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Deprivation and child protection set to be factor in deciding NHS health visitor levels

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Deprivation and child protection factors could be used instead of just caseloads to calculate the number of NHS health visitors needed, according to Viv Bennett, deputy chief nursing officer for England

New models to calculate NHS health visiting numbers are being drawn up by strategic health authorities, she said.

This was in response to criticisms from delegates at the Unite/CPHVA conference last week in Harrogate that numbers of health visitors were dangerously low.

Speaking to Nursing Times, Ms Bennett said: ‘The Department of Health is working with the SHAs to develop some information models where you can test out what kind of public health community workforce you might need.’

She asked: ‘In the future, are caseloads going to be the most sensible way to decide the workload of health visitors?

‘What you might need to look at is a weighted population measure, where you add in factors for the area’s deprivation or child protection, for example,’ Ms Bennett added.

Child protection issues

The recommendation comes after the high profile ‘Baby P’ case and ahead of the children’s workforce strategy, now being drawn up by the Department for Children, Schools and Families.

This is looking at health visitor numbers and is scheduled to be published by the end of the year.
Cheryll Adams, Unite/CPHVA lead professional officer for strategy and practice, said there needed to be a dramatic cut in caseloads if the government was serious about its commitment to child protection.

‘We’re not saying every health visitor should have a caseload of 250 – we’re saying that the average number of children should probably be 250, maximum 400,’ she said.

‘Caseloads should have always been weighted but, because of cutbacks, we have seen caseloads grow and grow.

‘To get health gains there has to be an optimum size caseload because, if they stay at the size they are currently at, issues will be missed and you are not going to be meeting the needs you are aspiring to.’

Latest survey results, published by the union in September, suggest caseloads of more than 500 children are commonplace for 40% of health visitors. The survey of 829 health visitors in England found 70% were unable to meet the needs of the most vulnerable children.

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Readers' comments (1)

  • Denise Hine

    what about school nurses? i was a school nurse up until 3 years ago with a reletivly small caseload but large child protection and looked after caseload. most of my time was spent involved with the conferences and meetings for these vulnerable children. i was still expected to at least complete the core program for the rest of my caseload.

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