Retention of health visitors vital as families forced to turn elsewhere for help

A decline in health visitors has pushed more families to rely on already ‘overstretched’ GP practices and emergency departments for minor issues and developmental concerns, nurses have warned.

Calls have been made during a debate at this year’s Royal College of Nursing (RCN) Congress to focus on the retention of the health visiting workforce, amid a more than 40% decline since 2015.

Fellow of both the RCN and Institute of Health visiting, Dr Ruth Oshikanlu was among several nurses who took to the podium to warn of the risks of a dwindling health visitor workforce.

Dr Oshikanlu warned: ‘Families are struggling without support when it matters most –the foundation of human life – because our numbers are significantly down.

‘We’re essential to prevention, early intervention, and giving every child the best start in life.’

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She stressed the focus must be on retaining the workforce.

‘We cannot keep pouring energy into training new health visitors, while experienced, skilled practitioners continue to leave the system that is stretched, undervalued, and unsustainable,’ Dr Oshikanlu told RCN Congress in Liverpool this week.

‘We must prioritise retention as a national strategy, and we must ringfence budgets for health visitors.

‘If we fail to retain health visitors, we’re not just losing a workforce, we’re failing children and families.’

‘Health visitors are a crucial safety-net’

BJ Waltho, from the RCN Dorset branch, added that health visitors were a ‘crucial safety-net’ for many families and warned that a reduction in home visits and routine contact ‘means that early detection of domestic abuse, child neglect, and maternal health and mental health issues often go unnoticed until they are escalated to a crisis’.

She warned of the impact of a dwindling health visiting workforce on other healthcare settings.

‘Without the preventative community-based advice and support that health visitors provide, more families are relying on overstretched GPs and emergency departments for minor issues and developmental concerns,’ said Ms Waltho.

A lack of health visitors has also resulted in more mothers turning to social media for advice, she said, ‘with potentially devastating consequences’.

Meanwhile, Mary Abiona from the RCN East Midland Region, urged the government to take the issue of a declining health visitor workforce ‘far more seriously’.

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‘For many families, a health visitor is not just a professional; they are often a lifeline. They offer reassurance, education, safeguarding, and early intervention during one of the most vulnerable periods of life,’ she said.

‘Health visitors play a vital role in prevention, early intervention, and reducing health inequality.

‘If you are serious about giving every child the best start in life, the government must urgently invest in rebuilding the health visiting workforce.’

‘A dilution of the specialist health visitor workforce’

The debate was put forward by health visitor Nicola Freeman, who flagged that some health visitors were reporting responsibility for over 1,000 children.

Ms Freeman raised concerns around a ‘dilution of the specialist health visitor workforce’ and suggested the role was in some cases ‘being substituted’.

‘While all members of the wider team play a play a vital role, this must not come at the cost of the specialist public health expertise that underpins safe, effective intervention,’ she told congress.

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She added: ‘We must reinvest in the health visiting workforce, and we must ensure services are accessible and sustainable, and we must align national ambition locally.

‘Investing in health visitors is investing in our future of our nations.’

The resolution – that this meeting of congress, in light of recent reports and investigations, calls on council to take urgent action to address the decline in numbers of health visitors and the impact on the babies, children and young families that they serve – was carried.