Nursing leader highlights health visitor pressure after Twitter debate

A leading health visitor has spoken up about the strain health visitors have been under during the Covid crisis after a Twitter exchange suggested many parents felt abandoned.

Alison Morton, the acting executive director of the Institute of Health Visiting (iHV), told Nursing in Practice that health visitors were struggling with ‘unmanageable caseloads’ because of ‘years of cuts’ and a reduced workforce during the pandemic.

She was reacting to the huge response journalist Jess Brammar received on Twitter after posting she had not met her health visitor during her child’s first year.

Some parents were outraged, with one believing health visitors had been ‘allowed to bow out’ from their jobs while another questioned whether they had been ‘hiding’ during the pandemic.

But Ms Morton told Nursing in Practice health visitors had definitely ‘not been hiding’ and were going ‘above and beyond’ to support families but had had to prioritise the ‘most vulnerable’ amid a ‘huge backlog of work’.

The latest NHS figures show health visitor numbers dropped by 35% from 10,279 in November 2015 to 6,672 in the same month last year.

Ms Morton explained: ‘The current state of health visiting is not the failure of a single health visitor, or manager or commissioner, but rather the predicted consequence of years of cuts to the health visiting service which predate the pandemic. Families have faced the brunt of these cuts.’

She said the stories on social media were ‘heartbreaking’ and it was difficult for health visitors to know ‘they are only reaching the tip of the iceberg’.

The social media discussion also highlighted the variation in quality of health visitor services between areas because there ‘just aren’t enough health visitors to meet the rising levels of need’, Ms Morton explained.

Many health visitors were also redeployed, particularly at the beginning of the pandemic, with some areas of England losing up to 63% of their workforce during the first wave. This led to a significant portion of face-to-face contacts being replaced with telephone contacts or video calls.

Ms Morton stressed the iHV condemned this redeployment of health visitors.

She continued: ‘We are pleased that parents are speaking out about the variation in support provided by the health visiting service as the concerns previously raised by health visitors have largely fallen on deaf ears, with little tangible action from the Government.’

She added that she hoped this would ‘accelerate the change’ called for in the recent Leadsom Review, which published a report last month concluding work must be done to ensure health visitors stay in the workforce amid concern about falling staff numbers.

Health visitors also reacted to Ms Brammar on Twitter last week, saying they had ‘worked tirelessly during the pandemic’ in a service that was constrained by Covid-19 policies and low staff numbers.