Over-stretched health visitors fear possible tragedies involving children

Two fifths of health visitors fear that they are “so stretched” that avoidable tragedies involving children could occur, a new poll suggests.

A new poll of 1,200 health visitors in England found that 43% were concerned tragedies could occur because a vulnerable child would not be identified until it was too late.

The Institute for Health Visiting (IHV) said that some organisations were sending less qualified staff to child health and development checks while health visitors focus on more vulnerable children.

But the body raised concerns that this could mean that other vulnerable children are “invisible” due to being seen by non-registered practitioners without health training instead of health visitors.

The survey found that some health visitors – nurses or midwives who have undertaken additional training and qualifications – had started providing early contacts with families over the phone.

It also found that visits before babies were born were sometimes only provided to vulnerable families.

The IHV said that 65% of reviews which are conducted around a child’s first birthday, and 79% of development checks for children are aged between two and two and a half, “are delegated to less well-qualified staff”.

Remarks made by the survey respondents “indicate concern this is now routine practice”, the authors wrote.

They added: “Health visitors add that they cannot be confident of identifying perinatal mental health needs of mothers and fathers due to very limited contact and assessment beyond 6-8 weeks for most families.”

The report adds: “Health visitors are now are ‘walking a very tight rope’ between being strongly driven to meet… the five mandated contacts (with families) on the one hand and child protection social work-by-proxy on the other.”

And it said that “43% are so stretched they fear there may be tragedy at some point”.

Dr Cheryll Adams (pictured), executive director of the IHV, said: “This is hugely worrying as many of the issues that health visitors are trained to assess during these contacts with families are hidden and are easily missed by less qualified practitioners.”

She added: “Cuts to public health budgets by the Treasury have led to a loss of around a quarter of the total health visiting workforce over the past three years, but these losses aren’t consistent across the country with losses being greater in some areas and smaller in others.

“Another round of public health budget cuts are due in 2019/20. Unless these are stopped now, we will see a further reduction in health visitors and more negative outcomes for children and families, and in turn, for society as a whole.”

The survey also demonstrated high caseloads, work-related stress and concerns over shrinking numbers of staff.

More than two in five (44%) said they were responsible for 400 or more children, and almost three quarters (72%) said their stress levels had gone up, in part due to concerns over the safety of vulnerable children.

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