The Institute of Health Visiting (iHV) is delighted to announce the launch of its eighth Annual Report.

Launched at the iHV annual Leadership conference on 1 December 2020, the report details the Institute’s developments, partnerships and projects over the past 12 months, plus the preliminary findings from our latest annual survey.

After the initial disappointment of having to postpone so many of our plans for 2020, #TeamiHV quickly embraced the challenges of working online to not only deliver our conferences and PIMH Forums on a virtual platform but our training as well, and this has been very enthusiastically received.

2020 has been a year like none before for health visiting, as it faced the challenges of adapting to a world forced into “lockdown”. The challenges of COVID-19 have been felt both by the Institute and in practice, bringing with them much learning. Our first concern is always the families we support, whom we know this year did not receive either adequate or, in some cases, any support during a crucial time.

Whilst much of the world’s attention was focused on reducing the transmission of the virus and treating acutely ill patients (mostly adults), it was clear that the needs of children and families were increasing, yet they were largely overlooked by policy makers. At the iHV, we have been concerned from the outset about the wider impacts of the pandemic and have raised concerns about the vulnerability of babies and young children who are at home, hidden from society and some living with significant adversity and abuse.

 

 

 

 

 

Charity collective, Best Beginnings, Home-Start UK and the Parent-Infant Foundation, publish a new report sharing families’ experiences of lockdown during pregnancy or with a baby.

Babies in Lockdown: listening to parents to build back better (2020), based on a survey of over 5000 families, highlights the chronic under resourcing of services for families, the inequalities in babies’ early experiences and its worsening forecast due to the COVID-19 pandemic. The report warns that many families with lower incomes, young parents and those from Black, Asian and minority ethnic communities, will have been hit hardest by the pandemic. The Babies in Lockdown Report shines a light on UK baby inequalities as charities call on Government to act now to avoid a “Post-COVID19 lottery”.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“The iHV welcomes this excellent report which lays bare just how challenging it has been for many parents during lockdown. It was distressing to read their stories and, in particular, how the most disadvantaged have felt the hardest impact of lockdown and lack of support. It is important that we listen to the voice of these parents and ensure that we are better prepared to meet the needs of young children and their families as the pandemic continues. We support the report title, we now need to build back better for infants and their families and this will include ensuring that all families receive support from the health visiting service during this crucial stage of their parenting journey”.

The report tells us that:

  • COVID-19 has affected parents, babies and the services that support them in diverse ways.
  • Families already at risk of poor outcomes have suffered the most.
  • Without action, the pandemic could cast a long shadow on the lives of some babies.

The Babies in Lockdown: listening to parents to build back better (2020) report makes three policy calls for the UK Government:

  • A one-off Baby Boost to enable local services to support families who have had a baby during or close to lockdown.
  • A new Parent-Infant Premium providing new funding for local commissioners, targeted at improving outcomes for the most vulnerable children.
  • Significant and sustained investment in core funding to support families from conception to age two and beyond, including in statutory services, charities and community groups.

The Children’s Commissioner for England has published a report looking at the provision of early years services for children across the country, alongside a warning that many nurseries are at risk of closure, hitting the life chances of some of the most vulnerable children and holding back the economic recovery following lockdown.

The report, ‘Best Beginnings’, is an in-depth examination of early years provision in England. It describes a system that is disjointed and often failing to target those disadvantaged children with development problems who most need early help.

It comes amid a recent warning from childcare providers that one in four nurseries and pre-schools fear closure within the year, rising to one in three in the most disadvantaged areas, as a result of the coronavirus lockdown.

Dr Cheryll Adams CBE, Executive Director iHV, commented: 

“Best beginnings is a powerful and very well researched report from Anne Longfield, the Children’s Commissioner and her team. It recommends a strengthened holistic, cross-government approach to ensuring that every infant is supported to meet its full potential, whether through strengthened community services, including health visiting, or a strengthened childcare/nursery offer.

“I particularly liked the starting point: There are certain things that every baby needs as the foundations for a healthy, happy life:

  1. Loving, nurturing relationships with parents and carers
  2. A safe home free from stress and adversity
  3. The right help to develop good language and other cognitive skills
  4. Support to manage behaviour and regulate their emotions
  5. Good physical and mental health and access to healthcare”

“Helping parents achieve this for their infants is the essence of health visiting.”

The report shows the need for an overhaul of the early years system in England. It details how too many children, particularly those growing up in disadvantaged families, are already behind by the time they start formal education. Last year, 29% of five- year-olds in England were not at the expected level of development by the time they started school, including 45% of children receiving Free School Meals. In Middlesbrough, 38% of children are not achieving the expected level of development aged 5, while in Dudley and Sandwell it is 35% of children.

The report sets out how starting school behind can undermine children’s life chances. The Commissioner’s office analysed data on all children in England who had not met the expected level on half of their early learning goals at age 5 and tracked them through to the end of primary school. These children were:

  • five times as likely to end up being excluded by age 10
  • twice as likely to have had contact with children’s social care by age 11
  • three times more likely to be struggling with reading at age 11
  • four times more likely to be struggling with writing at age 11.

Recent research also shows these children are more likely to leave school with no GCSEs, more likely to suffer some form of mental ill health and more likely to be obese.

The Children’s Commissioner is calling for a new ‘Best Beginnings’ early years investment plan, ranging from Children and Family hubs to midwives and health visitors, to tackle these problems at the beginning of a child’s life rather than waiting until crises develop in later years. While some foundations of an excellent early years service are already in place, the Children’s Commissioner is urging the Government to bring together and turbocharge these services into one system which provides first class provision that works for families and ensures that all children, including the most disadvantaged, get the best possible start in life.

The Children’s Commissioner makes a number of recommendations including:

  • An emergency recovery package for the childcare providers whose finances have been worst affected by Covid-19. Government should also reconsider the design of Universal Credit which makes it hard for lower earning families to get help with childcare, as parents have to pay costs upfront and then wait to be repaid.
  • An expanded offer of 30 hours free childcare and early education for all children aged two, three and four, and 15 free hours for all one-year-olds, so that early years education is seen as part of ordinary life, in the same way that school is.
  • A cross-government ‘Best Beginnings’ strategy led by a Cabinet Minister for the Early Years. This would set out how a revitalised and extended Healthy Child Programme, the Early Years Foundation Stage, Children and Family Hubs, antenatal services and the Troubled Families Programme would work together.
  • A Family Guarantee of support for under-fives and their families delivered by health visitors, early help and Troubled Families workers, family nurses or family support workers based in Family Hubs.
  • A national infrastructure of Children and Family Hubs. These would be a centre point of support for children and families and act as a gateway to multiple services. Each hub would be a base for universal services so that every child is reached.
  • A Government review of early education and childcare funding to ensure it is working as effectively as possible to help children and families who need it most.
  • A single system for supporting families with early years education and childcare, with fees charged in relation to families’ incomes as they are in Sweden and Norway.
  • A national workforce strategy for the early years, focusing on staffing across existing health, local government and early years settings.
  • Better sharing of data between different services, so children who need help do not fall through the gaps or go unidentified. This should include more effective use of a child’s NHS number and Unique Pupil Number so it is possible to match children in different databases.

iHV is working collaboratively with Public Health England to capture the stories, workarounds, innovation and rapid learning that has taken place in the health visiting service since the country went into lockdown in March.

We plan to publish these in a special edition of our case study series as a record of this time when history is being made. Capturing your experiences in this way will help us celebrate your successes, learn from each other and provide a legacy for future generations to reflect on.

We invite you to be part of this by submitting your experiences in a variety of ways listed below. 

Tell us what it has been like for you

Demonstrate why health visiting matters

Whilst working in a pandemic has presented numerous challenges for the health visiting profession and the families that we work with, it has also provided a unique opportunity for the profession to demonstrate its crucial role, supporting children and families across the breadth of clinical, social and statutory need.

The pace and scale of change has been second to none and health visitors have risen to this challenge with professionalism and autonomy, flexing and developing innovative service “workarounds” to ensure that families receive the best possible support. Different areas have responded in different ways. No doubt some innovations have worked better than others – it is only by testing and refining that we can really learn and drive quality improvement.

It is imperative that we capture this learning to ensure that we are better prepared for any future pandemics.

What do we need to celebrate? and what have we collectively learned to strengthen future planning?

To avoid reinventing the wheel, or investing time in ideas that have been proven not to work elsewhere, it is important that we all learn from our collective successes as well as our failures.

Help us to capture this by submitting:

  • Service level case studies that describe your journey and the ways you adapted your service. We are particularly interested to include case studies which detail the ways you managed social distancing, including use of PPE and technology. 

What issues did you face locally? What were the most pressing needs of the families in your area? How did you address these? What did you learn along the way (what worked – what didn’t/ benefits and limitation)? What was the impact/ outcomes (include any data/ direct service user feedback and quotes). 
(Your case study should be written following the PHE case study guidelines for standard format, and the additional information listed in the iHV case study template – 1800 words maximum)

  • Family stories – families have faced considerable challenges – tell their story. What challenges did they face, why did this matter? what did you do? and how did your intervention make a difference? – what would the outcomes have looked like without health visiting input? We are interested to receive submissions from the breadth of the health visiting role outlined in the 15 High Impact Areas in the iHV Vision (800 words maximum)
  • Creative submission – for those of you with a creative flair – have you captured your experiences of working in a pandemic in an artistic way? A poem, a piece of art? We would love to share your stories of working during a pandemic through a variety of mediums.

How to submit

If you would like the work that you are doing to be considered for this publication, please complete your application following the guidelines (please use the iHV case study template).

We welcome the inclusion of photographs which capture your experiences and the ways that your service has adapted during the pandemic. Please ensure that you have gained consent from all subjects in the photographs (service users and staff) for their use within the iHV case study publication.

Please send your completed application to [email protected] by midnight on Monday 29 June.

All submissions will be peer reviewed and applicants will be notified of the outcome within 3 weeks of the closing date.

If you would like to talk through your ideas – please contact Alison Morton [email protected]

 

Call for Case Studies

iHV is working collaboratively with Public Health England to capture the stories, workarounds, innovation and rapid learning that has taken place in the health visiting service since the country went into lockdown in March.

We plan to publish these in a special edition of our case study series as a record of this time when history is being made. Capturing your experiences in this way will help us celebrate your successes, learn from each other and provide a legacy for future generations to reflect on.

We invite you to be part of this by submitting your experiences in a variety of ways listed below. 

Tell us what it has been like for you? Demonstrate why health visiting matters?

Whilst working in a pandemic has presented numerous challenges for the health visiting profession and the families that we work with, it has also provided a unique opportunity for the profession to demonstrate its crucial role, supporting children and families across the breadth of clinical, social and statutory need.

The pace and scale of change has been second to none and health visitors have risen to this challenge with professionalism and autonomy, flexing and developing innovative service “workarounds” to ensure that families receive the best possible support. Different areas have responded in different ways. No doubt some innovations have worked better than others – it is only by testing and refining that we can really learn and drive quality improvement. It is imperative that we capture this learning to ensure that we are better prepared for any future pandemics.

What do we need to celebrate? and what have we collectively learned to strengthen future planning?

To avoid reinventing the wheel, or investing time in ideas that have been proven not to work elsewhere, it is important that we all learn from our collective successes as well as our failures.

We are looking for:

  • Service level case studies that describe your journey and the ways you adapted your service. We are particularly interested to include case studies which detail the ways you managed social distancing, including use of PPE and technology.

What issues did you face locally? What were the most pressing needs of the families in your area? How did you address these? What did you learn along the way (what worked – what didn’t/ benefits and limitation)? What was the impact/ outcomes (include any data/ direct service user feedback and quotes). 
(Your case study should be written following the PHE case study guidelines for standard format, and the additional information listed in the iHV case study template – 1800 words maximum)

  • Family stories – families have faced considerable challenges – tell their story. What challenges did they face, why did this matter? what did you do? and how did your intervention make a difference? – what would the outcomes have looked like without health visiting input? We are interested to receive submissions from the breadth of the health visiting role outlined in the 15 High Impact Areas in the iHV Vision  (800 words maximum)
  • Creative submission – for those of you with a creative flair – have you captured your experiences of working in a pandemic in an artistic way? A poem, a piece of art? We would love to share your stories of working during a pandemic through a variety of mediums.

How to submit your case study:

If you would like the work that you are doing to be considered for this publication, please complete your application following the guidelines (see iHV case study template).

We welcome the inclusion of photographs which capture your experiences and the ways that your service has adapted during the pandemic. Please ensure that you have gained consent from all subjects in the photographs (service users and staff) for their use within the iHV case study publication.

Please send your completed application to [email protected] by midnight on Monday 29 June.

All submissions will be peer reviewed and applicants will be notified of the outcome within 3 weeks of the closing date.

If you would like to talk through your ideas – please contact Alison Morton [email protected]

 

Child Safety Week (1-7 June) is the Child Accident Prevention Trust’s annual campaign to equip anyone working with families with essential, practical child safety advice they can share.  It will be different this year but as important as ever.

90% of serious accidents to children under five happen in the home.  This has obvious implications for children during lockdown and as it begins to ease.

Challenging as current circumstances are, they also bring great opportunities to harness practitioners’ energy and determination to support and engage with families in need.

So CAPT are offering more free content than usual, which they’ve made really quick and easy to share – it’s crammed with practical safety advice for families during lockdown and beyond.

Child Safety Week (1-7 June) is a great opportunity to share it.  But if you can get their advice out sooner, please don’t wait as the need is now.

Lockdown help

CAPT has developed a range of new content that you can use to support families under pressure in lockdown. This includes articles, fact sheets, illustrations and social media posts.

So far, CAPT has focused on their top tips for lockdown safety plus burns and poisons – two risks that may be heightened during lockdown – with more topics to come.

CAPT has also developed a Parents Pack for practitioners to refresh their knowledge and share with families far and wide.

Child Safety Week, 1 to 7 June

Throughout Child Safety Week, CAPT will have a focus on social media, with lots of posts and tips to share, making it easy for families to get relatable, helpful advice to keep children safe.

Make sure you get them by following www.facebook.com/ChildAccidentPreventionTrust or @childsafetyweek

Beyond Child Safety Week

CAPT is reworking the Child Safety Week Action Pack as an essential year-round resource, for use once practitioners can undertake face-to-face group work again.

Sign up for your free action pack and CAPT’s free safety campaigns, advice and resources at https://www.capt.org.uk/csw-sign-up

Dr Cheryll Adams CBE has written to the Prime Minister, Boris Johnson MP,  to ask him to start to strengthen the health visiting profession now so that it can play its part to help all UK children to be given the opportunity to have the very best start in life.  The Institute is particularly concerned by the growing rates of poverty and widening of health inequalities in the UK, both pre and during the COVID-19 pandemic, and their impact on babies, all children and their parents. This has happened alongside a significant loss of health visitors and development of unwarranted variation in the service across the UK over the past five years.

In the letter to the Prime Minister, the Institute is calling for a national strategy to start to rebuild the health visiting service now, so that it will be able to respond to a range of problems that are expected to be found when families come out of lockdown.  These include missed developmental delays, maternal and paternal mental illness, and growing levels of reported domestic violence. Science has shown that, if not recognised promptly, all can have a significant impact on an infant’s growth and development and their functioning in the future.

Dr Adams has offered the Institute’s recently published Vision document as a framework for new developments for health visiting alongside their expertise.