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Parents reporting a steep decline in health visitors discussing immunisations

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Significantly fewer parents of young children in England are reporting that health visitors are discussing immunisations with them compared with six years ago, reflecting an ongoing decline over the past two decades, official data has shown.

Figures produced for Public Health England show that in 2000, 61% of parents with children aged 0 to 2 years said their health visitors had spoken with them about child vaccinations.

However, by 2010 this had reduced to 52%, before a steep drop-off to 33% in 2015, and 34% by March 2016.

“The new birth visits are so jam-packed there is a lot to cover”

Health visitor

Meanwhile, over a similar period the number of parents with young children saying they had spoken with their practice nurse about immunisations increased, as did conversations with GPs.

From 2001 to 2016, discussions with practice nurses increased from 14% to 35%, while the proportion of parents reporting GP conversations about vaccinations went up from 23% to 41%.

Health visitors suggested they had less opportunity to speak with parents about immunisations now and that they also had more constraints on their time, due to the amount they had to cover when they carried out checks.

PHE said the decline in health visitors having these conversations and the increase by primary care staff was likely to reflect the shift towards general practices now being the main provider of immunisation services to young children.

At Unite’s Community Practitioners and Health Visitors Association conference last week, where the data was presented, one health visitor said: “[This is due to] less contact with mothers and parents.

“We used to see [parents] more regularly - now they have been passed to other professionals”

Health visitor

“It’s all about commissioning and the number of follow-up visits you can do with parents. We used to see them more regularly – now they have been passed to other professionals,” they said.

Another health visitor suggested that because an additional antenatal visit had been introduced, this meant one of the postnatal visits had been dropped by some services.

“The new birth visits are so jam-packed there is a lot to cover…It may even be that for some parents it is mentioned but they are not recalling it [vaccination information], because they are being bombarded with everything else in between,” she said.

“The amount of screening that we have to do, the amount of information [we have to provide] may mean we defer to the red book or the website for NHS Choices. But for the detail, it’s about which one takes priority,” said another health visitor.

“I’m sure everybody mentions immunisations…but I imagine it’s the depth [of information] because of all the other things, that is causing this decline,” she added.

“It is more likely that parents will recall either their GP or general practice nurse discussing immunisations”

Public Health England

But PHE nurse consultant for vaccinations, David Green, told Nursing Times that the simultaneous reduction in conversations about immunisations among health visitors and increase among primary care staff was probably due to the change in focus on general practices providing vaccinations.

However, he stressed that health visitors, along with GPs and practice nurses, had a “crucial” role in supporting families and ensuring children have the best start in life.

“Today, general practices are the main provider of immunisation services to infants and pre-school children in England and, therefore, it is more likely that parents will recall either their GP or general practice nurse discussing the importance of immunisations with them,” he said.

“We know health visitors, through their contacts with families, are well placed to advise parents on health and wellbeing issues, including immunisations. This includes signposting to others including GPs,” said Mr Green.

He stressed that the data from the annual survey of around 1,000 parents was unpublished and unverified, which meant it was subject to change. 

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