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Health visiting in the London Borough of Sutton 2020/21

5th March 2021

A Voices blog by Debbie Holroyd FiHV, Practice Educator/Health Visiting at Sutton Health and Care Alliance, sharing her experiences of the health visiting service in Sutton during the pandemic.

Debbie Holroyd FiHV, Practice Educator/Health Visiting at Sutton Health and Care Alliance

As we work through another national lockdown, it is worth pausing to reflect on how our health visiting service in the London borough of Sutton has managed during these very difficult times. The work of the health visitor often goes unnoticed, however the positive feedback that we received from parents during the pandemic has been a much-needed boost and highlighted how vital the health visiting service has been to families dealing with a multitude of issues during these challenging times – it is important that we share their experiences.

Help, when needed, is really crucial and I got that even in the pandemic. Thank you

New mother

As the iHV State of Health Visiting in England Survey (2020) found nationally, our health visiting teams reported increased levels of vulnerability and demand on their services. Set within a national context of increased domestic violence, perinatal mental illness, child neglect, substance misuse, speech and communication issues, families struggling to cope with isolation, home schooling and poverty, these inequalities which may remain less obvious under normal circumstances are brought into sharp relief during COVID.

Sutton is no exception. Against a backdrop of staff redeployment last year, staff worried about the families they had left behind knowing the remaining workforce was diminished and largely working virtually from home. As a result, morale was low at times… it’s hard working from home, dealing with families in crisis without the support of colleagues in the office to come back to.

Quite often, a lot of the emphasis is on the needs of the most vulnerable families in our above core caseload, with understandable concerns around safeguarding. Yet all families have found parenting challenging during the pandemic and the continued ongoing work with our universal caseload, as ever, reveals the most unidentified needs. Our work upstream within this cohort remains crucial if we are to invest in human capital and truly make an impact on health inequalities. It remains true that we are the only service to have this universal access to families in the earliest years – which is so important as the needs of babies and young children are largely hidden from sight, with many well-documented reasons why families are hesitant to reach out for support when needed.

Despite the challenges, health visitors are making a difference by providing vital support to families that need it. The results from our parent feedback survey conducted in December/January 2021 revealed how valued our service is:

Thank you for everything that you are doing whilst under so much pressure. It is much appreciated. There must be so many new Mums who need your support and I’m sure you are striving to support them the best you can, in this dreadful situation. I salute you!”

(new mother)

While families struggled to access services generally, we know continuity of carer from a trusted healthcare professional is so important. Telling your story to a variety of professionals is exhausting (we know clients “give up”), especially when distressed, lacking support and with an urgent need.

“It was really personal, I didn’t feel rushed, I saw the same health visitor every time so she knew me”

(new mother)

We also have a dedicated Infant feeding team who work with the HVs and CNNS  to support all new mothers, we are proud to have UNICEF gold accreditation since September 2019. This service has adapted to working during a pandemic and made a real difference to families, as highlighted by the  feedback below:

“I am a mother of two kids. The elder one is a lovely daughter who is 5 years old and the sweet newborn boy who is 8 weeks old.

I wanted to share my story with you and your team as it is very special for me and I want to extend my heartfelt thanks to your entire team.

When the HV came for the first appointment for my little boy, I cannot thank her enough. When she came, my son and I were having a very tough time breastfeeding, he had a major weight loss after birth. I was everywhere… breastfeeding, pumping, bottle feeding, dealing with his silent reflux, my c-section recovery.

I was so overwhelmed that I burst into tears in front of her. She gave me so much time, checked the latching and encouraged me to continue to breastfeed. She gave the contact numbers for breastfeeding support groups and sat with me to plan a feeding routine for him as I couldn’t think when to breastfeed, bottle feed and pump. I was so scared with the weight loss and feeding issues that I was about to quit breastfeeding. It was due to her encouragement that I continued and now he is 8 weeks and exclusively breastfed! She is giving me ongoing support with his weight checks and silent reflux issues.

The infant feeding support worker took my call in the breastfeeding support group. She has been so patient, answering all my questions over and over. There was a point where I was calling her almost every day for 2 weeks and she kept assuring me that things will be alright. She checked and taught proper latching on video calls and shared many helpful videos for latching and group information to make me feel that I am not alone. She always gave me the mental support during the initial days of colic, reflux and breastfeeding issues which kept me going.

The best thing about both of them is that they are very patient, pleasant and welcoming. I feel very comfortable asking them any query that I have, although I know I keep asking same things over and over again. This support kept me going so I didn’t quit breastfeeding.

I love breastfeeding and it wouldn’t have been possible without the two of them.

Once again thank you so much to the entire team!”

Regular contact really helps.

The Advice line manned in the first lockdown from 9-5 consistently by one experienced HV was invaluable. There was an increase in traffic (around 10 calls per day) as parents avoided A&E departments. We received more calls around accidents – burns in particular, depression, isolation, feeding issues and social welfare checks from social services. This line continues to be well used and provides a useful access interface to our service.

Our Facebook page has also seen an increase in traffic and provided an excellent resource for local parents struggling to find things to do with their children in lockdown,  and provides easy access to key health promotion messages with links to local, and national resources.

One of our SCPHN students produced some amazing videos, including one on Perinatal mental health which is well worth a look…click here.

New mothers and families are isolated, young parents are a particularly  vulnerable group. We have streamlined and reintroduced our Enhanced parent Pathway targeted at mothers under 21. These women receive 12 contacts antenatally and in the first year from an allocated HV and nursery nurse. These contacts are underpinned by the 15 High Impact areas  (iHV 2019).

Our Specialist Perinatal Mental Health Health Visitor has done fantastic work helping to enhance communication between the services in Sutton and support mothers experiencing low mood and depression after the birth of their baby.

She is running group face-to face-baby massage sessions for new mothers with elevated Edinburgh Postnatal Depression Scale scores. These have been so valuable to get mothers together with their babies especially during the isolation of lockdown. She continues to offer listening visits both face-to-face and virtually, and works with other local services to offer support.

Mothers’ feedback  (Baby massage group)

“ We loved it …wish it could last for longer.”

 “It was extremely nice to be able to go somewhere to meet other mummies in our current situation and something nice for the baby, great bonding time, I would definitely recommend it! Thank you J for making it the best experience and making me feel comfortable.”

Our staff give their best, they give themselves, their amazing skills and time to those families who need them, they go above and beyond to provide a level of care which has been and will continue to be needed as this pandemic recedes. There is a saying “ it takes a village to bring up a baby”, certainly during C19 that village can be very small.

The health visiting services  are in an optimum position to mitigate the sequelae of the pandemic and help our children and families be the best they can.

We owe it to this and all generations to invest in the First 1001 critical days of a child’s life, it is after all an investment in our future – and a well-funded, robust health visiting service is part of that future.

Debbie Holroyd FiHV, Practice Educator/Health Visiting at Sutton Health and Care Alliance