The Duchess of Cambridge will host a roundtable at the Royal Institution today to mark the release of new research from The Royal Foundation Centre for Early Childhood.

A year on from its launch, The Centre for Early Childhood will be unveiling the findings of new research into early childhood development, as The Duchess of Cambridge and the Centre host a small roundtable to discuss the results and broader importance of early childhood development to society.

The roundtable will be attended by representatives from the early years sector; the Secretary of State for Health, Sajid Javid; the Minister for Families, Will Quince; and officials from the Department of Health and Social Care and the Department for Education. Together, they will discuss the findings of the research published today, and the huge opportunity that there is to shape the future of our society by focusing on the importance of early childhood to lifelong outcomes.

Conducted by Ipsos UK on behalf of The Royal Foundation Centre for Early Childhood, the research comes two years after The Duchess’s landmark survey – ‘5 Big Questions on the Under-Fives’ – which attracted the largest ever response to a public survey of its kind with over 500,000 responses in one month, sparking a national conversation on the early years. The research delves even deeper into public perceptions of early childhood, focusing on three key areas: the prioritisation of the early years; the link between the first five years of life and lifelong outcomes for mental health and wellbeing; and the support parents seek when raising young children.

Seven in ten people say the early years should be more of a priority for society.

Earlier this year, The Duchess travelled to Denmark where she learnt about how the Danish approach has created an enabling culture for early childhood development, specifically how it has promoted infant mental wellbeing alongside physical health, and how it harnesses the power of nature, relationships and playful learning in the first five years of life. The service in Denmark is modelled on the health visiting service in England. However, in contrast, the work to support families in the earliest years in Denmark is a national priority and the workforce is afforded much higher status and greater investment than their counterparts in England.

Today’s research also follows over a decade of work by Her Royal Highness in which she has seen first-hand how some of today’s hardest social challenges have their roots in the earliest years of a person’s life. The Duchess is committed to raising awareness of the importance of early childhood experiences and of collaborative action to improve outcomes across society. She launched The Royal Foundation Centre for Early Childhood in June 2021.

Speaking about the research published today, The Duchess of Cambridge said:

“Our experiences in early childhood fundamentally impact our whole life and set the foundation for how we go on to thrive as individuals, with one another, as a community and as a society.

“The findings published today present us with a huge opportunity and demonstrate there is real appetite from the public to bring this issue up all of our agendas. There is more we can all do – every member of society can play a key role, whether that is directly with a child or by investing in the adults around them – the parents, the carers, the early years workforce and more.

“If we come together to raise the importance of early childhood development, we’ll soon see that healthy, happy individuals make for a healthier, happier world. Which is why every second we spend with a child, is an investment in our collective future.”

Alison Morton, iHV Executive Director, says:

“The findings from today’s research, alongside the long-term commitment of the Duchess of Cambridge to raising awareness of the importance of early childhood experiences, provide an opportunity to shift the needs of babies and young children higher up the national agenda. With such a vast body of evidence making the case for investment in the earliest years of life, we hope that today’s Roundtable will ‘light the touch paper’ for the change that so many of us who work in this field have hoped for – but hope is not enough. In the words of the Duchess of Cambridge, there is definitely ‘more we can do’ and it starts in the heart of government.”

The iHV welcomes the important findings of the latest report, ‘Bringing Baby Home’ published by the Fatherhood Institute for Fathers’ Day and Infant Mental Health Awareness Week. The report is based on the findings of a systematic scoping review of the UK literature on UK fathers in their baby’s first year after the birth. The report presents findings on men’s adjustment to fatherhood; relationship with their partner; associations of ‘father-factors’ with mother wellbeing and child outcomes; engagement with services; and related policies in the four countries of the UK.

The Fatherhood Institute’s hard-hitting conclusion is that NHS maternity, health visiting and other family services are failing babies by ignoring their fathers during the first postnatal year. It finds that even without the additional challenges of the COVID-19 pandemic, services are often not set up to engage with, assess and support new fathers. This is despite clear evidence that fathers’ physical and mental health has a significant impact on babies’ future health and wellbeing, on key maternal outcomes and that the perinatal period can be a ‘golden moment’ for encouraging better health behaviours among fathers.

Alison Morton, iHV Executive Director, says:

“Health Visitors know and understand the important role that fathers play in family life and the health and wellbeing of all family members – they wholeheartedly agree with the premise of this report and want to be enabled to deliver father-inclusive services. The report’s hard-hitting findings make difficult reading, with stories of families being let down – but they point yet again to the need to address the root cause of this problem. If things are to change, we need to address the systemic and structural challenges that are hampering efforts to deliver father-inclusive services. We also cannot ignore the ‘elephant in the room’ – we need more health visitors – we have a national shortage of around 5,000 health visitors and this results in less time being available to provide families with the support they need, and families are facing the brunt of this with a postcode lottery of support.

“This report provides clear evidence that this needs to change and that investing in father-inclusive care and early help makes sound economic sense. At the iHV we have great examples of where health visiting services have developed father-inclusive services, we have also trained health visitor ‘Father Champions’, but more needs to be done. We agree with the report’s authors that ‘father-inclusive care’ should be the norm and not the exception.”

The report’s authors make four key recommendations for how services could be improved:

  1. Fathers’ names, contact details and NHS numbers should be entered onto NHS birth notifications so that fathers can be contacted directly by services. As is the case for mothers, the father’s NHS number would link to his medical record for use by practitioners and for research purposes, within a framework of data protection law and ethical guidelines.
  2. All tax-funded services and interventions for families in the perinatal period – including those commissioned by central government (e.g. the Reducing Parental Conflict programme and Family Hubs) should be commissioned, designed, delivered, promoted and evaluated in ways that recognise fathers’ own need for support (whether or not they share a household with the child’s mother) and their impact on children and mothers. Practitioners should use evidence-based strategies to achieve high levels of father-inclusion, and should follow (and where relevant be inspected against) key guidance. The Fatherhood Institute is working with the Royal College of Midwives to produce a father-engagement toolkit, to be published in October 2022.
  3. The government should fund, pilot and evaluate a scalable, locality-wide approach to embedding father-inclusive practice across a whole network of perinatal services in a number of local areas.
  4. Given the unavailability of parental leave to the vast majority of UK fathers, and the huge significance of fathers’ participation in solo parental care in baby’s first year for later care patterns, the government should pilot new approaches to leave taking, focused on different groups of working fathers, including those who are employed, self-employed and working in the ‘gig economy’. Ways in which employers do or could support fathers should be included in the pilot.

Adrienne Burgess, Head of Research at the Fatherhood Institute, who co-authored the report, said:

“We ourselves were stunned, when we pulled this research together, to discover the extent to which infant and child outcomes (and outcomes for mothers, too) are impacted by fathers’ behaviour and characteristics in the first few months after the birth. It is also deeply disappointing to discover that no systematic support is offered to new fathers by NHS providers – no recognition of their role, or even, sometimes, their existence.”

At the Institute of Health Visiting, we are keen to be part of the solution – we have been working with the EU PATH Partnership and Dad Matters UK to produce a suite of new resources for healthcare professionals on father-inclusive services.

Look out for our blog on ‘All things Dad’ on Friday 17 June which launches these resources and sets out the work that we are leading to support ‘father-inclusive’ services.

 

 

 

 

 

 

The long-awaited Independent Review of Children’s Social Care, led by Josh MacAlister, was published this morning. The review aimed to identify the challenges facing children’s social care in England and ways to ensure that children grow up in loving, stable, safe families and, where that is not possible, care provides the same foundations.

In his opening remarks, the review chair states,

The time is now gone for half measures, quick fixes or grandstanding. Changing the easiest bits, papering over the cracks, or only making the right noises, may in fact make matters worse. It will create the illusion of change but without the substance. It will dash hopes and fail another generation.”

The Review consulted closely with thousands of care-experienced children, young people and adults, and the practitioners who work with them, and formed an Experts by Experience Board to support all stages of the process and shape the recommendations. Alongside numerous organisations working with children, the Institute of Health Visiting submitted written evidence to the review’s consultation in March 2021 and participated in the Child Safeguarding Practice Review Panel’s National Review to examine the circumstances leading up to the tragic deaths of Arthur Labinjo-Hughes and Star Hobson.

The review highlights numerous challenges in the current system including difficulties with multi-agency working, unnecessary barriers to sharing information about children, and a ‘broken care market’. The review also acknowledges that children’s social care can only function effectively when the wider system and welfare state is working well to support children – the report cites the work of the Institute of Health Visiting highlighting the knock-on impacts of recent cuts in health visiting, stating:

“Children’s social care picks up the needs of families which universal and other services cannot address. Therefore, getting the right support for families through universal services and, wherever possible, addressing issues before they escalate is critical”.

The review concludes that our current approach to children’s social care is not working, with record numbers of looked after children and a system skewed towards helping families only when they reach crisis point and children have already been harmed. In recent years, the system has been further strained as more families are struggling due to the impacts of the pandemic and the cost of living crisis has tipped more families with children into vulnerability. As health visitors, we are well aware that babies and young children are a particularly vulnerable group as they are less visible to other services, leaving many with unidentified and unmet needs.

The review provides a stark warning that,

“Without a dramatic whole system reset, outcomes for children and families will remain stubbornly poor and, by this time next decade, there will be approaching 100,000 children in care (up from 80,000 today) and a flawed system will cost over £15 billion per year (up from £10 billion now). Together, the changes we recommend will shift these trends and would mean 30,000 more children living safely and thriving with their families by 2032 compared to the current trajectory.”

The Institute of Health Visiting joins with other charities working with children responding to today’s report and calling for change.

Alison Morton, iHV Executive Director says,

“Today’s report is a wake-up call for our nation – too many vulnerable children are being let down as services often intervene with too little, too late. We cannot continue to ignore the voices of so many children and young people that have been captured in this report – sadly what they have told us has been known for far too long. And as health visitors, we will also continue to advocate for babies and young children whose needs are so often overlooked. Urgent action and investment is now needed to address the underlying root causes and fix a struggling system. We hope that policymakers will seize this opportunity and build a future where every child feels safe, secure, seen and supported”. 

#StepUpForChildren

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

 

 

 

 

 

 

Today, the First 1001 Days Movement has released a new report: “Why Health Visitors Matter: perspectives on a widely valued service”. This report is a compilation of short testimonies about why health visitors are important in ensuring that all babies and children are safe, healthy, and able to thrive. The testimonies showcase the vital role of health visitors, demonstrating the breadth and depth of their work.

The First 1001 Days Movement is a campaigning alliance of over 200 organisations who work together to promote the importance of sensitive and nurturing relationships for babies and young children’s emotional wellbeing and optimal development. The iHV is privileged to be a member of the First 1001 Days Movement steering group and we are indebted to all the members of this alliance who have joined together to call on the Government for investment in health visiting. This forms part of the Movement’s wider ambitions to drive change by inspiring, supporting, and challenging national and local decision makers to value and invest in the first 1001 days.

Key messages from the report:

  • Health visitors have the potential to do so much for our babies, our families, and our public services.
    The first 1001 days is a period of opportunity and vulnerability. Support for our babies, children and families is needed now, more than ever. Health visitors support children’s development and help to keep them safe. They are skilled Specialist Community Public Health Nurses able to engage and build relationships with families, understand their health and care needs, offer support and intervention, and broker engagement with other services.
  • Current resourcing decisions mean that many health visitors cannot effectively do the important work they were trained to do.
    Since 2015, when responsibility for health visiting was transferred to local authorities, it is estimated that at least 30% of the health visiting workforce has been lost, with further losses forecast. The Public Health Grant has fallen in real terms from £3.99 billion in 2015–16 to £3.3 billion in 2022-23, this is at a time when need has increased.

Currently, the health visiting metrics include phone and virtual appointments as “reviews”; and the latest quarterly data shows that 18.6% of babies missed out on their 9-12-month review and 27.7% of toddlers missed out on their 2-2.5-year-old review. More children are also falling behind with their development, yet fewer are engaging with services such as early education and childcare.

There is wide and unwarranted variation in health visiting support between different local authority areas. Urgent national and local action is needed to ensure that all babies and young children receive services that they need and meet national guidelines.

Alison Morton, Executive Director, iHV said:

“We welcome this report which is published at a critical time in our country’s journey through the pandemic and its wake. It lays bare the problems and far-reaching impacts of years of under-investment in health visiting on babies, young children and their families. The report is also focused on finding solutions – it presents a series of testimonies from those who have first-hand experience of the breadth and depth of the health visiting service and the difference that it can make when sufficiently resourced.

“The report is a call to action – babies can’t wait. Will we be satisfied to accept the picture that is being painted of ‘ghost children’ being let down by ‘ghost services’ that have been stripped bare and left ill equipped to manage the level of unmet need? We have a real opportunity to make a difference before it is too late – we join with members of the movement and call for concerted action from national and local government, united by a shared vision to do better for babies.

“We thank all the report contributors who generously gave their time in sharing their experiences and testimonies to bring to life the real and solid difference that health visiting can make for babies, children, families, and our future society.”

The report has 4 policy calls:

  • Local authorities must commission and fund health visiting services that are able to offer a high-quality service to all those who need them in line with the Healthy Child Programme.
  • The UK Government must properly resource local authorities to enable them to provide health visiting services at al level that delivers everything that government and NICE guidance expects of them, and that families need.
  • The UK Government must do more to encourage local authorities to invest in health visiting services and to hold them to account when services are not meeting national guidelines.
  • The UK Government must also address shortages in the health visiting workforce: it is time for a demand-driven, well-resourced national workforce strategy and plan.

How can you help?

The First 1001 Days Movement needs your help to make the case for better services for our babies, children, and their families.

You can help by:

  • Sharing the report, and your perspectives on why health visitors matter, with local decision makers and politicians, with your networks, and on social media. You can use the hashtag #HealthVisitorsMatter, share the link to the report and tag: @first1001days @sajidjavid and @iHealthVisiting
  • Writing to your MP and asking them to attend the NSPCC’s parliamentary event on 16 May (details here)
  • Writing to the Health Secretary, Sajid Javid, about their concerns.

 

 

 

 

 

Today, the Government published the second set of four reports in a series looking at the pandemic’s continued impact on education recovery and how schools, prisons, early years providers and further education and skills providers are responding to the impact of the COVID-19 pandemic.

TheEducation recovery in early years providers: spring 2022 report draws on inspection evidence gathered in the spring 2022 term and discussions with early years inspectors about the ongoing implications of the pandemic on children.

The pandemic has continued to affect young children’s communication and language development, with many providers noticing delays in speech and language. Others said babies have struggled to respond to basic facial expressions, which may be due to reduced social interaction during the pandemic.

The negative impact on children’s personal, social and emotional development has also continued, with many lacking confidence in group activities.

Children’s social and friendship-building skills have been affected. Some providers reported that toddlers and pre-schoolers needed more support with sharing and turn-taking. To address this, staff were providing as many opportunities as possible for children to mix with others and build confidence in social situations.

There continues to be an impact on children’s physical development, including delays in babies learning to crawl and walk. Some providers reported that children had regressed in their independence and self-care skills. As a result, several have increased the amount of time that children spend on physical activities, to develop gross motor skills.

An increasing number of providers were concerned that, compared with before the pandemic, fewer children have learned to use the toilet independently. This means that more children may not be ready for school by age 4. Providers were also concerned about obesity and dental health, so have focused on providing well-balanced meals and increased time for physical activity.

Alison Morton, iHV Executive Director said:

“Today’s report lays bare the far-reaching and largely overlooked impacts of the pandemic on babies, young children and their families. It is vital that this is taken seriously by policy makers with a COVID recovery plan and investment to address growing levels of need and vulnerability.

“We have a longstanding problem in this country with invisible vulnerable children who are not getting the support that they need, and the pandemic has made this situation worse. Therefore, it is vital that any enhanced package of support for ‘Covid recovery’ also includes investment in the universal safety net for our youngest citizens provided by the health visiting service.

“Babies, young children and families need joined up support – to achieve this we need more health visitors who are uniquely placed to reach all families, ideally preventing problems happening in the first place, but also who have a crucial role in identifying babies and young children with developmental delay and unrecognised disabilities that need early intervention and targeted support to achieve their full potential. I hope that this report will provide further impetus for much needed investment to turn the Best Start for Life Vision into a reality.”

Find details of the series of Ofsted reports here: https://www.gov.uk/government/collections/ofsted-education-recovery-series

 

 

Every baby, every child, happy, healthy, safe and valued
and every parent feeling supported and able to achieve this

The core mission at the iHV is to improve the lives of all infants and their families through leading excellence in practice and reducing health inequalities. To help achieve this the Institute has always had a strong focus on perinatal and infant mental health (PIMH). We really do believe that there is “No Health without Mental Health” and that a healthy parent and a healthy parent-infant relationship is the foundation for good mental health across the life-course and, in turn, a healthy society.

 

That said, family mental health and wellbeing is complex and, whilst individuals, different professions and services can and do make a huge difference, we know that by joining the junctions and pulling together we can achieve so much more.

 

Certainly, the successes of the iHV Mental Health Department across 2021 have only been possible through working well with each other and our wider partners and so, on a day that has become known for celebrating relationships, we are delighted to share the iHV Mental Health Department Report 2021/2022.

Alison Morton, Executive Director iHV, said:

“I am delighted to see today’s report published which sets out the phenomenal achievements of the iHV’s Mental Health team in the last 12 months. Supporting better perinatal and infant mental health (PIMH) is a priority for the Institute and for the nation – we are privileged to have such a highly skilled team leading this work. Congratulations to each member of the iHV PIMH team for their achievements and Melita Walker for her inspiring leadership.

“I hope that you will enjoy reading today’s report which showcases the numerous award-winning and innovative PIMH programmes that are being delivered across the UK by the iHV, and in partnership with others, to support practitioners in their work with families and better mental health across the lifecourse.”

Melita Walker, Head of Mental Health iHV, commented:

“I would like to thank the amazing team at the iHV and all our parent, professional and wider system partners. We could not have achieved the successes we have without their fantastic efforts and support. By collaborating and finding ways of keeping connected, even while working remotely, we have enjoyed discovering new talents and perspectives, been able to tackle new projects, opened up possibilities for new solutions and better results, and strengthened the opportunities to enable good family mental health and wellbeing.”

Roses are red
Violets are blue
Happy reading – and THANK YOU
For all that you do
#ValentinesDay

iHV welcomes new Maternal Mental Health Alliance (MMHA) economic research report which shows that health visiting has a clinically effective and cost-effective role in perinatal mental health care: The economic case for increasing access to treatment for women with common mental health problems during the perinatal period.

 

  • Independent research commissioned by the Maternal Mental Health Alliance (MMHA), conducted by the London School of Economics and Political Science (LSE), estimates the costs and benefits of addressing unmet maternal mental health needs.
  • The report presents the clear economic benefits from training midwives and health visitors in perinatal mental health and enabling their work with pregnant and postnatal women.
  • Changes to standard practice could have a net economic benefit of £490 million over ten years; £52 million in NHS savings and quality of life improvements worth £437 million
  • Universal services such as health visiting and midwifery have a clinically effective and cost-effective role in perinatal mental health care, identifying women in need or at risk, and facilitating access to or providing treatment as part of their routine work with women during and after pregnancy.
  • The report recommends scaling-up integrated provision across the UK as both desirable and viable from an economic perspective.

In a new study commissioned by the MMHA, researchers from LSE evaluated the economic viability of reforming current treatment for pregnant and postnatal women experiencing common maternal mental health problems such as depression and anxiety.

The report, ‘The economic case for increasing access to treatment for women with common mental health problems during the perinatal period’, estimates the costs and benefits of a model of care which could give women’s mental health the same priority as their physical health. The model, which focuses on the essential role of midwives and health visitors, would allow for women’s mental wellbeing to be accurately assessed at every routine contact and suitable treatments to be offered.

The proposed ‘integrated model of care’ would include dedicated maternal mental health training for health visitors and midwives as well as greater collaboration with other healthcare services.

In the report, resources needed to set up and provide this model of care – namely employment and training costs – are measured against their economic return. Researchers conclude that it could lead to cost savings of £52 million for the NHS over 10 years, and improvements in women’s quality of life estimated at £437 million. In total, this is a net benefit of £490 million over 10 years.

Policy analysis by MMHA member, Centre for Mental Health, determines that equitable integrated service provision is the logical and economical next step in the evolution of perinatal mental health care in the UK. It would close a major gap and ensure women get timely access to help for their mental health needs.

Alison Morton, Executive Director iHV, said:

“Even before COVID-19, there were many system challenges to ensuring that all families had access to the right care and treatment, at the right time, for their mental health and wellbeing. Against a backdrop of rising levels of unmet need, we now need to do better. I am therefore delighted to see this robust and long-awaited research published today – it  presents a sound economic case for health visiting, as an  evidence-based solution to some of these challenges, with a fully costed model of care which demonstrates significant savings alongside improving the lives of families experiencing perinatal mental health problems.

“This report is a significant resource for policy makers looking to deliver the Government’s Start for Life commitment to improve parents’ access to perinatal mental health support and give every child  the best start in life. With such clear evidence, it is vital that the Government acts now to strengthen the health visiting service in England as part of an effective integrated system of perinatal mental health support for families.”

Melita Walker, Head of Mental Health iHV, added:

“Mental health problems in the perinatal period are common and as all families have a health visitor, they are ideally placed to offer skilled, professional support quickly when it’s needed. However, current shortages of health visitors make that difficult, and many families are missing out on effective early help for common mental health problems.

“This new report demonstrates that health visiting has a clinically effective and cost-effective role in perinatal mental health care, identifying families at risk of or suffering from mental health problems and facilitating access to, or providing, effective evidence-based treatments as part of their routine work with women and their families during the perinatal period.

“Ensuring all health visitors have the training and time to meet women’s mental health needs is a sound investment that would make a difference to many thousands of women and their families. Furthermore, this timely new economic evidence strengthens the findings and recommendations highlighted in the latest research by Professor Jane Barlow, on the unique leadership role of Specialist Health Visitor in Perinatal and Infant Mental Health in supporting effective integrated PIMH services.”

If we are serious about using sound evidence to make the biggest difference, then going forward we need to:

  1. Build back our health visitor numbers
  2. Ensure all health visitors have appropriate capacity and high-quality training in family mental health
  3. Have a Specialist PIMH Health Visitor supporting families in every Local Authority in England, every Health Board in Wales and Scotland and every Health and Social Care Trust in Northern Ireland.

 

Oxford University study recommends commissioning of Specialist Health Visitors in Perinatal and Infant Mental Health throughout UK to tackle growing social cost issue

Oxford University has published research examining the training and qualifications of Specialist Health Visitors in Perinatal and Infant Mental Health (Sp HV PIMH), and their role in supporting health visitors and families at risk of /or experiencing mental health problems during the perinatal period.

 

The report recommends that Sp HV PIMH should be commissioned throughout the UK to tackle this issue, which has an extremely high social and financial cost. Currently, Sp HV PIMH constitute just 0.8% of the health visiting workforce (in England). The Oxford research found that in some areas Sp HV PIMH posts had never been funded, and in other areas the funding had been discontinued or cut – these were cited as the biggest barriers to the promotion of perinatal and infant mental health.

Perinatal mental health issues can have a devastating impact on women and their families, and results in a financial cost of £8.1 billion for each one-year cohort of births in the UK, with 72% of this cost relating to adverse impacts on the child. As such, maternal and family mental health has been designated as one of six high-impact areas for the health visiting workforce.

Abigail Reynolds, a mum with lived experience, shared:

“I was diagnosed with severe Anorexia Nervosa in early 2019, when I was seven months pregnant with my second child. The past three years have been unimaginably challenging, but my health visitor​s support throughout my illness and recovery has enabled me to rebuild my life, to learn how to care for myself as well as my children – and to believe I am worthy of that care – and to gain the confidence to begin using my personal experience to help educate and support others in both the eating disorders and perinatal mental health areas.

“Health visitors are so well placed ​within the community, and have a unique opportunity to build trusting relationships with the whole family to support family mental health​ – they are a vital part of the system.”

The study surveyed 41 Sp HV PIMH and 3 Perinatal and Infant Mental Health Champions, who described their casework as focusing on areas such as parental antenatal depression, antenatal anxiety, general anxiety, birth trauma, postnatal depression and panic attacks, using a range of interventions including listening visits and motivational interviewing amongst others.

Survey respondents reported current barriers to the promotion of PIMH as being a lack of funding (82.3%) and a lack of understanding among commissioners about PIMH (64.7%) and the role of HVs in PIMH (73.5%) – with the discontinuity in funding that has occurred over recent years being perceived to have led to a constant need to reinvent the wheel.

Melita Walker, Head of Mental Health at the Institute of Health Visiting, said:

“We welcome this timely report which clearly sets out the important role of Specialist PIMH Health Visitors. Health visitors have a key role in supporting good family mental health. However, even before the Covid-19 pandemic, there were many system challenges to ensuring that all families had access to the right care at the right time. So this year, more than ever, the time has been absolutely right to have a focus on leadership – the role of the  Specialist Health Visitor in Perinatal and Infant Mental Health and how a well-resourced health visiting service, as part of the PIMH system, can maximise the opportunity for good family mental health and wellbeing.

“The timing of this report fits very well with priorities for family mental health and the Government’s recent commitment for PIMH in the last budget. Its recommendations echo what national think tanks, such as the Maternal Mental Health Alliance and the First 1001 Days Movement, are campaigning for and provides policy makers and commissioners with sound evidence to improve family mental health through an effective health visiting service.”

iHV responds to the House of Lords’ Public Services Select Committee report published today into how public services support children and families – Children in crisis: the role of public services in overcoming child vulnerability.

Baroness Armstrong of Hill, Chair of the Select Committee, reports:

“We found a crisis in child vulnerability. Over a million children are now growing up with reduced life chances, too many ending up in care, too many with poor health outcomes… The crisis has grown worse during the pandemic, but it’s been building for many years, partly due to large cuts in early intervention funding.”

This important report is a stark reminder that underinvestment has created worse outcomes for children and higher costs for the taxpayer, as children slip through the gaps between services and do not get the support they need. The report includes clear recommendations for a national strategy for child vulnerability, and also recommends that ‘health visiting’ should be key partners in delivering Family Hub provision.

Responding to the report, Alison Morton, iHV Executive Director, said:

“Today’s hard hitting ‘Children in Crisis’ report lays bare the preventable suffering and misery that has been caused to our nation’s children whose needs have been largely overlooked.

“Cuts have consequences and the poorest children have been hit the hardest. It is time for the Government to prioritise children in their plans to ‘Build Back Better’, particularly babies and young children who have been overlooked the most.

“We call on the Government to make good their pledge to ‘rebuild health visiting’. Health visitors provide a vital infrastructure of support for all families, and a crucial safety-net, identifying vulnerable babies and young children.

“The Government say that they will maintain the Public Health Grant, but this is being maintained at a level that is too low to fund the number of health visitors needed to support all families and identify vulnerable babies and young children. Following years of cuts since 2015, there is now a national shortage of 5,000 health visitors in England and the profession faces its biggest workforce challenge in living memory. As a result, despite health visitors’ best efforts, the service is now so stretched that many families are not getting the support they need, and vulnerable babies and young children are being let down.

“Investment in health visiting is needed to provide the prevention and early intervention support to stop this growing tsunami of children in crisis. This cannot wait any longer – our nation’s children deserve better.”