Health visitors fear for children’s wellbeing following ‘relentless service cuts’

Public health budget cuts have left health visiting services unable to offer the minimum level of support in many areas, a report by the Institute of Health Visiting (IHV) has found.

The figures indicate that around one in five health visitors left their job between 2015 and 2019, the full-time equivalent of 18% of the workforce.

A spokesman for IHV said this is due to public health budget cuts and the failure to protect health visitors’ preventative role by many cash-strapped local authorities following the health visiting commissioning move from the NHS to local authorities in 2015.

The consequences have been devastating, with 48% of health visitors saying they feel so stretched that they fear a tragedy where they work.

One health visitor told the IHV: ‘Larger caseloads and fewer staff mean families are not getting a tailor-made service to meet their needs. Vulnerable children are slipping through the net.’

Almost a third of health visitors report they are now responsible for between 500 and over 1000 children. Meanwhile, the IHV considers the optimal maximum to be 250 children in order for health visitors’ work to be fully effective, less in areas of high vulnerability.

Consequently, 58% of health visitors are working long hours and feeling ‘worried’, ‘tense’ and ‘anxious’.

One health visitor said: ‘I have taught myself to become numb to what is happening within health visiting – as a coping mechanism.’

The IHV is calling for urgent action to address this crisis, including new ring-fenced cross-government funding for early intervention and the health visiting profession.

As well as statutory protection for the health visitor role in leading the delivery of the Healthy Child Programme and for health visiting to be returned to statutory regulation.

And workforce modelling, a new workforce strategy for health visiting and a new focus on improving the quality of services that health visitors can offer families, regardless of where they live.

Dr Cheryll Adams CBE, executive director of IHV, said: ‘It is absolutely unacceptable that many families are struggling through the significant demands of early childhood without the vital support that they need and are entitled to through the government’s flagship Healthy Child Programme.

‘Indeed, the government’s pledge to give every child the best start in life has been left in tatters after year-on-year cuts to the public health grant, which have dismantled the health visiting services designed to support them in many areas.’

‘Our survey indicates that health visitors have seen rising demand for support from families, almost certainly related to austerity.

‘Meanwhile, they themselves have battled with ever-increasing caseloads, due to the fall in health visitor numbers. It was particularly disturbing that one in four health visitors told us that they are seeking professional help from a GP or elsewhere, due to the demands of their job.

‘Health visitors worry about children being at risk and there is no doubt that their stress levels directly related to them feeling unable to deliver the quality of service that they know they can – and should be able to – offer, as well as the fear of children’s needs being missed.

‘Our children are our future. They deserve much better than this.’

Cllr Ian Hudspeth, chairman of the Local Government Association’s Community Wellbeing Board, said :

‘Working with government and the NHS, councils want to protect our world-class health visiting service by attracting, training and keeping new essential workers.

‘The government announcement of a real-terms increase in public health funding this year is positive but this report reinforces our call for long-term sustainable funding for vital council services, including for children’s public health and prevention.

‘Every pound invested by the government in council-run services such as public health helps to relieve pressure on other services like the NHS. There cannot be a sustainable NHS without a sustainable public health system.

‘Since councils took over responsibility for the public health of those aged 0-5 in 2015, they have done everything they can to provide this vital service, but years of funding reductions mean public health services are struggling to keep pace with the scale of demand.’

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