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Birmingham trust issued warning notice over health visiting service 'meltdown'

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An NHS trust has been told to take urgent action to reduce risks to children and families, amid reports of its health visiting service being in “meltdown”.

Birmingham Community Healthcare NHS Trust has been issued with a warning notice by the Care Quality Commission (CQC) following a recent inspection.

“We recognise our health visiting teams are facing big pressures”

Linda Lockwood

The notice is not yet in the public domain but has been seen by the union Unite, which has 600 members working at the trust.

Unite claims the CQC found that the average health visitor caseload per whole time equivalent post was about 500 families – double the figure recommended for safe practice by the union’s Community Practitioners’ and Health Visitors’ Association.

It said the trust had been warned by the watchdog to make “significant improvements” in the quality of healthcare by March next year.

Unite regional officer Su Lowe said: “The health visiting service in Birmingham is in meltdown, with health visitors leaving and not being replaced. This deteriorating situation impacts negatively on the services they can provide to families and young children.

“The health visiting service in Birmingham is in meltdown, with health visitors leaving and not being replaced”

Su Lowe

She said: “We are into unsafe practice territory where serious issues, such as postnatal depression and domestic abuse, could be missed because of the current lack of resources.

“Staff morale is at breaking point; the trust has failed to follow the clear guidelines on caseloads; and there appears to be a complete lack of governance,” she said. “Our members feel that when they raise concerns they are ignored and the issue brushed under the carpet.”

Ms Lowe said the union was trying to secure “urgent talks” with the trust about the recovery plan but managers had disappeared in a “veil of secrecy” since the notice was issued.

The trust’s acting director of nursing, Linda Lockwood, confirmed it had received a warning notice and that work was being done to address concerns.

She said: “We recognise our health visiting teams are facing big pressures, agree with the CQC findings and fully accept the recommendations of the warning notice.

“We have already taken actions to better support colleagues in delivering community services for children and families and implement an extensive programme of improvement within the timescales agreed.

“For example, average caseloads for health visitors have started to reduce recently, although not yet to the level we are aiming for while we continue to recruit to health visiting vacancies; and we have increased the number of health visiting antenatal contacts in direct response to the CQC’s recommendation about reducing risk to children and families.”

Ms Lockwood said the trust had been “open” with its health visitors about the warning notice and had held frequent meetings with them to understand the pressures they were under.

She added the trust would welcome the opportunity to meet representatives from Unite to outline the actions it was taking in response to issues identified by the CQC.

A spokesman the CQC confirmed inspectors had assessed the trust in May but said he was not able to comment on the findings until the report was published.

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