This site is intended for health professionals only

Health visitors under "serious pressure"

Health visitors are facing a cocktail of high stress levels and low morale as workloads increase, a symposium in London was told yesterday.

Unite, the health visitors' association has revealed that 2 years of job cuts have taken their toll on the profession.

The report shows that three quarters of health visitors knew of colleagues off sick due to work-related stress and a similar number said they had experienced increased stress themselves.

Some 32% of health visitors said they were definitely unable to respond to the needs of the most vulnerable children on their caseload.

Just under half of health visitors said their morale was "fairly poor" or "very poor".

Unite Acting Lead Professional Officer Cheryl Adams said: "This research based on interviews with more than 800 health visitors in England reveals a depressing cocktail of a profession under serious pressure.

"But we are taking heart from the Health Secretary's recent comments that more health visitors need to be employed to combat public health inequalities."

Cheryl Adams added: "Promoting the health and wellbeing of children and families, you need the right combination of skills and our members are telling us that skill-mix is turning into grade mix, with serious implications for safe and effective practice and health outcomes."


Related story: Health visitors' future in question

Are you a health visitor feeling the strain? Do you feel under pressure at work due to too few staff?  Please supply your comment, name and location in the feedback box below. Your details will not be published if you so request. Terms and conditions apply

"I have worked as a health visitor for 26 years. As time has gone on, the job has changed beyond recognition and now it is more akin to social work. All we seem to be able to do is to stick plasters over the wounds. We have no time to investigate the cause. I retire this year leaving a job that I use to enjoy. I think it is sad that fewer health visitors are being trained and that no one will take over. I see the future for health visiting as grim, with 1 or 2 health visitors controlling a team of skill mix, until they too retire and skill mix stands on its own" - Name and address supplied

"I must comment on behalf of school nurses. We have been subject to gross under funding for many years and are expected to increase productivity year on year. Most of our work is around child protection and the stressors that accompany it. It will be interesting to see how the stressed health visitor's scenario has a knock on effect to the school nurses" - Name and address supplied

"I have been a health visitor 30 years. I came into health visiting to do health promotion, not social work. Having been sponsored by the health authority to do a Public Health Nursing module, there is now no time to do public health work. I must do the 'social work' as a priority. Health visitor posts are replaced with 'Skill' mix. Our caseloads therefore often double at a stroke and we have to give more time to management of teams, no matter how good the staff are. Allocation of work to skill mix is increasingly restricted by requirements for minimum HV home visits contact or assessments. 'Cover' for bases when the HV is off is cumbersome and time consuming and relies on the goodwill of equally stressed colleagues. Agenda for Change favoured hospital staff in giving more holidays. For HVs it simply means trying to fit more work into fewer working days as there is no backfill for absence from any cause. Policy may well appear to support the work and role of Health Visitors but there is absolutely no 'political' will to maintain our role. There is no sense that Health Visiting is more than the sum of the parts of its role. The attitude seems to be that odd tasks can be sheared off and passed on to others with no loss to the patient or well being of the community" - Name and address supplied

"I recently retired from health visiting after 40 years nursing (mainly a health visitor, but latterly as a specialist working with children with special needs). I loved my job but it became extremely stressful. I now work as a nurse adviser for 12 hours per week with NHS 24 and I am amazed at the number of phone calls received from parents of young children who should be asking their health visitors for advice - Name and address supplied

"I was until the beginning of this month a professional lead for health visiting. I have lost my position under a reconfiguration. One of the reasons was the health visitors low scoring on the staff satisfaction services. I defended them and explained that over the last few years partnership working has taken its toll. Senior management has never supported any initiatives within health visiting, claiming safeguarding and school nursing were so far behind they had priority. This, and the public lack of support for the staff, has lead to low morale. Conversely, improved working conditions means staff are now entitled to work when and how often they wish, which means full-time posts are now in the minority. Lorenzo was implemented with no data inputters. This again has had a detrimental effect on time available for clients. Agenda for Change gave everyone extra annual leave but no backfill in our area. This has meant the loss of the equivalent hours of a full-time health visitor. Staff are off with work-related stress and vacancies are open for long periods. Staff are missing out on opportunities due to a poor online recruitment process. People complain that there are too many managers but the service needs to be managed in order to support staff" - Name and address supplied

"I took early retirement earlier this year due to not being able to do my job properly. For four years I had been working 8am-6pm or 7pm and still wasn't able to do preventive work, it was just child protection, working as a mini social worker. I loved the job and unfortunately left extremely disillusioned" - A Burnt Out Ex-Practitioner

"Our trust has a freeze on jobs posts and no employment of bank or agency staff, so collectively, all health visiting services are being affected. I feel for the colleague writing below but working unpaid overtime, which we all do, has to stop. We do it because we don't want our clients to suffer, but at the end of the day we are making it worse for ourselves. The trust sees we are coping and so let us continue. We should ensure our child protection work is covered and then fit in the rest of our work, but at the end of our working day we should go home to be with our families. It is only then that the trusts will recognise that if they want to provide a public health service (which can have long lasting benefits to families and their health, ultimately saving the trust money in the future) they have to maintain health visiting posts and not lose them because of reshuffling and cost-cutting ventures. So all of us need to stand up and be heard" - Name and address supplied

"I work in an area of high levels of child protection, children of concern and deprivation. Each member of our team has  around 600 families each, far too many to deliver safe and effectve care to. We work overtime, take work home and worry about our workloads" - A concerned practitioner