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Children should have extra health visitor appointment at three years, say MPs

A group of MPs has called upon the Government to introduce an additional health visitor appointment for children between the age of three and three and a half years.

The health select committee, chaired by GP and Conservative MP Dr Sarah Wollaston, suggested that the extra mandated visit would ensure that ‘potential problems that may inhibit the ability of children to be ready to start school are identified and addressed’.

The extra visit would complement the current five mandated visits all children should receive, with the priority being that every child should receive these visits ‘in a manner that does not compromise their quality’.

The recommendation features as one of many from the committee to revise the Healthy Child Programme, which they state is ‘not adequately supporting the improvement in health and wellbeing and reductions in health inequalities which it aims to do’.

The group have called for a revision to the programme that will see interventions begin before conception and will improve links between health visiting, midwifery, obstetrics and primary care, including an ‘explicit objective’ enabling women to see the same health visitor or midwife at each visit.

The recommendations – published in the committee’s report entitled ‘First 1,000 days of life’ – also criticised the way services are funded and called on the Government to shift the way money is spent, claiming that ‘structural problems in the way Government departments and public services are funded, financed and commissioned disincentivise investment in early intervention’, with too large a proportion of funding going towards care too late.

The report states: ‘The Government must use the Comprehensive Spending Review in 2019 to shift public expenditure towards intervening earlier rather than later. We recommend the Government use the 2019 Spending Review as an opportunity to initiate the next early years revolution with a secure, long-term investment in prevention and early intervention to support parents, children and families during this critical period.

On workforce, the committee asked the Government to publish a plan for services covering the first 1,000 days that sets out how the ‘capacity, capability and skill mix of staff’ will be improved.

Fiona Smith, professional lead for children and young people’s nursing at the Royal College of Nursing, said that many of the recommendations mirrored those made by the College.

She said: ‘We are pleased to see the committee agree with a number of our recommendations including the need to draw up a national first 1,000 days strategy to bring services closer together and to review the commissioning of health visiting and school nursing.

‘Improving the health and wellbeing of the youngest children should be a major priority for every society and it is right that this report recognises the importance of health visitors in a child’s first 1000 days of life. Health visitors work on the frontline in local communities and make vital interventions from birth, helping to prevent illness and promote health and wellbeing – however, Government ambitions to increase the size of this workforce in England were not underpinned by a comprehensive workforce plan and as a result numbers are now flatlining.

‘The committee’s call for an ‘Early Years Revolution’ is one that the Government and NHS England must demonstrate they share through investment, not just in health visitors, but in all parts of the nursing workforce that support children and young people. Anything less will see this revolution remain words on a page with families missing out on the very interventions that can be the difference between leading a healthy life, and not.’

The report follows data published last year, which found that half of health visitors in England are working with caseloads of more than 400 children, well above the recommended level of 250.