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Early years review highlights low health visitor numbers

woman carrying child


Work must be done to ensure health visitors stay in the workforce amid concern about falling staff numbers, a report has found.

Andrea Leadsom MP, the former House of Commons leader, is chairing a review of the experience of families during the first 1,001 days of their babies’ lives, which was launched in July last year.

In the latest update from the review last week, she vowed to work with bodies including the NMC and Health Education England to ‘ensure health visiting is viewed as an attractive career and that skilled health visitors are developed and supported so they can stay in the profession’.

The document had noted ‘concern’ around staffing, with the latest NHS Digital data showing health visitor numbers dropped by 35% from 10,212 in December 2015 to 6,653 at the same time last year.

It warned the remaining workforce faces ‘unsustainable workloads’, meaning ‘with too many families to see, [health visitors] cannot take the time to get to know and understand their needs, often missing important opportunities to take early action’.

The focus on recruitment and retention is part of the review’s six-part action plan, which also includes that all families are offered the minimum five health reviews mandated in England.

Currently, not every family receives the minimum number of reviews, with ‘disparities based on demographic and geographic factors’, and general support services are ‘patchy, not joined up and not easily accessible for parents’, the review found.

Other recommendations included:

  • Councils should provide a ‘universal plus’ offer for families who may need extra support on top of the ‘universal’ offer available to all in the first 1,001 days of life.
  • The ‘red book’ – or personal child health record, which stores information about a new baby – will be digitised for all babies by April 2023, as part of a more digital offer.
  • The quality and relevance of data collections should be improved, including promoting data sharing where appropriate.

A cabinet minister will be appointed to oversee the implementation of the recommendations in the coming months.

Ms Leadsom said: ‘The six action areas will have a transformational impact on our society and I am looking forward to the implementation phase of the review where we will continue to work closely with families and the early years sector.’

Alison Morton, acting executive director at the Institute of Health Visiting, said: ‘I welcome the clear commitment within this review to reduce inequalities and ensure that every baby achieves their full potential – this is an ambition shared by health visitors and lies at the core of our profession.’

She added: ‘There is no time to waste, against a backdrop of increasing vulnerability facing many families. I look forward to working with the review team on the implementation phase.’

Nursing in Practice explored how health visiting has adapted to the coronavirus pandemic in its in-depth feature on the impact of lockdown on children last month.