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Health visitor service dependent on ‘postcode lottery’, survey finds



The level of health visitor support that parents receive depends on a ‘postcode lottery’ rather than their needs, a survey has found.

The level of health visitor support that parents receive depends on a ‘postcode lottery’ rather than their needs, a survey has found.

While many receive high quality support from health visitors, some feel ‘let down’ by the service, the survey of 1,000 mothers from England carried out by the Institute of Health Visiting (iHV) revealed.

The report, ‘What do parents want from a health visiting survey?’, warned care quality has been affected by the ‘perfect storm’ of challenges facing the health service including high caseloads, low staff numbers and public health budget cuts.

This has led to a ‘mixed picture’ of health visiting nationally and ‘very poor’ provision in some areas, it suggested.

Over three quarters (78%) of mothers polled said they know who their health visitor is and how to contact the team if needed.

However, less than half of respondents (41%) said that they were given a clear explanation of the health visiting service available to them

Other complaints raised by respondents included a lack of continuity of health visitor, the appointments feeling rushed and too little time spent on emotional transition to parenthood.

Almost a third of parents (29%) who received additional support said it was to help them adjust to parenthood, the second most given reason behind breastfeeding (31%).

Health visitors should try to personalise care rather than use a ‘one-size fits all’ approach, the report concluded.

Parents in the survey ‘valued being treated as an individual, with easy access to personalised support when they needed it,’ said director of policy and quality at the iHV Alison Morton.

‘We can’t ignore the facts, however, that some parents are not receiving the support that they need or that health visitors want to provide,’ she added.

‘The challenges facing health visiting have been described as a ‘perfect storm’ driven by significant cuts to public health budgets, reductions in health visiting numbers, unmanageable caseloads and some poor commissioning decisions that have affected the quality of support.’

Local investment in public health budgets as a whole has fallen by almost £900m since 2014 with the most deprived areas seeing ‘disproportionate’ cuts.

Meanwhile, the latest figures show health visitor numbers stand at 6,999 as of October 2019 – having dropped from 9,481 at the same point five years ago.

In 2018, the IHV found that caseloads are rising with 44% of health visitors reporting caseloads of more than 400 children in its State of Health Visiting survey, up from 28% in 2015. The optimum recommended number is 250.

Health visitor workload and caseload size will directly influence how much time a family will have with a health visitor, said the iVH.