Health visitors reveal risk to young families of public health cuts

Most health visitors’ workloads have increased in past two years.
health visitor with client

Health visitors in England are feeling the impact of public health budget cuts, with 85% saying their workload has increased over the past two years.

And a further 16% of health vistors report they now have caseloads of between 500 and 1,000 children, according to a survey. The Community Practitioner and Health Visitors Association recommends a caseload of no more than 250 families.

The Institute of Health Visiting’s (IHV) annual state of health visiting survey comes a year after the government announced £200 million worth of cuts to the public health budget.

Further cuts loom

Figures from NHS Digital show 988 full-time-equivalent health visitor posts were lost between September 2015 and August 2016, and a health select committee report published in September showed 56% of local authorities in England are planning further cuts to health visiting services in 2016-17.

The IHV survey of 1,224 health visitors also revealed:

  • 40% say their increased workload is a result of a reduction in health visitor numbers.
  • 80% report seeing more domestic violence and abuse and perinatal depression.
  • Respondents said that only 70% of young families are receiving the mandated health visitor reviews at six to eight weeks, one year and two to two-and-a-half years.
  • They also said only 30% of families receive an antenatal visit.
  • Just 5% of health visitors say they are able to offer consistent continuity of care to families, while 72% worry about providing inadequate safeguarding and child protection support.

Radical Downgrading

IHV executive director Cheryll Adams said the survey showed there had been a radical downgrading of health visiting, and urged the government to reinvest in services.

According to the latest 2015-2016 quarterly data from Public Health England fed back from local authorities, 80.4% of 6-8 week visits from health visitors were delivered. For 12-month review, the figure was 80.8%, and for the 2- 2.5 year review it was 81.8% 

‘Health visitors should provide a universal service to every family in the country with a child under the age of five,’ she added. ‘This survey exposes the risks to all children and families from a decommissioning of health visitor posts, which it seems is just about to accelerate.

‘The impact will not only be felt by children and families – there will be a knock-on effect on the NHS and other local authority services such as safeguarding. 

‘We can expect increased use of secondary health and local authority children’s services in the short, medium and longer term as many health and social concerns won’t be identified early enough. The cuts will increase health inequalities because needy families will be missed until their problems are obvious.’

A Department of Health spokesperson said: 'Health visitors are a vital part of the community care that the NHS provides - that's why we've funded, recruited and trained thousands more since 2010.'

Further information

Funding cuts threaten the NHS public health agenda

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