As part of our 10 years of children's public health in local government interviews, Alison Morton, Chief Executive Officer for the Institute of Health Visiting and frontline health visitor Rebecca Price discuss how innovation is offering hope in what has been and remains a challenging period for the profession.
Rebecca Price has worked as a health visitor in Hull for 25 years – so is perfectly placed to comment on the impact of the move to local government. “I’ve seen the good, bad and ugly in health visiting, but in the last 10 years we’ve definitely seen the most improvements,” she said. “Since moving over we have seen increased investment in capacity and a renewed focus on growing our own workforce.”
Ms Price, who is the Health Visitor Service Lead at Humber Teaching NHS Foundation Trust, said:
“We’ve a really supportive commissioner in the council and have developed good relationships with other NHS and local government services. Over the last 10 years there have been challenges, not least the Covid pandemic, but prioritising the training and upskilling of our health visitors has allowed us to retain our workforce.”
‘Momentum is gathering’
As well as increasing the number of health visitors – there are now nearly 50 full-time equivalents, a rise of 12 since 2022 – specialist health visitor posts have also been created. There are three currently covering infant feeding, perinatal mental health and special education needs. These health visitors work directly with families referred to them by the rest of the team as well as providing support and training to other health visitors.
Ms Price said: “They are invaluable. In the case of infant feeding, they can be deployed within 24 or 48 hours of a referral and are helping to make a real difference. For example, breast-feeding rates have nearly reached 50 per cent – up from under 7 per cent 15 years ago. That is a fantastic achievement for a city that is the fourth most deprived in the country and secured us UNICEF gold accreditation last year.
“We want to be there for our families – they are facing huge challenges and we will be supporting some of them for many years as their families grow. There’s been the pandemic and cost of living crisis and we are seeing growing numbers accessing food banks. We know it’s difficult.
“We’re also starting to develop good relationships with other services – we have provided training to staff in the family hubs and voluntary sector organisations working with young families. We want to ensure the messaging is evidence-based and consistent and others know about what the health visiting service has to offer families.
“And we are working hard to encourage families to take up their offer of the healthy child programme and understand the vital contribution to early years. We are going to schools and sixth forms to promote careers in health visiting and are beginning to grow our own workforce with healthcare assistants taking nurse degree apprenticeships and our nursing associates doing the training to become registered nurses. It really seems to be gathering momentum.”
‘The best start in life’
Institute of Health Visiting Chief Executive Officer Alison Morton agrees. “Hull is a great example of what can be achieved when you have strong leadership and commissioners who believe and back their health visitors. Hull is storming ahead and leading the way into excellence. There are plenty of other great examples elsewhere too.
“But the problem is that it’s not universal. In some areas services are stripped to the bone – and are struggling to do much more than safeguarding. Our recent survey of health visitors showed that. We know budgets are tight, but health visiting is exactly the sort of service we should be investing in right now if we want to improve the nation’s health.
“Families are facing increasingly complex health and developmental challenges, yet the support they need is becoming harder to access. There are massive differences in the availability of health visitor services across the country, creating a postcode lottery that leaves many families without essential early support that can make such a big difference.
“And health visitors are under immense pressure, with unmanageable workloads, enormous caseloads and a longstanding workforce crisis that is threatening the sustainability of services.
“But there is hope. We know the Government is looking at three key themes for the future of the NHS – from hospital to the community, from treatment to prevention and from analogue to digital. Health visitors are perfectly placed to be at the forefront of that working alongside partners in local government and the NHS.
“Prevention is the bread and butter of what we do. With the right investment we could make a real difference to the families we work with and help the NHS save money. What we need in the future is the ability to do more and really make the most of our public health skills - to do more drop-in clinics, for example, in places where it is easy for families to access such as supermarkets and libraries.
“There are plenty of families who are good at navigating their way through the system now, making sure they get appointments. But they are not always the ones most in need. Invest in health visiting and we can ensure every baby has the best start in life. We remain optimistic for the future.”
Please note this is an independent article. The content and views reflected within are those of the named contributor and not necessarily those of the LGA.
