Health visitors needs additional support and investment, MPs have said, as children continue to miss out on mandated face-to-face health visiting contacts amid staffing challenges.
Speaking at a Westminster Hall debate yesterday for Infant Mental Health Week, MPs highlighted that some infants are still missing out on some of their five mandated health visiting contacts while the health visiting workforce is estimated to be down by about 30% since 2015.
Sarah Olney, a Liberal Democrat MP, argued virtual visits must not become ‘a new normal’ as health visitors could miss ‘so much’ – such as evidence of domestic violence and attachment disorders – by ‘not visiting mothers in their home’.
She added: ‘I just wanted to end by stressing the importance of that face-to-face contact – the health visiting service needs support, it needs investment in its workforce.’
In May, local authority quarterly data revealed that 18.6% of babies had missed out on their nine to 12 month review, and over a quarter missed out on their two to two-and-a-half year review. In this data, phone and virtual appointments counted as a review.
But the Government said in March that mandated health visiting reviews should be carried out face-to-face amid concerns about virtual services not reaching the most vulnerable children.
‘Huge damage during pandemic’
Andrea Leadsom – a Conservative MP and the Government early years healthy development adviser who secured the debate – agreed that ‘every family in England should be offered five mandated reviews from a health visitor between pregnancy and aged two and a half at a minimum’.
She also argued Infant Mental Health Week is ‘vital’ this year because ‘it shines a spotlight on the huge damage done by two years of pandemic lockdowns’, including support from health visitors and family hubs becoming virtual, isolation and the exacerbation of existing social issues.
‘There is a wealth of evidence that demonstrates that poor mental health, substance dependency and domestic abuse amongst parents leads to significantly poorer outcomes for babies and young children,’ all of which evidence suggests increased during the Covid-19 pandemic, she added.
She continued: ‘From conception to age two, a secure and loving relationship between a baby and his or her carer literally shapes the way the baby’s brain develops. It’s when the building blocks for lifelong physical and emotional health are laid down… Health visitors provide a vital support service to families who are struggling.’
‘Mental health workforce plan to be published’
Responding to the concerns raised during the debate, care minister Gillian Keegan said the Government is investing £302m to improve start for life services and create a network of family hubs across 75 local authorities in England. This ambition is backed by the additional £2.3bn a year mental health, which will kick in by 2023/24, she added.
However, Ms Olney highlighted that the £302m investment in the Start for Life programme contains no funding for health visiting service, which sits outside DHSC.
Ms Keegan also said a workforce plan will sit alongside the new 10-year mental health plan, which is currently calling for evidence from nurses.
She explained: ‘We have immediate action to model the workforce to support the development of new roles, new ways of working and upskilling, and particularly with regard to perinatal and primary and community workforce including health visitors, and we will be working with HEE and NHSE/I to make sure we have this workforce plan to sit alongside the new 10-year mental health plan.’
This comes after a Parent Infant Foundation report yesterday underlined that since 2015 – when responsibility for health visiting was transferred to local authorities – the public health grant has fallen by £0.69bn in real terms and around 30% of the health visiting workforce has been lost, with further losses forecasted.
England’s public health grant allocation for 2022-23 was dubbed ‘effectively a cut’ and ‘another blow’ to services by public health experts, when it was announced in February.
What are the five mandated health visiting contacts?
As described in the Healthy Child Programme 0-5 years, there are five mandated review points:
• First visit – At 28 weeks pregnancy: Health promoting Visit
• Second visit – At 10-14 days after birth: New baby Review
• Third visit – At six to eight weeks old: Six to eight week assessment
• Fourth visit – At nine to 12 months old: One year assessment
• Fifth visit: – At two to two and a half years’ old: Two to two and a half year review