Over the past few days many of you have supported us in our preparation of a briefing for MPs for the Parliamentary Debate on health visiting cuts which took place on Wednesday afternoon (23 October). If you weren’t able to watch the debate at the time, we have the link here:

If you haven’t yet had time to look at our blueprint Vision for the future of health visiting (Health Visiting in England: A Vision for the Future), please do read it – you are going to be hearing a lot more about it. It has attracted incredible support from those who truly can make a difference and it was very encouraging to hear Jo Churchill, Parliamentary Under Secretary of State for Prevention, Public Health and Primary Care, referring to it, and stating her desire, during the debate, to meet with us to discuss it.

When we meet with Jo Churchill, we will be taking with us the results of our latest State of Health Visiting survey. Thank you to those of you who have already completed it, and some of your anonymous comments have already been shared.  But we do need a good sample size to make the findings robust. So, health visitors, please do take the time to complete it as we will continue to use the aggregated data in our ongoing lobbying of government and will be publishing the survey report at our Leadership conference on 3 December – you are welcome to join us for this inspiring day. Tickets are selling fast so don’t miss out!

The link to the survey has been shared out via email to health visitors, however, if you cannot locate it, please contact [email protected] to request the link.

iHV responds to Local Government Association (LGA)’s analysis on children’s social care, published today, which calls for Government to use the upcoming Spending Round to fully fund the demand on children’s services next year to allow councils to provide the vital support that children and families rely on.

Severe funding shortages and huge demand pressures mean councils were forced to overspend on their children’s social care budgets by nearly £800 million last year in order to try and keep children safe, the Local Government Association reveals today.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“The Institute has long warned that more children entering safeguarding procedures and care would be an inevitable consequence of cutting preventive services such as health visiting which identifies needs in families early, mobilises support for families in need and reduces long-term negative consequences of late identification for these children, such as safeguarding issues and care proceedings. These new figures should be of concern to the whole population as, as well as negatively impacting on the child his/herself and their potential future, these high levels of vulnerable children impact crime rates and criminal justice budgets and increase demand on the NHS from complex health needs.

“One in three health visitors has been lost over the past 4 years and the imposition of unhelpful new ways of working makes it impossible for the profession to adequately offer the necessary long term support that some families need. Alongside the LGA, we also call on the Prime Minister and Treasury to use the upcoming spending review to reinvest into public health, preventative and children’s services. The economic arguments are clear.”

Today, the Department for Education launches their new campaign Hungry Little Minds which provides valuable information and resources for parents to boost their children’s language and literacy development with fun, everyday activities.

This welcomed campaign responds to the compelling evidence that early language is a primary indicator of child well-being. Health visitors are well aware that the early years provide a critical opportunity for building healthy, resilient children, with positive early experiences shaping outcomes throughout the life-course. Crucially, the resources recognise the most important role that parents play in their child’s development – particularly their language development, which starts before birth and is significantly shaped in the earliest years of life.  Health visitors are ideally placed to support the reach of these important messages through their crucial work with parents and children as part of the Healthy Child Programme.

The three year Hungry Little Minds campaign, launched with social media and online adverts, aims to help parents understand that they have a massive impact on their child’s learning and that reading, playing and chatting with them is a simple thing they can do to help them develop even when they are too young to say much back. The campaign provides lots of simple tips and activities that parents can slot into their routine and that children love.

Parents can access tips and activities from https://hungrylittleminds.campaign.gov.uk/ and also search for activities in their area using a new postcode finder service.

The Institute of Health Visiting fully supports today’s call by The King’s Fund and the Health Foundation for a reversal to cuts made to public health funding.

We endorse their call for an urgent review of the public health allocation as part of the expected roll-over grant in place of the anticipated full Spending Review. In particular, we call on the Treasury to carefully consider the wealth of evidence and benefits to society and the public purse from investment in supporting families during the crucial first 1000 Days of Life. Our children are this country’s greatest asset for the future, yet disadvantage and inequalities start early and can last a lifetime if not addressed. Recent year-on-year cuts to the public health grant are having an irreversible impact on our most disadvantaged children. These children cannot wait any longer for decent policies to ensure every child has the best start in life, with sufficient national levers and budgets to support full implementation. We are calling for action now, and our case for a strengthened health visiting service is set out in our recent letter to The Rt Hon Elizabeth Truss MP, Chief Secretary to the Treasury.

We fear that the damage done in the last 3 years will take many more to correct without urgent action now.  It is fundamentally and morally very wrong that it’s been necessary to cut child health clinics and easy access to health visiting services in many areas of the country and, in so doing, the support they once provided for thousands of parents. Prevention and early intervention is often described as “turning off the tap rather than mopping the floor”. This is essential if we are to tackle key priorities like childhood obesity; infant, child and perinatal mental health problems; falling immunisation rates; and soaring unnecessary A&E attendances in the under-fives that could so easily be addressed with better early support and opportunities for parents to talk about their worries with a trusted professional. There are now massive variations in the type of service that health visitors can offer parents up and down the country, with minimal services most often the norm.

We too call on the Treasury now to fulfill their responsibility to the public by once again investing in public health and early preventative interventions for families.

 

iHV is delighted that Andrea Leadsom MP, Leader of the House of Commons, has been asked by the Prime Minister to chair a cross-Government working group set up to review how to improve the support available to families in the period around childbirth to the age of two – the first 1001 days.

Andrea Leadsom

Andrea Leadsom

The cross-Government Ministerial group will seek to identify gaps in available provision and make recommendations on how coordination across Departments can be improved to help give every child the best possible start in life.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“This is excellent news for health visiting.  It was Andrea who launched the 1001 Critical Days Manifesto, which has since reached into many other countries. She really understands the importance of infant mental health, and the critical role of the health visitor for supporting all families and especially those who need the most help.  We look forward to working with her moving forwards.”

 

The root causes of mental health problems can often be traced to adversity in childhood or adolescence, but the effects can have a life-long impact on well-being and the ability to live a satisfying and productive life throughout adulthood.

iHV welcomes Mental Health Policy Commission: Investing in a Resilient Generation report which sets out the evidence base around the factors that can impact on young people’s mental health.

Dr Cheryll Adams CBE, Executive Director iHV commented:

“This is a very timely and helpful piece of work emphasising the huge benefits to NHS spending from investing in prevention of mental illness in the very early years, and in schools. We really hope that local authorities will take note of its recommendations and reconsider any more cuts planned to health visitor services. Savings can be made in different ways and this document makes clear that cutting preventative services creates a significant burden of expenditure that must be picked up later by public services.

“It is time to be brave and invest for tomorrow, not today, giving more children a bright future by supporting them as babies and infants when supportive interventions for families have the most powerful impact on their mental wellbeing. The toll of mental illness is now so significant and conspicuous that there is a civil and moral duty for all those with influence to reduce this by supporting investment into early preventative strategies as laid out in the recommendations of this report.”

Part 2 of the government’s plan for action to significantly reduce childhood obesity by supporting healthier choices was published this week.

This publication outlines the actions the government will take towards its goal of halving childhood obesity and reducing the gap in obesity between children from the most and least deprived areas by 2030. Building on the first chapter of the childhood obesity plan, the new measures include proposals to counter ‘pester power’ by preventing stores from displaying unhealthy food at checkouts or including it in buy-one-get-one-free deals.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“The Institute of Health Visiting welcomes the tightening of the update plan for Childhood Obesity. It is crucial that the preventative measures outlined are actioned with speed to ensure that all children in the UK are able to thrive and develop to their full potential.

“Tackling the wider factors that impact on obesity is crucial and we applaud the move to target advertising. The need to work across all sectors who provide “food away from home” is crucial and proposals to work with schools are well placed, we trust that these actions will also include early years providers – both state and private nursery provision, as the early years are crucial in the development of healthy weight in the later years.

“Whilst it is not explicitly stated there is a need to ensure that the revised actions have a focus on the early years (0-5 years) as we know from research that the influence of early nutrition and eating patterns is directly correlated with obesity in later years. To support this it will be crucial to consider the early year’s health and social care work force in the development of training proposed in this update.”

The government is calling on industry to recognise the harm that adverts for foods high in fat, sugar and salt can cause. It will consult on introducing new TV and online advertising restrictions to prevent children from being targeted by these unhealthy products, and to incentivise companies to reduce the sugar and calories in the products they sell.

The second chapter of the plan also promotes a new national ambition for every primary school to adopt a daily ‘active mile’ initiative, such as the Daily Mile.

In light of the publication of the Government’s green paper on Transforming Children and Young People’s Mental Health Provision (in February 2018), iHV is delighted at the decision of the House of Commons Select Committees on Health and Education who have agreed to launch a joint inquiry to scrutinise the proposed scope and implementation of the green paper. Key recommendations include: considering the role of health visitors and children’s centres in promoting emotional wellbeing in the early years.

The Institute of Health Visiting (iHV) calls for Government to reverse the cuts to public health budgets and reinvest in health visiting services to protect and support the health and development of babies, children and families, and, in the medium and longer term, for all in our society.

In a letter to the Chancellor, the Institute details how the year-on-year reductions in the public health budgets is leading to far-reaching declines in health inequalities across England – impacting the long-term health outcomes for our children, as well as society.

A policy change in 2015 moved the commissioning of health visiting services to local government, coinciding with a 6.2% reduction of the public health budget during that financial year and further annual cost savings of 3.9% each year until 2020.

Dr Cheryll Adams CBE, executive director iHV, said:

“We know so much today with respect to what can influence children’s outcomes across their life course and in turn benefit the whole country. The impact of the public health budget cuts on babies and children is very worrying and upsetting. It is alarming that, in the two years since the commissioning change, the number of health visitors seems to have reduced by around 18%*, and could rapidly be approaching an all-time low.”

Health visitors play a vital role in supporting babies, children and families in the early years of life. There is a strong research base that demonstrates that a significant part of an individual’s ‘blue print’ for their future mental wellbeing is laid down in the first two years of life.  This is a critical window for supporting parents to help their children build solid social and emotional wellbeing.  Health visiting services are effective at identifying and reducing the impact of health inequalities, so reducing the burden of care both in the short and longer term.

Dr Adams continued:

“As a nation, we cannot afford not to invest in our children as they are our future, yet recently their needs seem to have become invisible against the many competing demands being made on Government and the NHS. The work of the health visitor often goes unseen, until you take it away. Government may soon have to face the effects of some of the lowest ratios of health visitors to children experienced by this country in living memory.

“It’s time to act, to help ensure the best health outcomes for all UK children today, and in the future. We need urgent action from the Government to increase their investment in public health prevention and early intervention to ensure that health visitors can continue to give every child the opportunity to have the best start in life.”

*NHS Digital

iHV welcomes the government’s announcement of £80 million support to extend opportunities to children with special educational needs and disabilities.

The multi-million pound package will ensure that thousands of children with special educational needs and disability (SEND) have the same opportunities as any other child.

As part of its mission to extend opportunity to all, the government has already introduced the biggest reforms to the SEND support system in a generation by placing children and their families at the heart of the system.