The Institute of Health Visiting (iHV) has published its preferred plan for the relationship of health visiting with the NHS in the next 10 years.


As the NHS writes its new 10-year plan, with a specific focus on children, prevention and mental health, the Institute of Health Visiting has published its own recommendations for strengthening health visiting services alongside.





Dr Cheryll Adams CBE, Executive Director, Institute of Health Visiting said:

“Health visitors have a vital role in delivering early preventative services for infants and children, and in supporting parents through the emotional challenges of early parenthood. Unless there is a plan to strengthen health visiting services alongside the new NHS 10-year plan, it will be impossible to deliver on many of what we expect to be its worthy ambitions. We hope that our rationale, and the recommendations in our new position statement, will be taken seriously by those writing the plan.

Dr Adams continued:

“Moving health visiting commissioning completely from the NHS to local authorities, in October 2015, has created many challenges for the quality of services that health visitors have been able to deliver, and for the essential relationships that health visitors need to have with NHS partners. Part of the challenge has come from cuts to public health budgets, but it’s more complex than that – the loss of close relationships with NHS services, in particular with general practitioners, has also been very unhelpful.

“Three years of the local authority commissioning model has seen a loss of around 20% of the workforce and worryingly high levels of grade mix.  Therefore, we are proposing a new joint NHS/Local Authority governance/commissioning model – this we hope will avoid such challenges for services to our most vulnerable members of society in the future.

Further recommendations

“Other recommendations include that every family should have at least nine universal contacts. This requires new investment into the profession, but that will be more than offset by savings in preventable treatment costs in later life. Nine core universal contacts being delivered by health visitors is becoming the norm for Welsh families, with Scottish families receiving eleven! This is based on the evidence of what can be achieved by providing robust health visiting services during the very early years – and English children shouldn’t be disadvantaged.”

Dr Adams concluded:

“Our position statement makes clear what we believe needs to happen to improve outcomes for children through strengthened health visiting – with a renewed focus on children’s services, improving mental health and prevention and reducing inequalities in the essential early years period. We are circulating it widely to decision makers and those concerned about giving every child the best start in life.”



A survey of local councillors responsible for children’s services confirms an increasing crisis in children’s social care, with the overwhelming majority (87%) saying that demand for local authority support for children and families has risen over the past two years. The findings suggest many councils are struggling to provide this help.

The new report, published by the National Children’s Bureau, found that two-thirds of councillors have warned their council doesn’t have enough funding to provide universal services for children and families.

It also found 41% of councillors said a lack of funding was preventing them from meeting their statutory duties to children, with 36% saying there was insufficient funding to help children in care.

The report – Off the Radar – calls for increased funding for children’s social care, better data collection and sharing, and a cross-Government strategy for improving children’s lives.

Dr Cheryll Adams CBE, executive director iHV, said:

“Health visitors, now commissioned by the local authorities, provide the universal preventative service for children and families. It’s alarming to see the effects of decommissioning on both children’s public health and social care services.”

This week, the iHV was on two national platforms focused on the future of child health. We use these opportunities to raise our concerns about the pressures on health visiting services and the risks to children and families as a result.

The national platforms, Westminster Briefing and Public Policy Exchange,  are for mixed audiences of government officials, policy makers, local authority commissioners and those involved in running and delivering children’s services.

Dr Cheryll Adams addressing the Westminster Briefing

Dr Cheryll Adams addressing the Westminster Briefing

These events allow for discussion and debate of important issues affecting public health and, coincidentally, both events were focused on Early Years Public Health services this week. They provided a great opportunity to get the facts and evidence about about the benefits of the health visiting service and early intervention to those involved in commissioning and delivering children’s services.

Any delegates unsure of the complexity of the HV role were encouraged to arrange to shadow a HV!