'Stretched' health visitors concerned children will slip through the net

Results of the Institute of Health Visiting’s (iHV) annual survey for 2017 have found that a third of health visitors in England feel they are so stretched that there may be a tragedy in their area at some point.

This figure is up from 25 per cent in 2015, when responsibility for health visiting services in England moved from the NHS to local authorities.

The survey also showed more than one in five (21 per cent) of the 1,400 health visitors surveyed have current caseloads of over 500 children. In 2015, just one in eight health visitors (12 per cent) reported working with more than 500 children.  

The iHV recommends an average of one health visitor to 250 children to deliver comprehensive health improvement. 

Meanwhile, 42 per cent of health visitors surveyed reported being able to offer continuity of care only to vulnerable children and those subject to child protection processes. This is up from 26 per cent in 2015.

Dr Cheryll Adams, executive director of the Institute of Health Visiting (pictured), commented, ‘Health visitors are advanced specialist practitioners, previously nurses or midwives, who are very skilled at working with families to support them through stressful times. 

‘We are being told that many families see a health visitor only until their child is eight weeks old, with less skilled staff carrying out all their later developmental reviews.  Health visitors’ time is being targeted to picking up work once done by social workers in some areas of the country, meaning that these health visitors are not able to deliver their primary preventative role – the only professionals previously able to offer this as a universal service.  

'Without a universal preventative service many children and families in need will be missed until their problems become serious, which goes completely against the role and responsibilities of a trained health visitor and where they can have their greatest impact. 

‘Our worry is that the number of children needing care proceedings will increase, even more children will need mental health services, postnatal depression will go undiagnosed, there will be greater demand on GPs and hospital services and more children will enter school less well prepared in terms of their social, emotional and communication skills. Cutting the public health workforce is a false economy.’

Dr Adams continued, ‘There is a significant research base that demonstrates the importance of investment in the early years to reduce later costs by up to eight or nine times including the cost of social care, the NHS and criminal justice services. As a nation, we cannot afford to not invest in our children - they are our future.   There is already a large group of children and families who are affected by the recent reductions to public health budgets, and without new investment this number seems set to increase.’