Families living in poverty struggling to access early childhood services, new report finds

A new report by NSPCC and the UK Committee for UNICEF (UNICEF UK), published this week, sets out how families experiencing poverty face barriers to accessing early childhood services at every level in the UK.

The report, “Opening Doors: access to early childhood services for families impacted by poverty in the UK”, draws from an evidence review and new research with parents and carers who are experiencing poverty and raising children aged under-5, as well as early childhood professionals.

Poverty can have a negative impact on a young child’s development, increasing their likelihood of ill health, poor mental health, and putting them at a disadvantage before they start school. In the UK, more than one in three (36%) children in families where the youngest child is under five are living in poverty.

However, inequalities are not inevitable. Access to high quality early childhood services, such as maternity, health visiting and integrated support in children’s centres or family hubs can significantly reduce these inequalities and provide a lifeline for families on low incomes. Despite this evidence, the report provides new data on a sector under enormous pressure, with early childhood professionals often working in unsupportive environments, and a significant shortage of midwives and health visitors.

The report found that this shortage is resulting in a lack of outreach, rushed appointments, and a different professional at each contact, which can damage relationships with parents and leave them unable to discuss sensitive issues.

One mother said: “It’s really difficult when they change your midwives all the time and change your health visitor, and they change where you’re going for appointments.”

The NSPCC and UNICEF UK believe that the upcoming UK-wide Child Poverty Strategy and the 10-Year Health Plan in England offer crucial opportunities for the UK Government to improve access to local early childhood services and ensure they are inclusive of families on low incomes.

They also want to see the Government invest in rebuilding midwifery and health visiting workforces as well as rolling out integrated services like family hubs across the country. This requires additional investment to address the shortfalls of 2,500 full-time midwives and 5,000 full-time health visitors in England by 2030.

Vicky Nevin, Policy Manager at the NSPCC and co-author of the report, said:

“Midwives, health visitors and other professionals provide support that can make a real difference for parents who want to do the best for their young children but are struggling with money.

“Worryingly, our research shows that service doors are often closed, hard to reach, or out of touch with the needs of families impacted by poverty. This poses serious risks to the health, wellbeing and safety of little ones.

“Early childhood services should be top of the agenda when the Child Poverty Taskforce next meets this December. It is vital for the Government to rebuild and reform services that provide quality support to all babies, young children and their families.”

Responding to the report, Alison Morton iHV CEO said:

“The scourge of poverty and lack of joined-up high-quality support for families is damaging the life chances of too many. We thank the NSPCC and UNICEF UK for laying bare these challenges in their “Opening Doors” report this week. We also thank them for adding their weight of support in calling for a significant increase in the number of health visitors in England, to ensure that all families can have access to high-quality support when they need it. A collective voice is a powerful voice – and partners across the sector are ready, willing and able to work with the government to turn this into reality.”

Read Opening Doors: access to early childhood services for families impacted by poverty in the UK report

NSPCC calls on Government to implement updated and improved Healthy Child Programme

The NSPCC is calling on the Government to implement an updated and improved Healthy Child Programme alongside a robust NHS workforce plan.

Today, the NSPCC gained widespread print coverage on their health visiting story which highlighted that more than 84,000 babies have missed out on their new birth visit, in their first two weeks of life, last year.

Their story lays bare the figures from the Office for Health Improvement and Disparities (OHID) which showed a steep decline in the proportion of babies receiving a new birth visit by 14 days in England, from 88% in 2020/21 to 83% in 2021/22. The NSPCC also highlighted the wide variation of delivery between local authorities and the national workforce shortage of 5,000 health visitors in England.

The NSPCC is calling on the Government to implement an updated and improved Healthy Child Programme alongside a robust NHS workforce plan which will help give health visitors the resources and tools they need to adequately support families right from the start of a child’s life.

The story was covered in print in The Independent, Express, Daily Star, The i, Daily Telegraph, The Sun, Metro and Mirror and online in the Daily Mail as well as regional and online outlets.

There was also broadcast coverage on Sky News as well as Good Morning Britain and across commercial radio stations.

Jack O’Neill, NSPCC senior policy and public affairs officer, said:

“It is vital that families receive that crucial first health visit as soon as possible after a child is born to ensure parents and the new baby are living in a safe and healthy environment”, and “called on Government to improve the Healthy Child Programme and boost health visitor numbers”.

Georgina Mayes iHV Policy and Quality Lead said:

“We welcome the support and ongoing pressure from NSPCC to ensure that every baby gets the best start in life. Too many babies and children are currently missing out on vital health visitor mandated contacts. This matters as we now have unequivocal evidence on the importance of the earliest years of life – but we also know that becoming a parent can be a particularly challenging time for many families. Having access to the right support can make a big difference and can prevent small problems reaching crisis point. Sadly, too many families are missing out on the support that they need due to an almost 40% reduction in the number of health visitors, alongside rising levels of need.”

The situation is serious but it’s not too late to change direction and for the Government to ensure there is sufficient funding to deliver the Healthy Child Programme in full, including a national workforce strategy to address the shortfall of 5,000 health visitors in England. Whilst we welcome the Government’s workforce pilots announced in the autumn budget, and restatement that health visitors are one of six essential services, action to address the health visitor workforce shortages cannot wait another 2 years. Urgent action is needed now to put the brakes on and prevent further losses. The longer that this is left unaddressed, the harder it will be to deliver the Start for Life vision and rebuild the health visiting service in England.

The iHV would like to say a huge heartfelt thank you to the NSPCC for their unwavering support of health visiting and for championing babies, children and families. We would also like to say a special thank you to Jack O’Neill (NSPCC Senior Policy and Public Affairs Officer) and Pierre Hyman (NSPCC Policy & Public Affairs Manager) for leading this media story which has received excellent coverage.

Help give all of Scotland’s babies a Fair Start in life

Calling all health visitors in Scotland…sign up to join NSPCC Scotland’s hustings on 26 April (10:00-12:00) to give all of Scotland’s babies a Fair Start in life.

See their invite below:

What?

NSPCC Scotland, supported by Children in Scotland, are hosting a virtual hustings on Monday, 26 April, 10-12noon, focused on safeguarding and support in the early years.

The event will raise awareness of the distinct needs of babies and their families, as we emerge from the pandemic, with parliamentary candidates in advance of the Scottish elections.

The panel will include representatives from all of Scotland’s political parties, including the Minister for Children and Young People, Maree Todd.

They have also invited families, health visitors, midwives, social workers, early years staff, third sector partners, family nurse partnership teams and specialist perinatal and infant mental health services to raise issues from practice with political parties.

Why?

Babies need us to fight for them. They are a uniquely vulnerable group of children; they are completely dependent on adults for their care and protection, and cannot verbalise their needs or seek support.

Around 50, 000 babies will have been born in Scotland since the start of the COVID-19 pandemic[1], born into a society of heightened anxiety and stress. While we might think infants will be too young to remember, we must not overlook the impact the pandemic will have had on them and their families.[2]

There is extensive evidence showing early experiences have profound effects on lifelong development. Yet, last year in Scotland, around half of the children on the child protection register, and over a third of children coming into the care system, were younger than five years old[3].

The Promise[4] has as a key foundation the provision of better and more responsive scaffolding for families. Despite a decade of policy frameworks which recognise the importance of the early years, of early intervention and prevention[5], the scale of ambition is not matched by the scale of investment.

They believe getting it right for families in the early years is the most efficient and cost-effective way to realise Scotland’s long-held aspirations around equality and prevention.

Following incorporation of the UNCRC, they want to hear how political parties will deliver a rights-based approach to budget setting and decision making to ensure early years services are holistic, preventative and integrated to better support families.

How?

Book your place at the virtual hustings here

They look forward to seeing you there😊

[1] Based on previous year birth rates. See https://www.nrscotland.gov.uk/files/statistics/rgar/2019/Pages/bir-sec.html

[2] https://www.bestbeginnings.org.uk/news/the-babies-in-lockdown-report

[3] https://www.gov.scot/binaries/content/documents/govscot/publications/statistics/2021/03/childrens-social-work-statistics-2019-20/documents/childrens-social-work-statistics-scotland-2019-20/childrens-social-work-statistics-scotland-2019-20/govscot%3Adocument/childrens-social-work-statistics-scotland-2019-20.pdf?forceDownload=true

[4] https://www.carereview.scot/wp-content/uploads/2020/02/The-Promise.pdf

[5] EY Framework; https://www.gov.scot/publications/early-years-framework/pages/4/

NSPCC – Many new parents may be ‘suffering in silence’ during lockdown

On Maternal Mental Health Awareness Day (6 May), the NSPCC highlights rising concern that many new parents may be ‘suffering in silence’ during lockdown.

The Institute was pleased to support an NSPCC virtual roundtable looking at the effects of the COVID-19 crisis on new mothers’ mental health, and the risk of potential long-term consequences on babies’ health and development. The panel said their services had adapted to support parents digitally, but they shared concerns about the effect of the COVID-19 crisis on mothers and babies.

The NSPCC reported an increase of 28% in calls to its helpline about parental mental health in the first three weeks of lockdown.

Before the pandemic, up to one in five mothers and one in 10 fathers experienced perinatal mental health problems, the charity said.

Eileen O’Sullivan, a specialist health visitor in Warwickshire, said:

“Supporting mothers digitally can be challenging and there is a concern that some may be suffering in silence, too scared to share how they are really feeling over video.

“I am also seeing that my colleagues are being extra vigilant because we don’t want to miss anything.”

The NSPCC cited data from the Institute of Health Visiting, which found in some areas of England at least 50% of health visitors, including some from perinatal mental health and parent-infant teams, were redeployed into other health services in the initial period of the lockdown.

The NSPCC is urging the Government to ensure support is provided to parents as the country comes out of lockdown, and to come up with a plan to rebuild health visiting and perinatal services after the crisis.

Andrew Fellowes, public affairs manager at the NSPCC, said:

“At the NSPCC we know that, if undetected and untreated, perinatal mental health problems can have a devastating impact on women, partners and babies, both immediately but also long after the COVID-19 situation has passed.

“It is imperative that families continue to have access to services during the lockdown so that mental health problems can be identified and specialist support provided if needed.”

The iHV continues to support health visitors, our perinatal mental health champions and specialist health visitors in perinatal and infant mental health to deliver their services to families who may be adversely affected by the lockdown, particularly with respect to safeguarding and mental health issues. We have produced specific guidance to help which can be found in our COVID-19 (coronavirus) guidance for health professionals webpage: https://iHV.org.uk/COVID-19

iHV responds to NSPCC survey findings

iHV responds to the results of the latest NSPCC survey which finds that mothers report lack of consistent care during pregnancy and post-birth – only 6% of mums could recall seeing the same health professional in health reviews that take place during pregnancy and up to their child’s 1st birthday.

The NSPCC survey of over 2,000 mothers with children aged 1 to 3 in England about their experiences of health reviews revealed:

nearly a quarter saw a new person each time
over a quarter had a letter, phone call or text message instead of a face-to-face visit
40% said their health professional didn’t establish a relationship where they could share concerns about their wellbeing
over a quarter reported rarely being asked about their mental health.

Commenting on the NSPCC survey, Dr Cheryll Adams CBE, Executive Director of the iHV, said:

“The NSPCC findings match those from our own recent survey of 1000 parents with Channel Mum. It is unacceptable that mums, at one of the most vulnerable times of their and their infants’ lives, aren’t getting access to consistent and high quality advice from a trusted health visitor as they should. The cuts to public health budgets have bitten deeply. It’s not only health visitors who have been lost, it’s also child health clinics, meaning that mothers will turn to the internet for advice which may be reliable, but very often isn’t, it may even be dangerous.”

The results of the NSPCC survey closely match iHV’s recent publication ‘What do parents want from a health visiting service?‘ survey report which found that parents want:

Continuity of health visitor – someone who knows them as an individual and who they can trust
Equity of access to support – receiving all mandated contacts and extra help when needed, regardless of where they live

Dr Adams continued:

“Our annual State of Health Visiting survey findings, published last week, demonstrated that 80% of mothers now don’t formally see a health visitor after their 6-8 week contact – so most are not receiving the five checks mandated by government by a health visitor, if at all. Only 34% reported being able to offer an antenatal contact to all or most families. Postnatal depression will inevitably be missed and much more. Health visitors are doing their very best, but are now mostly working with caseloads that are so large they are unsafe.”

Download State of Health Visiting in England: Results from a survey of 1040 practising health visitors

Dr Adams concluded:

“It is a national scandal that our youngest and most vulnerable citizens and their parents continue to be subjected to ever disintegrating levels of state support. For the health visitors themselves, it is devastating to no longer be able to provide the services which they know families need.”

Ahead of the upcoming budget and spending review, iHV joins NSPCC’s call to urge government to invest in the public health grant so families get the care they need – Fight for a Fair Start campaign.

iHV welcomes NSPCC Fight for a Fair Start Campaign

iHV welcomes the NSPCC ‘Fight for a Fair Start’ campaign – calling on Government to ensure all new parents receive a minimum of five face-to-face visits from the same health visitor.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

The Institute of Health Visiting welcomes the NSPCC Fight for a Fair Start campaign and its call to strengthen the essential support that health visitors should be offering to all families during the first years of their baby’s life.

The reduction in universal contacts by health visitors following the loss of one in four health visitors over the past 4 years, often accompanied by fragmenting of continuity of care, means that there may be a generation of children and new families with emotional health needs which are going unrecognised. Indeed, the Children’s Commissioner has already expressed her concern regarding hidden children, those with significant needs who may not be sufficiently well known to services. We are aware that the number of referrals to child mental health services has doubled over the past few years and this can only be set to increase further unless there is new investment into supporting new families.

Implementation of the new green paper on public health (Advancing our health: prevention in the 2020s) would seem to provide an impetus for reinvestment. We hope that the Treasury will take that opportunity using the next Spending Review before even more children’s lives are affected.

One in four families across England are missing out on vital health visits as their baby reaches their first birthday, increasing the risk of mental health issues with the parents going undetected. Data from Public Health England for 2017/18 has also revealed that these 12 month visits drop to around one in two for families living in London.

In addition, further NSPCC research highlights that antenatal visits are particularly inconsistent, with an estimated 38% of families not receiving a health visit before the mother gives birth.

The transfer of budgetary responsibility for health visiting services from the NHS to local authority public health in 2015 has coincided with a significant reduction in the public health budget and workforce numbers.

There has been a 26% fall in health visitors employed by the NHS operating nationwide between 2015 and 2019, with almost half of those still in the service working with caseloads of more than 400 children each. The Institute of Health Visiting recommends a maximum of one health visitor to every 250 children to ensure a safe service is delivered.

In response the NSPCC is launching a national campaign ‘Fight for a Fair Start’, and is calling on the Government to ensure all parents receive a minimum of five face-to-face visits undertaken by a consistent health visitor.

The NSPCC is inviting people to join the campaign by raising their voice and signing the Fight for a Fair Start petition.

Read full NSPCC press release

NSPCC launch “Look, Say, Sing, Play” campaign for parents

The NSPCC has launched a new campaign, ‘Look, Say, Sing, Play’, which aims to show parents why taking a cue from their young child and reacting to what they’re doing is so important. The campaign empowers parents to change everyday moments into brain-building ones. It’s aimed at parents with babies under two, and is designed to be relevant right from birth.

A survey of more than 2,000 parents and expectant parents revealed that 62% were unaware that the interactions they have with their new baby in moments such as playing, singing or story time can be brain building ones.

The campaign is based on fun and easy tips to help parents have high quality interactions with their baby by bringing more Look, Say, Sing, Play into their daily routine. It’s about making the most of what they’re already doing, rather than adding to the list of things they need to do. As well as helping with brain development, the tips are also designed to help parents bond with their baby.

Right from birth, every time you talk, sing or play with your baby, you’re not just bonding, you’re building their brain.

You can find out more, and sign up for free and fun brain-building tips today.

Look Say Sing Play webpage for parents and Sign up for brain-building tips

Look Say Sing Play webpage for professionals

NSPCC and Barnardo’s launch All Babies Count report

Last Monday, the NSPCC and Barnardo’s held the England launch of the All Babies Count report – An unfair sentence: Spotlight on the criminal justice system.

Download a pdf version of the report

For the report and further information about the All Babies Count campaign

Please use the hashtags #allbabiescount and #earlyintervention to join the discussion on twitter.

The NSPCC and Barnardo’s look forward to continuing this important discussion over the coming months. They are eager to work collaboratively with others working in this field to ensure that the needs of babies affected by the criminal justice system are considered and met at national and local levels of government – please do get in touch with them directly if you are interested in this work.

NSPCC – The Dad Project Report

The Dad Project looked at how the relationships could be strengthened between dads, their child and his or her mother, and the services that work with them during pregnancy and the year after a baby is born. The project was run by the NSPCC, with support from the Design Council and funding from the Guy’s and St Thomas’ Charity.

Read The Dad Project report

Mothers and babies missing out on vital support says NSPCC

The wellbeing of more than one in 10 newborn babies in England could be improved if all new mothers with mental illness had equal access to good services, an NSPCC report reveals today. The charity is calling on Health Ministers to lead a drive to address major gaps in access to mental health services for pregnant and new mums.

Mental health problems can begin or escalate when a woman is pregnant or in her child’s first year. They can have a damaging effect on family life, and in the worst cases, impact on babies’ health and welfare.

Evidence shows the vast majority of these illnesses are preventable and treatable, with the right support. The charity recognises there are many excellent services working hard to ensure families get the support they need. However it describes how a lack of focus on mother’s mental health has led to a ‘postcode lottery’ for families, with less than half of mental health trusts having specialist mental health services for expectant and new mums.

Peter Wanless, CEO of the NSPCC, said: “This report clearly shows that with the right services, it is possible to prevent the harm caused by maternal mental illness. But opportunities to help many more families are being missed.

“We have to start treating the mental health of mums and babies with the same importance as their physical health.

“Pregnancy and the first months of a child’s life are critical for their future wellbeing and parents naturally play a vital role. If the Government is serious about giving every child the best start in life it must take action to fill the gaps in services.”

Dr Ian Jones, Vice-Chair of the Royal College of Psychiatrists’ Perinatal Section, said: “Maternal mental health remains a neglected area but is of huge importance and has long-lasting impact on the woman herself, her family and wider society. This NSPCC report highlights the need for specialist perinatal mental health services and the postcode lottery that characterises current provision. We must work to give women and their families the care they require.”