The role of the health visitor: where are we now?

Read the latest guest paper “The role of the health visitor: where are we now?” by Alison Morton, iHV CEO, published in this month’s Paediatrics and Child Health Journal. The paper is written in the easy to access style of this popular journal and will be of interest to health practitioners from all backgrounds who work with babies, children and families and share our ambition to improve health and reduce inequalities.

The paper outlines the USP of the profession as the backbone of early years services and a vital safety-net for all families; it ends with our call to policymakers and the next government for investment in health visiting to ensure that all families are supported from preconception and through the ups and downs of their parenting journey during pregnancy and the first five years of their child’s life.

“Since its inception, health visiting has adapted over the years to respond to the greatest public health threats of the day. With many similarities to 2024, in the mid-19th century there were huge public health needs across society, with multiple initiatives set up to try and improve the health of the population. At that time, attention was focused on reducing the high rates of infant mortality driven by malnutrition and communicable diseases spread through poor sanitation and unsafe housing. Of these projects and home visiting initiatives, many failed or went out of fashion – but health visiting stood the test of time.

“Health visiting has been described as the backbone of early years services across the UK and the safety-net around all families. With child health deteriorating, more children falling behind with their development, growing concerns about invisible vulnerable children, widening inequalities and soaring costs of late intervention, there is a clear imperative to act. Health visitors provide an important part of the solution; however, the service is facing significant challenges. When sufficiently resourced, health visitors play a crucial role in ensuring that families get good, joined-up support – preventing, identifying and treating problems before they reach crisis point. The benefits of an effective health visiting service accrue to numerous government departments, contributing to a whole system response to address a multitude of policy priorities for babies, children and families across health, education and social care.”

Read the paper here

To find out more about the role of the health visitor, watch our short film “Health visiting in your community”.

Don’t just take our word for it – listen to a wide range of other organisations and individuals speaking up about the importance of health visiting:

Watch the short film on health visiting by Her Royal Highness The Princess of Wales who said, “Families need support, like we’ve seen today, more than ever. And it’s so important that we recognise and celebrate this amazing role that health visitors play up and down the country.” (HRH The Princess of Wales, 2023).
Watch the film here.

Read Why Health Visitors Matter by the First 1001 Days Movement.

New evidence paper published by the National Children’s Bureau

New evidence paper published by the National Children’s Bureau: Impact of investing in prevention on demand for statutory children’s social care

The final report of the Independent Review of Children’s Social Care is expected imminently. To support the launch of the Review, the National Children’s Bureau (NCB) has worked with their academic partners to showcase the latest research on children’s social care.

The NCB’s new evidence paper (Impact of investing in prevention on demand for statutory children’s social care) demonstrates that investing in prevention, including family support and early help, can reduce demand for more expensive crisis support later, and also leads to better services overall.

The NCB says:

“We have a unique opportunity to strengthen families and invest in early intervention. We must seize this moment to transform children’s lives for the better. Rarely has the case for early investment been so clearly articulated. We have to seize the moment”.

Highlights from the evidence paper:

Increased spending on children’s social care preventative services (including family support and early help) has a positive impact on:
- Ofsted judgements
- Numbers of Children in Need
- Rates of 16–17-year-olds starting periods in care.
The distribution of local authority spending on prevention has become increasingly less well matched to need.
Two recent papers have reinforced the contributory causal relationship between family poverty and levels of child abuse and neglect and the demand for children’s social care services, including rates of entry to care.

The evidence paper concludes with a brief summary of further contextual research on the association between household income and intervention, and on systems-thinking in children’s social care.

You can read more in the NCB’s evidence paper here.

You can join the iHV in raising awareness of the publication of the NCB’s evidence paper and share on social media using the prepared tweet below:

The imminent #CareReview is our chance to secure a future where every child feels safe, secure & supported @NCBtweets’ new evidence paper shows how investment in preventative services can help build that future, saving money in the process. https://bit.ly/3yO2Y2D

Health visiting in England: The impact of the COVID-19 pandemic

Last week, we were delighted that the international ‘Public Health Nursing’ journal published a paper written by Alison Morton, the iHV’s Executive Director, and Dr Cheryll Adams CBE, Former Executive Director, on the impact of the COVID-19 pandemic in 2020 on families with children under 5 years in England, and the health visiting (HV) service that supports them.

The paper (Health visiting in England: The impact of the COVID-19 pandemic) presents a targeted review of the evidence, with data drawn from national surveys of health visitors and parents, a freedom of information request of employers, published research, and national data. Framework analysis and triangulation, using the Key Elements of an effective health visiting service, were used to categorise the key findings.

The findings from the review indicate that the impacts of the pandemic were wide-ranging and disproportionately affected the most disadvantaged families, increasing demand for health visiting support. The pandemic exacerbated factors that can lead to poorer outcomes for families. Health visitors’ ability to respond was compromised due to national policy decisions to partially stop the service and variations in local implementation including the redeployment of health visitors, pre-existing workforce capacity issues, and the effectiveness of innovations to identify and support vulnerable families.

Key learning from the pandemic response, including the need to prioritise the health visiting service, must be acted upon to reduce ongoing impacts now and ensure that the service is equipped for future emergencies.

Alison Morton commented:

“History has a habit of ‘airbrushing’ the past and it is therefore important that the events of the earliest months of the pandemic are recorded, and the learning is captured to support future responses to similar emergency situations. It was an honour to be able to complete this review in partnership with my predecessor, Dr Cheryll Adams. We are both delighted to see it published in the prestigious international journal, ‘Public Health Nursing’ which is the official journal of the Council of Public Health Nursing Organizations worldwide.

“Babies, young children and families have largely been forgotten in the pandemic response and we hope that this paper, alongside numerous others presenting similar messages, will provide the impetus for much-needed change and investment in the health visiting service in England”

The paper has been published online by Wiley – Public Health Nursing journal as an open access paper – you can read the paper in full here:

https://onlinelibrary.wiley.com/doi/abs/10.1111/phn.13053

Who is providing a safety net for babies and young children?

With many health visitors in England redeployed during the early weeks of the pandemic, Alison Morton’s paper published in the July issue of Journal of Health Visiting considers the consequences for children and families, as well as the health visitors intended to support them – Who is providing a safety net for babies and young children?

A recent survey highlighted that health visitors experienced the highest level of redeployment during the COVID-19 pandemic in comparison with social workers and midwives (Barlow et al, 2020). This happened at a time when families’ needs and vulnerabilities were increasing due to the secondary impact of lockdown, and when many support services were scaled back.

But was the redeployment of health visitors necessary? Are there lessons we need to learn from the delivery of the national emergency plan to ensure that we are better prepared in the future?

Redeploying specialist community public health nurses into non-public health roles during the biggest global public health emergency we have experienced in living memory would appear to be counter-intuitive. However, to understand the decisions made, it is important to avoid ‘hindsight bias’ – a common pitfall that occurs when we view circumstances based on the information we have after the event that was not available to the people involved at the time.

“If we face a second wave of infections, will future emergency plans include the redeployment of health visitors? We hope that this will not be the case, and that lessons will have been learned. It is vital that the needs of children and families are prioritised and given the attention they deserve..”

Go to Journal of Health Visiting: Who is providing a safety net for babies and young children?

Many thanks to Journal of Health Visiting for providing free access to this paper.