Coronavirus: Health visitors provide vital ‘safety net’ for babies during the pandemic

Making History: health visiting during COVID-19 provides an insight into the pace and scale of change as health visiting services adapted to working during the pandemic. It shines a spotlight on the vital ‘safety net’ that health visitors provided for babies and young children through a series of case studies.

While some families enjoyed the relative peace of an enforced slower pace of life, others were negatively impacted by lockdown and home was not a safe place, with rates of domestic violence and abuse, mental health problems and safeguarding concerns quickly becoming a source of concern.

Alison Morton, director of policy at the Institute of Health Visiting, said, ‘It has taken a global public health pandemic to shine a spotlight on the importance of the health visiting service.

‘Parents reached out to health visitors for support as many other sources of support were no longer available. Health visitors are Specialist Community Public Health Nurses providing a vital “safety net” for babies, young children and their families whose needs can easily be hidden from sight. Their specialist public health skills, supporting babies, young children and their families during the biggest public health emergency in living memory, have been needed more than ever.’

The report commends health visitors for rising to the challenge with professionalism and autonomy, flexing and developing innovative service ‘workarounds’ to ensure that families receive the best possible support.

It highlights the different ways that they have responded, with many introducing virtual contacts instead of face-to-face, as well as rapidly responding to urgent needs to support families using Personal Protective Equipment (PPE).

Councillor Ian Hudspeth, chair of the Local Government Association Community Wellbeing Board, described the report as ‘testimony’ to the commitment and resilience of health visitors and said it illustrates the pivotal role they play in ensuring children and families get the support they need in challenging times.

He added, ‘In the upcoming spending review, we are asking the Government to reverse the £700 million of public health reductions, to enable councils to strengthen this workforce and ensure we can continue to support families when they need us most.’

Commenting on the report, Andrew Fellowes, public affairs manager at the NSPCC, said, ‘The pandemic has had an unprecedented impact on new parents and their ability to cope with what is already one of life’s biggest challenges. We’ve seen increased calls to our helpline about issues like domestic abuse and mental health problems that can make it more difficult for families to give their babies the best start in life.

‘Despite the extraordinary challenges, health visitors have rapidly adapted to support new parents as best they can. Sadly however, a history of cuts to public health funding and a significant decline in NHS health visitors means that for too long not all families have received the support they need, and this has been compounded by the pandemic.

‘The Government must prioritise rebuilding the workforce, backing this up with adequate funding to ensure all families receive consistent care through the Healthy Child Programme. This needs to be reflected in the upcoming Spending Review to avoid failing a generation of children before they are born.’

Alison Morton concluded, ‘We need to learn from Covid-19 and the experiences of families and health visitors to ensure that the health visiting service is strengthened and fit to face the challenges that lie ahead as we adapt to living with the virus for the foreseeable future. The challenges that we face are not insurmountable - individually and collectively we have the ability to put things right. But this requires bold action to make the difference – there is no time to waste, the time to act is now.’

In July, at a Local Government Association webinar, Supporting the development of babies and young children during the COVID-19 outbreak, Alison Morton put forward the following recommendations for restoration of the health visiting service: 

• Health visiting services should be reinstated (where they have not been) as a matter of urgency as a vital support and safety-net for children, with appropriate measures put in place, including the use of PPE, to reduce the spread of the virus.
• Health visiting services must be fully prepared for any future waves of Covid-19. NHS England should revise the Community Prioritisation Plan (for phase one pandemic management) and develop clear messages on the importance of continuation of the service to ensure the needs of children are prioritised. This should include removing wording on the redeployment of health visitors.
• A clear workforce plan is needed to ensure that the service has sufficient surge capacity to manage the backlog of missed appointments, as well as demand for support due to the secondary impacts of the pandemic.
• An evaluation of the use of virtual, non-face-to-face service delivery methods is urgently needed to determine their effectiveness for identification of vulnerabilities and risks, impact on child and family outcomes and reducing inequalities to inform future digital change.
• A cross-government strategy is needed to reduce inequalities and “level-up” our society - this will require investment to strengthen the health visiting service, which plays a crucial role in the early identification and support of the most disadvantaged families.
• The impact of working during the Covid-19 pandemic on staff well-being cannot be underestimated - a proactive plan is needed to ensure staff have the right support during the restoration of services and to create high quality workplaces for all staff in the future.

Making History: health visiting during COVID-19 is available here.