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Two-fifths of health visitors feel unable to safeguard vulnerable children



Health visitors are worried they cannot offer vital support to vulnerable families and young children following successive years of cuts, a report has found.

The Institute of Health Visiting (iHV) – which surveyed 1,291 UK health visitors in their annual report, The State of Health Visiting – found 42% of health visitors are worried they can’t do enough to safeguard vulnerable babies and young children.

This comes amid ‘escalating numbers of families facing poverty and adversity’, with health visitors witnessing ‘increasing needs’ in several ways in the last year, it warned.

For example, survey respondents reported an increase in speech, language and communication problems (cited by 86%), perinatal health problems (81%), domestic abuse (80%), child behavioural problems (80%), poverty (72%) and child safeguarding (71%).            

The report noted that England is facing a shortage of around 5,000 health visitors, which has led to a ‘postcode lottery’ on the support available to families between areas. Health visitors told the iHV that they are ‘struggling to practice safely’ because of ‘large and unmanageable caseloads’.

Only 9% of respondents in England said they have the recommended ratio of 250 children aged to 5 or less per staff member, compared to around two-thirds of health visitors in Scotland and Wales. And more than one in four in England said they are accountable for over 750 children.

This means not all families are receiving routine health and development reviews mandated by the Government. For example, only 21% of health visitors in England said they are able to offer all families the antenatal contact, and only 21% are able to offer all families a two-year review.

The iHV has now called on the Government to fulfil its pledge to ‘rebuild health visiting’ by injecting an extra £500m in the public health grant. This comes after the Government was criticised for maintaining – and not increasing – the public health grant in its autumn budget.

Ministers should also introduce policy to recruit 5,000 more health visitors in England and accountability in public service delivery to end the ‘postcode lottery’ of support, it said.

Alison Morton, executive director at the iHV, said the health visiting service is ‘now so stretched that they can only reach the ‘tip of the iceberg’ of need’ in many areas. ‘Vulnerable babies, young children and their families are being let down,’ she added.

‘Becoming a parent can be challenging for a multitude of reasons. The good news is that getting help early can make a big difference. The pandemic has left many families without this vital safety net of early support provided by a health visiting service that reaches out to them,’ she continued.