed during lockdown.

Colleagues at the Institute of Health Visiting tell us that in some parts of the country, more than 50 per cent of staff were redeployed – in one area of London it was 78 per cent. Unsurprisingly, caseloads doubled: on average, health visitors now have 500 children to look after. That is simply unworkable.

A workforce which was severely under-resourced since well before Covid took hold is now facing an almost insurmountable backlog of work. Many babies and young children will have missed out on important health checks; many new parents will not have been seen or received support. How many families will have missed out on advice on vaccinations, or infant feeding problems? How many cases of post-natal depression, developmental delay, malnutrition, neglect or non-accidental injury will have been missed?

Redeployment of these vital members of the paediatric team must never happen again.

UK children face a winter from which some will never fully recover. Their needs must be prioritised by this Government. Proper resourcing of a profession as key as health visiting is a very good place to start.