What do parents want from a health visiting service?

30th January 2020

• Continuity of health visitor – someone who knows them as an individual and who they can trust
• Equity of access to support – receiving all mandated contacts and extra help when needed, regardless of where they live

Health visitors remain the most trusted source of information and support for new parents. Yet, a survey of 1000 parents by the Institute of Health Visiting (iHV) and Channel Mum has found that parents are experiencing very different levels of support depending on where they live, rather than their level of need.

Whilst many families continue to receive a high quality of support, the survey equally found that some parents felt let down by the service which did not have the capacity to offer them enough support when they needed it most and didn’t understand the needs of their family.

The survey found that the main drivers for dissatisfaction were lack of continuity of health visitor, the appointments feeling rushed and too little time spent on emotional transition to parenthood.

 

 

The survey report ‘What do parents want from a health visiting service?‘ is a new report that seeks to understand what parents want and what a good service should look like – the results of a survey of 1000 mothers of children aged 0-23 months completed by Channel Mum in April 2019 on behalf of iHV.

 

 

Alison Morton, Director of Policy and Quality at the Institute of Health Visiting, commented:

“Understanding what is important to parents should form the starting place for any policy for health visiting. Parents’ insight, experiences and suggestions are an invaluable resource to help us shape our services around the type of support that families require.

“Parents in this survey have clearly described the vital support that they received from their health visitor. Mothers described their experiences of early parenthood as a time of enormous adjustment and uncertainty, and they valued being treated as an individual, with easy access to personalised support when they needed it, rather than a ‘one-size fits all’ approach.

“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.

“There are many reasons for this. 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. For the past five years the Institute of Health Visiting, alongside other professional bodies, has been warning government that cuts have consequences.”

Siobhan Freegard, founder of Channel Mum, said:

“We are acutely aware of the importance of mothers bonding with their babies and giving continuity of care – and this survey shows mothers want to bond with their health visitors and have continuity of care too.

“Often, health visitors are ‘mothering mothers’ and so it’s vital new mums feel safe, secure and able to talk openly and honestly, and for this, they prefer to have contact with the same person where possible.

“This type of care is costly and needs greater investment in health visitor numbers, but ultimately, it’s a cost saver. Early intervention can spot issues and support families to flourish and grow.”

We are privileged to live in a time when we have more evidence than any other generation before us on the importance of the first years of life as a foundation for future health and wellbeing. We need to use this opportunity to make a difference to the lives of infants, children and their families – investment during the first 1001 critical days is a smart investment and saves money in the long run.

Ms Morton concluded:

“By listening to the stories of those who have experienced health visiting services as they really are, we can strengthen a learning culture which will be integral to quality improvement and help inform the refresh of the health visiting model and the Healthy Child Programme.

“I would like to thank all the parents who generously shared their time and experiences with us and Channel Mum for carrying out the survey. Parents are the true experts on what a good health visiting service needs to look like.”

 

 

Additional survey information:

• The Institute of Health Visiting has incorporated the findings from this survey in the development of our recently issued ‘Health Visiting in England: A Vision for the Future’ – our evidence-based blueprint to improve outcomes for children and families and reduce inequalities through strengthened health visiting services. It was published to support Public Health England’s refresh of both the 4-5-6 health visiting model for England and the Healthy Child Programme during 2020.
• The key findings of the Channel Mum survey are:
  • Continuity – Parents want continuity of health visitor so that they can build a positive, trusting relationship with them and feel that their needs are understood – this was found to be the most important factor in parents’ satisfaction with the health visiting service.

Mothers’ comments:

 “My health visitor knows me and addressed my emotional needs when no one else understood. She supported me, gave me advice and pointed me in the right direction, boosting my confidence as a first-time parent. I felt completely comfortable knowing she had my interests and my baby’s interest as a priority”.

“Keeping to one health visitor – in the past 2 years I’ve had 5 different health visitors”.

• • Unwarranted variation in services – The survey has highlighted a mixed picture of health visiting nationally – many mothers valued the service that they had received, however some reported a poor experience:
    • The quality of the service that families receive is based on where they live, rather than their level of need with a wide variation in the type of support available.
    • Every child in England should be offered five mandated health reviews in the first years of life. Yet based on PHE data, in the last year around ¾ million children did not receive one of the five mandated reviews. And our own iHV survey of health visitors in November 2019 found that in England only 10% of 2-2½ year reviews were completed by a health visitor, with some areas completing these reviews by a postal questionnaire rather than a face to face contact.
    • Health visitor workload and caseload size will directly influence how much time a family will have with a health visitor. The iHV annual survey 2019 highlighted that in England almost 29% of health visitors are responsible for 500 – 1000 children (the optimum recommended number is 250), with only 25% being responsible for 300 or less children.

Mothers’ comments:

“More standardised care [is needed] – A friend lives 1.5 miles from me and had a baby within 2 weeks of me yet had a very differentexperience of health visitors. She had a home visit prior to birth and was given useful advice. I didn’t receive this”.

“Be consistent – If I have a friend who has a child the same age as mine (a week apart) and she has had a health visitor appointment as routine, then so should I”.

Go to Health Visiting in England: A Vision for the Future (full report and executive summary available)

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