Tags: A&E

Babies under one have the highest rate of A&E attendance: HVs can help

Babies under one have the highest rate of Accident and Emergency (A&E) attendance: Health visitors can help overstretched A&E departments

A new report by the Institute of Health Visiting (iHV) reveals that the under ones are the largest group of people by far who attend A&E across the country. A large proportion of these attendances are for non-urgent conditions, suggesting that they could be managed and supported by other means, including health visitors in the community.

Addressing soaring rates of A&E attendance is a national government priority. A focus on prevention and meeting people’s care needs outside hospital is an important part of the NHS Urgent Care Recovery Plan – this needs to include children aged 0-4.

The new report reveals:

  • Babies under the age of one have the highest rate of A&E attendance compared to any other age group and the rate of 0–4-year-olds attending A&E has increased by 42% in the last 10 years.
  • The rate of potentially avoidable A&E attendances is much higher in babies and young children.
  • In North West London, 59% of babies who attended A&E did not need treatment and were sent home after reassurance, costing an estimated £1.8 million per year in this one area of London alone.
  • It is perfectly normal for parents to worry when their baby or young child is unwell. It can feel quite frightening, particularly for first-time parents who do not have good support networks. While A&E is the right place for very sick babies and young children, improving access to high-quality care in the community could help to reduce A&E attendance in babies and young children.
  • In the past, health visitors would have provided support to all parents to help them manage common childhood conditions such as feeding difficulties, minor illnesses and infant crying. However, due to a national shortage of around 5,000 health visitors – and cuts to the Public Health Grant that funds the service of £1 billion in real terms since 2015 – there are not enough health visitors to support families. And many health visiting ‘drop-in’ baby and child health clinics have been closed or scaled back in recent years.
  • These cuts are a false economy as they put pressure on other services including A&E departments.

We urgently need more health visitors to ensure that all families get the support that they need in the heart of their communities. Health visitors provide an important part of the solution to reducing the pressure on A&E departments, GPs, and wider health and social care services. When adequately resourced, health visitors are often the first point of contact for families when they are concerned about their child’s health. As Specialist Community Public Health Nurses, they provide a trusted source of information and can support families to manage minor illnesses through their ‘upstream’ work in prevention and early intervention in communities.

With so much compelling evidence, the Institute of Health Visiting has joined forces with leading paediatricians and is calling for urgent investment into health visiting so all families can get the support they need in the community and take pressure off overstretched A&E departments.

The iHV has also released a new film “Can you see my baby? Health visitors prevent emergencies” which showcases the vital role of health visitors in reducing A&E attendances for babies and young children. The film hears from parents about the crucial support that their health visitor provided to them, boosting their confidence in managing their child’s health.

Alison Morton, iHV CEO, commented:

“I am delighted to see this excellent report and film on A&E attendances in babies and young children launched today. As more and more parents and carers turn to A&E for reassurance and ‘peace of mind’ to manage common childhood illnesses, hospitals are struggling to cope. Our report is not about blaming parents. It is perfectly normal to worry when your baby or young child is unwell, particularly if you are a first-time parent and learning to manage these conditions for the first time. Building more hospitals is not the only solution.

“Cuts to health visiting services over the last 8 years have been a false economy with fewer health visitors available to support families through prevention and early intervention in the community. The knock-on consequences have been felt across the health and care system, including A&E departments. To tackle the problem, we need to provide better support for families in the heart of communities and this includes rebuilding the health visiting service in England.”

Georgina Mayes, iHV Policy and Quality Lead and the film’s Executive Producer, said:

“The iHV film and report paints a worrying picture of increasing A&E attendance for the under ones across the country, at a time when health visiting numbers are the lowest in history. Health visiting is an important part of the solution to reducing A&E attendances. This report and film highlight the vital role of health visitors in providing expert, professional support to families when their child is unwell. More health visitors are urgently needed now to ensure all families can get the support that they need, which will in turn take pressure off overstretched Emergency Departments.”

View iHV report:

Read iHV report: Understanding the rise in 0–4-year-old Emergency Department (ED) attendances and changing health visiting practice

To cite this report , please use the link to the pdf here: https://bit.ly/471XYVB

Read Appendix 1 | A narrative summary of literature exploring the health visitor’s role in supporting parents with babies and young children with minor illnesses

Read Appendix 2| Case Study A: Healthier Together – an integrated, region-wide approach to improve outcomes for children and their families; and Case Study B: Health visiting in Hampshire: supporting a whole system shared-learning approach to address increasing demand on children’s Emergency Department (ED) attendances

Read Appendix 3 | Case Study: Boosting Health Literacy & Care: Digital Parental Support via ChatHealth messaging

Read Appendix 4 | An analysis of a randomly selected group of 100 infants under 12-months-old who attended Northwick Park Emergency Department (ED), North West London

View iHV short film, ‘Can you see my baby? Health visitors prevent emergencies’:

Watch film on Vimeo

Is health visiting helping families with minor illnesses? Tell us the answer by filling in our survey

Are you a health visitor, a health visiting leader or work as part of a health visiting team supporting babies, children, and families? How do you support families with childhood illnesses? Has this changed over time? We need your insights! Your voice matters!

iHV is working with three leading paediatricians on an important rapid review on the changing trends of A&E presentations for babies and children 0-4 years. As part of this project, we are undertaking a UK-wide survey to explore whether health visiting practice has changed over time. This focuses on health visiting’s role to support parents to manage  minor illnesses and improve their health literacy.

We want to learn about your experiences of practice now – and also compare this with your experiences before the pandemic (we are interested in any experience that you had working in health visiting between  2015 to March 2020 / choose the time when your service was most well-resourced during this period).

Why is this important?

Our A&E departments are witnessing an alarming rise in attendances for minor conditions among babies and young children, yet there has not been a similar increase in hospital admissions for this age group. There are many hypotheses for this changing trend.

What these attendances do tell us is that these parents are worried when their baby or child is unwell and they are choosing to get the help that they need in A&E, rather than elsewhere.

And this is where you come in!

Health visiting teams have a pivotal role in supporting families, managing minor illnesses, and enhancing parental health literacy. Your knowledge and expertise in this area can really help!

Tell us about your own experiences – advocate for the families where you work!

We want to hear your thoughts on the key drivers of families’ behaviours when they are managing minor illnesses.

Your answers will remain anonymous, enabling you to be candid about your experiences. We need your help to get a big sample to make sure that the findings count and are taken seriously by policymakers.

What next? With your help, we’re aiming to influence national policy to make sure parents get the right support when they need it most.  

The survey findings will provide vital information for the health sector. Your feedback will shape an important thematic report and short film that will tell the story of changing trends in A&E presentations for children 0-4 and the role of health visitors in this area. The report and film will be shared with politicians, policy makers, national bodies, and the media to influence policies that affect health and parenting support.

Thank you so much for your support.

How to take part in the UK’s first national health visiting minor illness survey

  • Take the survey yourself now and invite your fellow health visiting colleagues to participate.
  • The survey will only take around 10 minutes of your time.
  • For those people on our mailing lists (including members and expired members), you will have received an email from us with the survey link. So please do check your emails.
  • For those health visitors or members of health visiting teams who are not on our mailing lists, or can’t find your email, and would like to complete this vital survey, please contact [email protected] to request the survey link.

 Together, we can really make a difference!

#HealthVisiting #ParentalHealthLiteracy #ChildrensHealth #ManagingMinorIllnesses