The Institute of Health Visiting publishes a position statement and recommendations for government following this weekend’s news of a threatened reduction of 25% in the health visiting workforce in Suffolk, alongside threatened cuts to the health visiting workforce in other areas of the country coinciding with the latest round of cuts to public health budgets by government.

Last weekend, the Observer published an article with the alarming title “Fears for new mothers as Suffolk slashes health visitor numbers”. Suffolk County Council, alongside many other local authorities, is being forced to make difficult decisions about the health visiting services that they provide to families due to year on year cuts to the public health grant. A spokesperson from the council describes the cuts as “adjustments to the care and support we provide” with the rationale that the new service will “provide the very best care and support that our children and young people deserve.”

Whilst this might sound an admirable aspiration, it will only be achieved if it is built on sound evidence and best practice. Investing in the earliest years saves money in the long run and, more importantly, ensures that every child is supported to achieve the best start in life. We are concerned that despite this evidence, health visiting services are being diluted and eroded due to a persistent gap between what we know and aspire to achieve, and what is currently funded and provided.

The iHV welcomes the Association of Directors of Public Health (ADPH) position statement on the Best Start in Life.

Dr Cheryll Adams CBE said:

“The Institute of Health Visiting is delighted to support the ADPH position statement on Best Start in Life.  We hope this will also enhance our own work highlighting the risks where health visiting services have been dramatically reduced across the country. In some places, the cuts greatly exceed the percentage cuts to public health budgets which greatly impacts the services it is possible to deliver for very young children and a light should be shone on that too.”

The Institute of Health Visiting (iHV) fully supports the new recommendations on supporting breastfeeding mothers published today by the Royal College of Paediatrics and Child Health (RCPCH), during World Breastfeeding Week (#WBW17).  The new RCPCH recommendations show that social stigma is a major barrier to breastfeeding and more must be done to support women to continue to breastfeed beyond the first few weeks.

The new guidance, based on the latest research, aims to give practical advice on how long women should consider breastfeeding and makes the case for the health benefits of breastfeeding for both mother and child, as well as the cost savings to families and health services.

Dr Cheryll Adams CBE, executive director of the Institute of Health Visiting, said:

“We warmly welcome this new guidance from RCPCH on supporting women to continue breastfeeding beyond the first few weeks.  Breastfeeding is natural, but not all mums find it easy, and some mums cannot or choose not to do it, so we must respect that too.  Mums often need support, and health visitors are one of the key healthcare professionals to help mothers establish breastfeeding through the universal health visiting service, but there is a need to educate the wider public and change the attitude and culture of society around it.”

The RCPCH recommendations include:

  • Governments in each nation to ensure familiarity with breastfeeding is included as part of statutory personal, social and health education in schools;
  • UK Government to legislate for employers to support breastfeeding through parental leave, feeding breaks and facilities suitable for breastfeeding or expressing breast milk;
  • Local breastfeeding support to be planned and delivered to mothers in the form of evaluated, structured programmes;
  • The NHS to ensure the preservation of universal midwifery services;
  • UK Governments to commit to adequate resourcing to preserve universal health visiting services;
  • Public Health England to develop a national strategy to change negative societal attitudes to breastfeeding;
  • Welsh, Scottish and Northern Ireland Governments to review and evaluate their existing breastfeeding promotion plans;
  • The NHS in England and the Welsh Government to follow the lead of the Scottish Government and the NHS in Northern Ireland by requiring all maternity services to achieve and maintain UNICEF Baby Friendly Initiative accreditation; this requirement is currently met by all maternity units in Scotland and Northern Ireland;
  • UK Government to reinstate the UK-wide Infant Feeding Survey, which was cancelled in 2015, to ensure reliable, comparable data on breastfeeding is recorded across the four nations;
  • All healthcare professionals should be aware of local and national support for breastfeeding mothers.

Dr Adams added:

“We at the iHV will be working with the RCPCH to support their campaign to improve breastfeeding in the UK to help women to continue breastfeeding beyond the first few weeks and help change societal attitudes by educating the wider public.”

The iHV has written this position statement on their views on what the future of health visitor education should look like and in particular how it could be strengthened but also what the blocks to doing that are.