Health visitor survey reveals one in three fear being so overstretched that a tragedy could occur

Health visitors in England fear falling numbers could be putting children’s lives at risk, a new survey reveals.

• Institute of Health Visiting (iHV) polled 1,400 members
• Fall of more than 2,000 whole time equivalent health visitors between October 2015 and August 2017
• 21% have caseload of more than 500 children. iHV recommends one health visitor to 250 children

The 1,400-strong poll of members of the Institute of Health Visiting (iHV) found that one in three (33%) feared being so overstretched it meant a tragedy could occur – up from 25% in 2015.

One in five (21%) reported they had caseloads of more than 500 children, up from one in eight (12%) in 2015.

Effects of funding being transferred from the NHS to local authorities

The iHV says the survey shows the worrying impact of a reduction in their service on families in England since funding was transferred from the NHS to local authorities in October 2015.

Following the transfer, the Department of Health insisted a ‘minimum floor’ be set of three whole time equivalent health visitors to cover 1,000 children. The iHV recommends an average of one health visitor to 250 children to deliver comprehensive health improvement.

However NHS digital workforce figures demonstrate a fall of more than 2,000 whole time equivalent health visitors between October 2015 and August 2017.

The survey also shows:

• 51% of iHV members reported cuts to health visitor posts.
• 12% were awaiting news of the scale of expected cuts.
• Only 22% said there had been no cuts where they worked.
• 42% of respondents reported they can only offer continuity of care to vulnerable children and those subject to child protection processes (up from 26% in 2015) The iHV said health visitors need to be able to build up a trusting relationship with families over time to give them the confidence to disclose sensitive areas where they need help.

'False economy'

iHV executive director Cheryll Adams said: ‘We are being told that many families see a health visitor only until their child is eight weeks old, with less skilled staff carrying out all their later developmental reviews.

‘Health visitors’ time is being targeted to picking up work once done by social workers in some areas of the country.

‘Without a universal preventive service many children and families in need will be missed until their problems become serious, which goes completely against the role and responsibilities of a trained health visitor and where they can have their greatest impact.

‘Cutting the public health workforce is a false economy.’

Further information

• Health Visitors in England fear for some children’s futures as their numbers are reduced: Results from a Survey of English Health Visitors

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