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Widespread support for iHV survey: iHV responds to Government’s response

24th January 2023

Last week, the iHV launched its annual health visiting survey report on the State of Health Visiting in the UK. We have been overwhelmed by the media coverage and the number of organisations that have posted formal responses. We would like to thank all of our partners for their support. Having such high-profile endorsement of the report adds considerable weight to the validity of the findings and importance of the recommendations.

It is our hope that they provide a tipping point and policymakers will finally take action. We also hope that health visitors will take encouragement from these statements of support. This growing collective voice for babies and young children builds optimism that we can build a better future together. Read some of the responses below:

In response to the survey, Dr Camilla Kingdon, President of the Royal College of Paediatrics and Child Health said: “The role of health visitors cannot be understated. Their work plays an incredibly important role in looking after babies, and their families, and in keeping them safe. They are regularly described as a safety net and are essential in both prevention and early intervention of ill health in babies and young children. Yet the findings of this year’s survey are a harrowing read…

“The situation remains dire for many babies, young children, and their families, with health visitors seeing an increase in serious issues including the use of food banks, food scarcity, domestic violence, mental illness, homelessness, and safeguarding issues – all also symptoms of rising poverty.

“It’s clear to all child health professionals that without further support and focus, we are fast approaching a crisis in child health. We urgently need a fully funded health and care workforce plan in place, working alongside a cross departmental child health strategy to ensure every child has the best start in life. Without this the inequalities gaps will widen; post-code lotteries of care will remain, and babies, children, young people, and their families will continue to suffer.”

The Association of Directors of Public Health said: “Today’s report from the Institute of Health Visiting makes for stark reading. Poverty is the most important determinant of children and young people’s health in the UK and it is vital that every child born can be supported to live a healthy, long, fulfilling life.”

Cllr David Fothergill, Chairman of the Local Government Association’s Community Wellbeing Board said: “As this survey clearly shows, health visitors play a vital role in our communities but councils face growing shortages of them, with the number of health visitors decreasing by nearly 40 per cent since 2015 due to cuts in councils’ public health grant.

“At a time of increasing need and complexity, health visitors are needed now more than ever. That is why the Government should commit to an ambitious plan to increase the number of health visitors, so we can rebuild and regain these vital public health nursing services that have been lost over the last decade.

“Long-term investments in these key services can benefit children’s lives both now and into the future, through improving their school-readiness, attainment, resilience, and taking away burdens from our over-stretched health service.”

Claire O’ Meara, Head of UK policy and advocacy, Unicef UK, said: “We know that across the UK, many families with young children are at breaking point and slipping through the cracks of overstretched essential services.

“Today’s findings from the Institute of Health Visiting provides further evidence of this, with a reported increase in the number of families struggling with mental health issues, child safety and the cost-of-living crisis.

“This, coupled with the sobering fact that only 7% of health visitors feel confident that those families would get any support, is extremely alarming.”

National Network of Designated Healthcare Professionals for Children said:“The new Institute of Health Visiting membership survey shows widening inequalities in support for the most vulnerable, our babies and infants. NNDHP strongly backs the report’s five main policy recommendations, supporting harm prevention.”

The First 1001 Days Movement said: “Health visitors play an essential role in the first 1001 Days. They help protect babies’ mental health & wellbeing & refer parents to crucial support. This @iHealthVisiting survey & our 2022 #HealthVisitorsMatter report highlight the #babyblindspot still exists in Gov funding.”

The Parent Infant Foundation said: “This is such an important issue, particularly in these challenging times families are living in. #HealthVisitorsMatter because they help identify families who are struggling to bond with their babies early on and can make referrals to specialist parent-infant relationship teams.

Read the UK Government’s response published by the Nursing Times, which stated that it was “committed to giving babies and children the best start in life”. It pointed to a £300m investment it had made to fund a new three-year Family Hubs and Start for Life programme, which it said was set to improve health and education for children in 75 local authorities with high levels of deprivation. They added: “Local authorities are responsible for commissioning health visiting services and nationwide coverage of health visitor reviews improved during last year, compared with the year before. “We are doing everything within our powers to support the most vulnerable, including children living in poverty”.

We were disappointed by the Government’s response which failed to address the current health visitor workforce crisis, citing investment in other parts of the system and no details of any national workforce plan to rebuild the service. The response also contained misleading information on current health visitor mandated review metrics which appear inflated due to the ongoing practice of counting non face to face/virtual contacts (telephone, video and postal questionnaires). Whilst we recognise that these contacts bring some benefits for other areas of health visitors’ work, there is a growing weight of evidence that their use for the five mandated health review appointments will increase risks to babies and young children. The government is failing to take seriously the evidence that, as a direct result of this practice, more babies and young children with complex conditions, disabilities, developmental delay and safeguarding vulnerabilities will be missed and not get the support they need, further widening inequalities.

In response, Alison Morton, iHV Executive Director said: “At the iHV, we refuse to paper over the cracks – attempts to deny the problems, or water them down by producing good looking data that ‘ticks the box but misses the point’ are futile and hamper the change that is desperately needed to give every child the ‘best life from the start’. We will continue to speak out about the challenges and wider system failures that are impacting on babies, young children and families, as well as the health visiting service, to drive the change that is so urgently needed.”



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