iHV has co-signed an open letter to Sajid Javid, Secretary of State for Health and Social Care, calling on Government to give families a #FairStart. Signed by 25 organisations and several cross-party MPs, the letter urges the government to rebuild the health visiting service and to improve access to mental health services for new parents.

Further to the letter spear-headed by the NSPCC, in Westminster today, parents and professionals presented Sajid Javid with a Fight for a #FairStart petition signed by almost 22,000 people across England – urging him to improve access to perinatal mental health support, to rebuild health visiting services and to invest more in family help.

Georgina Mayes, iHV Policy and Quality Lead, attended the Parliamentary event to represent the Institute and provide evidence to support the call – including our most recent State of Health Visiting Survey and our popular useful infographic, “Who are health visitors and what do they do?” Health visitors provide a vital infrastructure of support for all families, addressing numerous cross-government department priorities for health, education and lifelong wellbeing and the prosperity of our nation. Yet this is often poorly understood, and places the health visiting service at high risk of cuts in the never ending short-term policy cycles.

Health visitors have the potential to do so much for our babies, our families, and our public services. The first 1001 days is a period of opportunity and vulnerability. Support for our babies, children and families is needed now, more than ever. Health visitors support children’s development and help to keep them safe. They are skilled Specialist Community Public Health Nurses able to engage and build relationships with families, understand their health and care needs, offer support and intervention, and broker engagement with other services.

Current resourcing decisions mean that many health visitors cannot effectively do the important work they were trained to do. Since 2015, when responsibility for health visiting was transferred to local authorities, it is estimated that at least 30% of the health visiting workforce has been lost, with further losses forecast. The Public Health Grant has fallen in real terms from £3.99 billion in 2015–16 to £3.3 billion in 2022-23, this is at a time when need has increased.

NSPCC’s new analysis of the latest Public Health England data shows that 19% of babies didn’t receive their 12-month health visitor review by the time they were 15-months old. In addition, the number of babies missing this vital check is up from five years ago when 18% of 15-month-old babies had missed their 12-month review, equating to a 10% decrease in the proportion of babies who had had their 12-month review by the time they were 15 months.

The under-resourced health visiting services are causing a postcode lottery of access to support.

The ‘Fight for a Fair Start’ campaign aims to improve access to mental health support for the one in five mums and one in ten dads who experience perinatal mental health problems during pregnancy and in the first year after birth. With the right support parents can continue to develop a healthy relationship with their baby, but without this support problems can worsen and leave parents struggling with day-to-day tasks.

‘Thank you from the iHV and all health visitors’ to all the parents and organisations who recognise the value of an effective health visiting service and have supported this campaign.

Together, we are fighting for a #FairStart for every family.

iHV joins a large coalition of charities, led by Sustain and The Food Foundation, and including Royal College of Midwives and Royal Society of Public Health, to send a letter to the Secretary of State for Health and Social Care, Sajid Javid, asking him for urgent action on the Healthy Start scheme.  He is being asked to extend the paper vouchers while the digital scheme is fixed.

The rising cost of living is adding more pressure to families in the UK already struggling to afford and access an adequate diet. On average, each month, 8% of households did not have enough money for food over the financial year 2019-20 according to the Government’s UK Food Security Report. Food insecurity levels in households with children remain extremely high. According to data from the Food Foundation, over 2.5 million children live in households that have experienced food insecurity in the past six months.

Against this backdrop, the Healthy Start scheme plays a vital role in supporting low-income young families and pregnant mothers to eat well. However, there are concerns about the roll-out of the digitisation of the scheme. These concerns have been raised repeatedly with officials at the NHS Business Services and the Department of Health and Social Care (DHSC) but the problems have not been rectified and time is running out before paper vouchers are removed from circulation on 31 March 2022.

The digitisation of Healthy Start can help to reduce access barriers if managed properly and with a clear understanding of the circumstances of those it is targeting. However, without urgent action, hundreds of thousands of families across England, Wales and Northern Ireland are at risk of losing the nutritional safety net provided by
Healthy Start.

First 1001 Days logo

The Institute of Health Visiting (iHV) joins over 60 First 1001 Days member organisations who have today jointly written to the new Secretary of State for Health and Social Care, Sajid Javid, asking him to address the impacts of the pandemic on babies and their families, and to take longer-term action to ensure all our children have the best start in life.

Alison Morton, Executive Director iHV, said:

“The importance of getting it right for every child cannot be over-emphasised. The needs of babies, children, and young people have all too often been overlooked in pandemic policymaking. Although some money has recently been spent on mitigating the impact of the pandemic on older children, nothing has been spent or allocated to children aged under two.

“We now need the Government to prioritise on babies’ health and wellbeing, and those of their families, to ensure that all children have the best start in life. Giving our babies the best start in life can improve health and wellbeing for decades to come and positively impact future generations.”

The letter describes three things that the Secretary of State should prioritise to make a significant difference:

  1. Securing funding in the upcoming Spending Review to deliver the Government’s Best Start for Life vision.
  2. Setting out clear expectations in the Health and Care Bill that local partners will cooperate in order to improve outcomes and reducing inequalities for children in the first 1001 days.
  3. Ensure that the new Office of Health Promotion can intervene when a local area is not delivering the Healthy Child Programme or is experiencing poor, declining, or unequal outcomes in the first 1001 days, providing additional support and resources where needed.

This year’s remit letter from Jo Churchill (Parliamentary Under Secretary of State for Prevention, Public Health and Primary Care) to Michael Brodie, Chief Executive at Public Health England (PHE), was published today confirming PHE’s strategic remit priorities for 2021 as an Executive Agency of the Department of Health and Social Care.

In the letter, the Minister thanks PHE’s staff for their vital role in protecting and improving the public’s health since the agency was formed in 2013 and, in particular, for their contributions to the pandemic response stating:

COVID-19 represents the greatest health challenge in living memory. Everyone working in PHE has shown extraordinary dedication in the face of this global challenge and your work has, and continues to have, a tremendous impact”.

The letter also builds on the Government’s plans to strengthen the public health system, including this year’s ongoing transitioning to new public health arrangements with the establishment of the United Kingdom Health Security Agency and the new Office for Health Promotion (OHP).

PHE will continue to respond to the wider health impacts of COVID-19, as well as acting on the following key priorities:

  • Reducing health inequalities
  • Obesity, healthy weight and nutrition
  • Mental health
  • Tackling health harms
  • Sexual and reproductive health
  • Early years
  • Public health reforms

We are delighted to see that the Early Years are once again formally acknowledged as a priority for the Government as a key part of their plan to reduce health inequalities. The remit letter also recognises the impact that the COVID-19 pandemic has had on children’s health and development, especially those children and young people identified as vulnerable within the Vulnerability Framework.

The key early years priorities for 2021/22 include:

  • Modernisation of the Healthy Child Programme, with a focus on speech, language and communication, and intensive parenting support to contribute to reducing health inequalities.
  • Contributing evidence to Leadsom’s Early Years Review for maternity and the first 2 years.
  • Improving the evidence and developing training to support a healthy weight and healthy lifestyle during pregnancy and during early years (0 to 5).
  • Supporting the Department of Health and Social Care (DHSC) in the evaluation of the Ages and Stages Questionnaire digitalisation programme, and provide data and analytical support for contract negotiations.

Georgina Mayes who has recently joined the iHV as Policy and Quality Lead said:

“I am delighted to see the Government’s renewed clear commitment to the early years with prioritisation of levelling up to ensure that no child is left behind. This work to reduce inequalities and improve outcomes for all children cannot start soon enough. Health visitors, as leaders of the Healthy Child Programme, will be central to the delivery of these plans through their universal reach into all families. We look forward to working closely with PHE to support the translation of these priorities into practice.”

100+ organisations (including the Institute of Health Visiting) say that despite the Prime Minister’s pledges, the needs of babies, children, and young people have all too often been overlooked in pandemic policymaking.

In a letter to the editor of the Daily Telegraph, the children’s sector has called for children and families to be put at the heart of recovery plans. The letter is published as the Telegraph launches its own Campaign for Children.

quote from Children at the Heart campaign

#ChildrenAtTheHeart

As part of the Children and Young People’s Health Policy Influencing Group, the Institute of Health Visiting joins organisations calling on the Secretary of Health to put #ChildrenAtTheHeart of the upcoming Health and Care Bill.

Alison Morton, Executive Director, iHV, commented:

“iHV joins together with partners as a signatory to this letter. The Integrated Care Systems plans have so much potential for good – let’s make sure they set off with children at the heart. At the moment services and policies for children are fragmented from the top of Government to the frontline.”

Logos of signatories of the Children and Young People’s Health Policy Influencing Group letter to the Secretary of Health

 

  • iHV joins a coalition of early years charities to warn government they’re at risk of failing a generation of babies born during the coronavirus pandemic.
  • Joint Statement on the future of public health in England – giving every child the best start in life.

In a Joint Statement on the future of public health in England, the iHV, alongside nine expert early years charities, put their eight principles to Matt Hancock which must be considered when looking at health visiting. The organisations are urging Government to recognise there is a timely opportunity to rebuild the nation’s public health services for children and families.

The coalition of early years charities consists of Action for Children, the Association of Child Psychotherapists, Best Beginnings, First 1001 Days Movement, Home Start, OXPIP, the Institute of Health Visiting, NCB, NSPCC and the Parent-Infant Foundation.

NSPCC sent the Joint Statement together with an open letter to Secretary of State for Health and Social Care Matt Hancock, saying that England’s health visiting programme is not equipped to meet the challenge of the Coronavirus pandemic, and must be rebuilt according to eight principles developed by the group of early years experts.

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

“We are delighted to be part of this important coalition sharing our joint position on the need to return investment to the health visiting service so that it may fully play its part in ensuring that all parents have the support they need. Then, and only then, will every baby have the opportunity for the best possible start in life.”

The Pandemic has also seen restrictions to the service and redeployment of health visitors, which have resulted in many families not receiving their entitled health visits. According to the Babies in Lockdown report, produced by Best Beginnings, Home Start UK and Parent-Infant Foundation, just 1 in 10 parents with children under two saw a health visitor face-to-face during the pandemic.

The organisations have long warned Government about the history of cuts to public health funding and the significant decline in NHS health visitors, which meant the service struggled to support families across the country even before the pandemic.

The letter, backed by over 2,000 members of the public, highlights that the restructure of Public Health England must prioritise giving every child a fair start in life.

Led by health visitors, all families in England are entitled to receive five check-ins from qualified health visitors via the Healthy Child Programme. However, NSPCC research with over 2,000 mothers in England, conducted with YouGov prior to the pandemic, found only 6% had been supported by the same health professional throughout the perinatal period. One in four mothers had reviews conducted via letter, text message, or a phone call instead of in-person support.

Whilst Public Health England recently announced that health visitors should not be redeployed over the winter, research by UCL found that in some areas of England, as many as 50% of staff were redeployed during the first phase of the pandemic.

Since April, the NSPCC’s helpline has received 1,897 contacts from adults concerned about parental mental health, with over half being referred for further support. The monthly average number of contacts post-lockdown has increased by over a third (34%) when compared to the average for January to March.

Dr Adams commented:

“Over the past five years we have seen an average 30% reduction in the number of health visitors in England, accompanied by a massive variation in these losses across the country. The average health visitor caseload is now 500 children, double the recommended number.

“The number of invisible vulnerable babies will have increased and perinatal mental illness is already reported by health visitors to be ‘sky rocketing’.

“The whole population will also be paying the price – the erosion of the health visitor role results in kicking the can down the road where the impact is picked up by other much more costly services. We urge the Government to listen to the voices of parents, charities and health professionals now and take urgent action to reinstate a robust health visiting service before even more damage is done.”

The NSPCC is inviting people to join the thousands who have already raised their voice and signed the Fight for a Fair Start petition.

 

Public Health England (PHE), NHS England (NHSE)and the Local Government Association (LGA) have issued a letter to all directors of nursing confirming details for winter planning in supporting children and families.

In the letter from Professor Viv Bennett, Ruth May and Ian Hudspeth, they advise that professionals supporting children and families, such as health visitors, school nurses, designated safeguarding officers and nurses supporting children with special educational needs should not be redeployed to other services and should be supported to provide services through in pregnancy, early years (0-19) and to the most vulnerable families.

Dr Cheryll Adams CBE, Executive Director iHV said:

“iHV is pleased and relieved that the Chief Nurses and LGA have supported our campaign for health visitors not to be redeployed again.  This profession has its own front line and infants and their families have never needed them more than they do at the moment.”

On 31 July, plans for the next – third – phase of the NHS response to the COVID-19 pandemic, effective from 1 August 2020, were set out in a letter from the Chief Executive Sir Simon Stevens & Chief Operating Officer Amanda Pritchard; this includes providers of community services.

The Government has agreed that the NHS Emergency Preparedness, Resilience and Response (EPRR) incident level will move from Level 4 (national) to Level 3 (regional) with effect from 1 August. This approach matches the differential regional measures the Government is deploying and builds on the guidance set out in the COVID-19 restoration of community health services for children and young people: second phase of NHS response to fully restore [the health visiting] service, with some prioritisation where indicated and as capacity dictates”.

The priorities for this phase are:

  1. Accelerating the return to near-normal levels of non-Covid health services, making full use of the capacity available in the ‘window of opportunity’ between now and winter
  2. Preparation for winter demand pressures, alongside continuing vigilance in the light of further probable Covid spikes locally and possibly nationally.
  3. Doing the above in a way that takes account of lessons learned during the first Covid peak; locks in beneficial changes; and explicitly tackles fundamental challenges including: support for our staff, and action on inequalities and prevention.

At the start of Infant Mental Health Awareness Week, the leaders of nearly 80 organisations, including the Institute, have signed a letter to the Prime Minister calling on him to make the youngest children a national priority in order to mitigate the secondary and potentially long-term impact of the COVID-19 crisis.

Dr Cheryll Adams CBE, Executive Director iHV, said:

“Health visitors have seen at first hand the impact of COVID-19 and the lockdown on new families, and therefore support this important call for much more attention to be placed by government onto the earliest days. There is no other time in the lifespan where investment will save so much on later fiscal spend. It is not only the right thing to do, it also makes sound economic sense and we hope that the prime minister will want to support this call.”

The letter from the First 1001 Days Movement argues that, as politicians decide on COVID-19 relief and recovery packages, there is an opportunity now to invest in the wellbeing of babies and toddlers and the parents that care for them, as part of efforts to build back a better Britain.

The signatories, which include major children’s and mental health charities and professional bodies who are all part of the First 1001 Days Movement, ask the Prime Minister to champion a cross-government strategy for improving outcomes for all children. This should set out a vision for how families will be supported to recover from the impact of COVID-19 and how the Government will begin to ‘level up’ and close gaps in outcomes which have widened during the pandemic.