Waiting for policy announcements is a bit like waiting for buses. Yesterday saw the long-awaited announcement of the local authority public health grant settlements, and this was followed swiftly today with Sajid Javid’s announcement of the elective recovery plan for the NHS.

The announcements lay bare the glaringly different priorities afforded to ‘sickness treatment’ in the NHS and the poor relation of preventative public health and early intervention.

It has been estimated by the NHS that 10 million people did not seek treatment during the pandemic, and around 6 million people are waiting for elective treatment. To address this backlog, Sajid Javid says the government has already allocated an extra £2bn to tackle waiting lists this year, with another £8bn being spent over the next three years – alongside this, there is a further £6bn of spending announced for capital investment in the NHS.

In contrast, England’s public health grant allocation for 2022-23 saw a 2.81% rise to council’s public health budgets, which brings total funding to £3.42bn in 2022-23, up by £93m from 2021-2022. The Government had previously pledged to maintain public health funding in real terms in the autumn budget, however, when compared to the current rate of inflation of 5.4%, this settlement represents a cut in real terms.

Recently, Sir Michael Marmot said: “It shouldn’t be that we either invest in treatment services or improving public health, we need to do both if we want to create better societies for people.”

Alison Morton, Executive Director iHV, responded:

“Yesterday’s funding settlement for local authorities in England is not good news. With long-standing workforce shortages, rising levels of vulnerability and a backlog of babies, children and families missed in the pandemic, this is another blow for public health. Where is the public health recovery plan?

“Our role at the iHV and as health visitors is not to be party political but to stay true to the key principle of health visiting to ‘Influence policies affecting health’ – and it is in our view that the Government needs to reconsider its priorities for babies, children and families as a matter of urgency. Whilst we are all acutely aware of the costs that this country faces in the wake of the pandemic, to gain perspective we need to view these decisions in the light of other policy decisions. In the autumn Spending Review, the price of a pint of beer was cut by 3p – this came at a cost to the Treasury of £3bn.”

We have escalated our concerns in a recent letter to the Minister, Maggie Throup, and officials in the Office for Health Improvement and Disparities. Whilst we welcome their plans for a workforce roundtable in February and the commitment of £10m for workforce pilot schemes, action is urgently needed to address the much bigger problem posed by the ever-increasing health visitor workforce shortages now – this cannot wait for another 2 years for these pilots to report their findings. Babies, young children and their families are at risk because we know that we have a shortfall of about 5,000 health visitors and this is having a significant impact on the service and the level of support offered to them.

This is your last chance to complete a short survey to influence the future of the public health workforce!

Survey closes midday tomorrow (12 Jan).

It is a crucial time for public health right now and the Royal Society for Public Health (RSPH) is calling for public health practitioners to take part in a very short survey to represent their views to help influence the future of the public health workforce.

The survey provides a fantastic opportunity for health visitors to highlight the challenges they are facing within their workforce and identify what solutions are needed. The survey focuses specifically on recruitment, retention and training.

Although the survey does not ask about individual public health professions and is quite broad in its approach, there is space to free text and expand on your thoughts so you can be specific about health visiting within these areas.

Your feedback will be used to help influence the RSPH’s submission to the Health and Care Committee’s inquiry into the future of the public health workforce.

It only takes about 10 minutes to complete the survey, so make yourself a cuppa and make sure your views are heard!

The survey closes at midday on Wednesday 12 January 2022.

The Nursing and Midwifery Council (NMC) has launched their public consultation for specialist community public health nursing (SCPHN) standards – building on ambitions for community and public health nursing.

The new NMC standards offer the opportunity to build on the advances in the evidence base for universal child and family health visiting for the pressing public health challenges of our times. It is vitally important that the views of health visitors are heard and shape these new standards.

We will be responding from the iHV – as well as submitting your own response, look out for our mailings on ways that you can help shape the iHV’s response.

 

The standards, for specialist community public health nursing (SCPHN) and specialist practice qualifications (SPQs), will equip the next generation of community and public health nurses working in health and social care with the right proficiencies to care for people in a rapidly changing world.

These essential education standards were last updated over 15 years ago. But we need fit for purpose standards that reflect the realities of modern nursing in health and social care now

These draft standards, which have been co-produced with subject experts, will provide the right proficiencies these professionals need to support and care for people in a rapidly changing world.

The consultation will run until Monday 2 August 2021. Normally these NMC consultations run for 12 weeks but they’ve extended this one to more than 16 weeks to give you and your colleagues more time to take part given the continued pressures on services caused by the pandemic.

  • 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.

 

The Institute of Health Visiting has provided the Treasury with the latest evidence and cost benefits for new investment into health visiting as part of its Comprehensive Spending Review.

As the Institute submits its evidence to the Spending Review, Dr Cheryll Adams CBE, Executive Director iHV, said:

“We hope that this clear rationale and evidence for investing into the early years through the health visiting service will be taken seriously when the Treasury reviews all the submissions. There has never been a greater need to act to support young families as they face the secondary impacts of the COVID-19 pandemic. A loss of 30% of the health visiting workforce, since cuts to public health budgets, is impacting on our most vulnerable citizens and their families, but this will also have a significant long-term legacy for the country as a whole.”

The Institute of Health Visiting joins over 40 million doctors, nurses and other health professionals from 90 countries, including many working on the frontlines of the COVID-19 pandemic, in sending a letter today to G20 leaders urging them to put public health at the centre of their economic recovery packages, to help avoid future crises and make the world more resilient to them.

In the biggest health community mobilisation since the run-up to the 2015 Paris climate agreement, over 350 medical groups representing health professionals (including the World Medical Association, the International Council of Nurses, the Commonwealth Nurses and Midwives Federation, the World Organization of Family Doctors and the World Federation of Public Health Associations) have signed the letter on behalf of their members, along with thousands of individual health professionals.

The letter asks governments to prioritise investments in public health, clean air, clean water and a stable climate in the economic stimulus packages currently under consideration. Such investments would reduce air pollution and climate-warming emissions, which damage human health, build greater resilience to future pandemics, and simultaneously create more sustainable jobs.

Dr Cheryll Adams CBE, Executive Director iHV, said:

“The world has the opportunity now to ensure that the next generation is not inhibited by the mistakes of the last.  By tackling climate change and ensuring better preparedness for any future pandemics, babies can be given the opportunity for a long and healthy life where they have the health, wellbeing and opportunity to contribute to their economy, to future economies, and to the wellbeing of their descendants.”

To achieve this healthy recovery, leaders of the G20 countries must involve their medical and scientific community in developing the stimulus packages. These stimulus decisions must also take into account medical and scientific assessments of how the measures will impact public health in the short- and long-term.

The COVID-19 pandemic has exposed doctors, nurses and other health professionals to death, disease and mental distress at levels not seen in decades. The scale of this pain could have been at least partially mitigated by adequate investments in pandemic preparedness, public health and environmental stewardship, the letter states.

As the COVID-19 pandemic has made very clear, the economy suffers when human health is compromised. A science-based approach to a healthy recovery from COVID-19 must lead to decisions to reduce both air pollution, which weakens the lungs, hearts and other organs, and greenhouse gas emissions, which cause drought, extreme heat, flooding, wildfires and other life-threatening disruptions. This should be alongside ensuring every baby is given the best possible start in life and access to education and their parents supported.

A healthy recovery requires governments to invest in sustainable and innovative industries, jobs, food production and food supply chains. In doing so, leaders will encourage healthier diets, more renewable energy, more walking, cycling and zero-emissions public transport, a radical regeneration of trees and nature and other changes that will underpin human, economic and planetary health well into the future.

This letter is supported and promoted by the Global Climate and Health Alliance, Every Breath Matters, and the World Health Organization in service of the global medical and health community.

New government funding of £210 million for NHS nurses to improve their training and skills should be expanded to cover public health workers, such as health visitors and school nurses, councils say.

Institute of Health Visiting. Library Photography. Picture: Cleverbox / www.matthewwalkerphotography.com

Offering greater training and upskilling opportunities would also encourage more people into nursing and to stay in the profession for longer, at a time when the sector is experiencing severe problems in recruitment and retention.

iHV Executive Director, Dr Cheryll Adams CBE, met Margaret Kenyatta, First Lady of Kenya, at the launch of the 5th International Global Network of Public Health Nursing (GNPHN) conference in Nairobi, taking place 14-16 May 2019.

Lady Kenyatta is a GNPHN council member.

Margaret Kenyatta, First Lady of Kenya, with the GNPHN Council at GNPHN conference 2019

 

Margaret Kenyatta, First Lady of Kenya, at GNPHN conference 2019

Proceedings are well under way at the GNPHN conference in Nairobi! Please see below just a few videos from the first day!

The arrival of First Lady Margaret Kenyatta to the conference venue, the Safari Park Hotel, Nairobi.

First Lady Margaret Kenyatta launches the conference by unveiling the quilt…

First Lady Margaret Kenyatta addresses the conference…

The Faculty of Public Health (FPH) has just launched a photo competition to celebrate what ‘public health looks like’.

They would love lots of public health practitioners to be involved and we think it would be great to see health visitors involved too! The aim is to capture powerful images that bring to life the incredible breadth and diversity of public health – to take photos of what ‘public health looks like’ through your eyes.

By entering this competition and taking a photo that represents what public health looks like to you, you’ll be helping FPH on their journey to showcase the value of public health and the impact your work has in the UK and around the world. And it would be great to have health visiting showcased too!

What can you win?

The ten winning photos will be displayed at a photography exhibition in Spring 2019. There are a number of other prizes up for grabs as well including cash prizes and free FPH membership.

How can you enter?

Capture a photo that best describes what public health is to you and submit it via the form on the FPH website.

The deadline for submissions is Friday 19 October at 23:59.

If you’ve got any questions or want further info, first of all take a look on the FPH website. If you can’t find the answer to your query then you can email [email protected]

The Institute of Health Visiting (iHV) calls for Government to reverse the cuts to public health budgets and reinvest in health visiting services to protect and support the health and development of babies, children and families, and, in the medium and longer term, for all in our society.

In a letter to the Chancellor, the Institute details how the year-on-year reductions in the public health budgets is leading to far-reaching declines in health inequalities across England – impacting the long-term health outcomes for our children, as well as society.

A policy change in 2015 moved the commissioning of health visiting services to local government, coinciding with a 6.2% reduction of the public health budget during that financial year and further annual cost savings of 3.9% each year until 2020.

Dr Cheryll Adams CBE, executive director iHV, said:

“We know so much today with respect to what can influence children’s outcomes across their life course and in turn benefit the whole country. The impact of the public health budget cuts on babies and children is very worrying and upsetting. It is alarming that, in the two years since the commissioning change, the number of health visitors seems to have reduced by around 18%*, and could rapidly be approaching an all-time low.”

Health visitors play a vital role in supporting babies, children and families in the early years of life. There is a strong research base that demonstrates that a significant part of an individual’s ‘blue print’ for their future mental wellbeing is laid down in the first two years of life.  This is a critical window for supporting parents to help their children build solid social and emotional wellbeing.  Health visiting services are effective at identifying and reducing the impact of health inequalities, so reducing the burden of care both in the short and longer term.

Dr Adams continued:

“As a nation, we cannot afford not to invest in our children as they are our future, yet recently their needs seem to have become invisible against the many competing demands being made on Government and the NHS. The work of the health visitor often goes unseen, until you take it away. Government may soon have to face the effects of some of the lowest ratios of health visitors to children experienced by this country in living memory.

“It’s time to act, to help ensure the best health outcomes for all UK children today, and in the future. We need urgent action from the Government to increase their investment in public health prevention and early intervention to ensure that health visitors can continue to give every child the opportunity to have the best start in life.”

*NHS Digital