Service cuts prompting worries for health visitors

The Institute for Health Visiting has warned that public health budget cuts have left health visiting services unable to offer the minimum level of support in many areas.

An annual survey of health visitors in England indicates that many health visitors across England have been robbed of their ability to protect vulnerable families by devastating cuts to public health budgets, leading to calls to ring-fence new funding for the profession.

Official figures indicate that around one in five health visitors were lost between 2015 and 2019 – the full-time equivalent of 18 per cent of the workforce – with 48 per cent  of health visitors saying they feel so stretched that they fear a tragedy where they work.

The iHV State of Health Visiting survey indicates that those professionals best placed to help children get the best possible start in life lack the resources to do so. This is due to public health budget cuts and the failure to protect health visitors’ preventative role by many cash-strapped local authorities, after health visiting commissioning moved from the NHS to local authorities in 2015.

The findings also show that only 21 per cent of health visitors rated the quality of care that they can now offer families as ‘good’ or ‘excellent’, and that 29 per cent of health visitors are now responsible for between 500 and more than 1,000 children.

While in 2015, 65 per cent of health visitors were able to offer continuity of carer to all, or most, families, by 2019 that number had fallen to just 35 per cent. Continuity of carer has been shown to be greatly valued by parents and health visitors, as it allows them to build a trusting relationship and gives parents confidence to ask for help.

The Institute is calling for: new ring-fenced cross-government funding for early intervention and the health visiting profession; 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; workforce modelling and a new workforce strategy for health visiting; and a new focus on improving the quality of services which health visitors can offer families, regardless of where they live.

Cheryll Adams, 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.”

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