A poll of 1,291 practitioners by the Institute for Health Visiting (iHV) reveals how health visitors have seen widening health inequalities among young children and families over the last 12 months, in particular an increase in vulnerability and safeguarding risks.
Of those surveyed, 81 per cent reported a rise in perinatal mental health problems, 80 per cent an increase in domestic abuse and 71 per cent a rise in child safeguarding.
Other findings, published in a new report from the iHV, include:
- 86 per cent of health visitors reported an increase in speech, language and communication problems.
- 80 per cent a rise in child behavourial problems.
- 72 per cent an increase in poverty affecting children and families.
- 42 per cent of health visitors worry they ‘can’t do enough to safeguard babies and children’.
- Just 3 per cent of respondents felt they could provide an ‘excellent’ service.
The survey highlights a growing need for more health visitors due to rising levels of need and cuts to the workforce that have left remaining health visitors with ‘unmanageable’ workloads.
According to the iHV, more than 1 in 4 health visitors in England are accountable for over 750 children when the recommended ratio is one health visitor for 250 children from birth to age five, or less. It estimates there is a shortfall of 5,000 health visitors in England.
Due to cuts to the health visiting workforce, the survey finds that services are so stretched in parts of the country that many families are not receiving their mandated Healthy Child Programme contacts with a qualified health visitor.
A total of 15 per cent of health visitors reported that new birth checks are being carried out by practitioners who are not health visitors, while only 21 per cent said they are able to offer all families a two-year review.
The survey also covered health visitors’ use of video calls to contact families, with the majority agreeing that video contacts could not ‘safely or effectively replace face-to-face universal assessments’ or identify needs or enable disclosure of risk factors in vulnerable families.
One health visitor said, ‘Our team is stretched so thin we dread new vulnerable families being added to our caseload, thinking where on earth are we going to get the time to support them?
‘But we do, we make it happen, we turn up every day and keep going, our families would never know we feel this way if you asked them.’
The iHV is now calling on the Government to ‘make good their pledge to “rebuild” health visiting by:
- Introducing a £500 million ring-fenced uplift in the Public Health Grant over the next three years to reverse years of cuts, rebuild the workforce and enable sufficient resource to deliver the full breadth of the Healthy Child Programme.
- Ending the ‘postcode lottery’ of health visitor support.
'The service is so stretched that health visitors can only reach the tip of the iceberg'
Alison Morton, executive director at the Institute of Health Visiting, said, ‘Our survey findings this year paint a picture of a health visiting service under pressure due to the impacts of the pandemic which affect the most disadvantaged families the most and increase the demand for health visiting support.
‘In many areas, despite health visitors’ best efforts, the service is now so stretched that they can only reach the “tip of the iceberg” of need and vulnerable babies, young children and their families are being let down.’
A spokesperson from the Department of Health and Social Care said, ‘We’re committed to ensuring everyone has the best start in Iife and health visiting services are crucial to supporting children in the early years.
‘Local authorities and their teams are working hard to reinstate services to help families get the support they need and the Public Health Grant will continue to ensure investment is made in prevention and frontline services like child health visits.’
- The iHV report, 'State of health visiting in England' is available here
