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Overwhelmed and undervalued


Action needed with a third of health visitors lost since 2015, report finds

Action needed with a third of health visitors lost since 2015, report finds


The Government and local authorities must address health visitor shortages and improve services, with a third of the workforce lost since 2015, a report published today has found.

The document, from the First 1001 Days Movement, a coalition of baby wellbeing groups and professionals, highlighted that health visitor numbers have dropped by at least 30% since 2015 when responsibility for the service transferred to local authorities – with further losses forecasted.

It called on the UK Government to ‘properly resource’ local authorities so they can provide adequate health visitor services after they have ‘consistently underinvested in health visiting’ since 2015.

Local authorities must also commission and fund health visitor services that meet the Healthy Child Programme – a national framework on caring for children up to the age of five – and the Government must hold them to account if they are not meeting those guidelines, the report added.

Falling staff numbers have in part been driven by  the Public Health Grant – a small part of which funds health visiting – falling in real terms from £3.99bn in 2015-16 to £3.3bn in 2022-23, it said.

Calls for more face-to-face visits

The report also repeated calls for the five health visiting reviews mandated by the Health Child Programme to be face-to-face, with wide variation in health visiting support between local authority areas.

Although it acknowledged the Covid-19 pandemic has disrupted face-to-face reviews, it noted 16% of babies missed out on their 9-12-month review and 21% of toddlers their 2-2.5-year-old review in 2019-20, while the latest quarterly data is even worse at 19% and 30% respectively.

Meanwhile, government data from August 2021 found only 31% of 6-8-week-olds, 28% of 9–15-month-olds, and 23% of 2-year-olds had a face-to-face review with a health visitor that year.

The report said: ‘In many cases, the guidance is not being followed and the name health “visitor” is a misnomer. Workforce pressures and local decisions mean that many health visitors have not been routinely visiting families at home for many years.’

It also highlighted benefits of well-running health visitor services including reducing demands on ‘stretched NHS services’ such as general practice; identifying risk factors and early warning signs for clinical conditions; and supporting families facing multiple adversities or serious problems.

Sally Hogg, co-ordinator of the first 1,001 Days Movement, said: ‘This is a role that needs to be performed by skilled professionals, who can see families face-to-face and have the time to engage and build relationships with families.

‘Health visiting services in many areas of England have been decimated in recent years. The Government and local authorities must act now to ensure there are effective health visiting services across the country, so that no baby misses out.’

This comes after Institute of Health Visiting executive director Alison Morton told Nursing in Practice last week that ‘the call for more health visitors continues to fall on deaf ears’ but ‘ignoring the [issue] will not make it go away’.