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Fresh call for government action after Suffolk health visiting plans

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Health visiting leaders have made fresh calls for the government to take recognise the value and advanced specialist nature of the health visitor role, nationally, in the wake of leaked Suffolk County Council documents that revealed plans to slash the workforce by 25%.

A position statement issued today by the Institute of Health Visiting raises concerns about the “quality and effectiveness” of the service that families in Suffolk will receive if plans go ahead.

As reported on Tuesday, leaked documents seen by the Observer newspaper, exposed proposals to cut as many as 31 full time health visiting posts in Suffolk by September.

It was also reported that the council wants to dilute the role of health visitors, so they no longer carry out three of the five checks of mother-and-baby health. Under the plans, health visitors would focus on the most vulnerable families and nurses would instead undertake the three checks, the newspaper stated.

According to the documents, the proposed cuts will save the council £1m from its health visiting, school nursing and family nurse partnership services.

In response, the Institute of Health Visiting has said it has “very serious concerns” over what service families in the area will now receive, with national implications for policies affecting other parts of England.

In its position statement on the importance of health visitors, the institute said: “This is a skilled role backed by many years of training, where the practitioner carefully balances assessment and action to match the needs of the child without compromising ongoing engagement of the family on which the child relies.

“To the outsider, and clearly to some councils, it looks simple and something that can be picked up by any alternative grade of staff,” it said (see attached PDF below). “However, in the absence of specific role preparation and experience, this will be at a cost to achieving children’s outcomes.”

The institute goes on to give six key recommendations and actions for the government to help tackle the problems faced by the service.

It recommends a “radical shift in government policy to provide sustainable funding for prevention and early intervention services for children in England”.

It also wants to see all government departments, which accrue the benefits of an effect health visiting service, to “collectively commit to support immediate investment back into public health with pooled ring-fenced budgets for high quality health visiting services with protection into the future”.

Crucially, one of the institute’s recommendations calls for the recognition of the advanced specialist nature of the health visiting role.

It calls for “recognition of the advanced specialist nature of the health visitor’s role returning autonomy to work in partnership with families and others to meet the needs of all families in line with the requirements of the healthy child programme and removing the current ‘tick box’ approach currently being imposed on them”.

Other recommendations include increased training budgets for student health visitors and for the re-establishment of closer ties with other NHS services.

In addition, it has also called for “new national quality assurance requirements for commissioners of health visiting services to be benchmarked against” and noted that “sufficient incentives and levers” are needed to end the current variation in the health visiting provision.

Meanwhile, the institute stated that the planned national review of the healthy child programme should “include a review of the resources needed to secure national implementation in full, in all local authorities” to help ensure that a high-quality health visiting service is delivered to children and families.

Commenting on the statement, chief executive and general secretary of the Royal College of Midwives, Gill Walton, said: “The threat to health visitor numbers is further evidence of the government’s wrong-headed thinking.

“We need more health visitors, not less,” she said. “They are already suffering a serious shortage as is the midwifery workforce in England.”

“This shortage and lack of ready access to health visiting services will almost certainly affect the quality of care given to women and new families,” she said.

Ms Walton warned the shortages of health visitors would also have an “adverse” impact on the midwifery workforce.

“Either by design or necessity midwives will pick up this work,” she said. “They are already overstretched and unable to give every woman the time they need.”

She added: “In order to ensure that there is proper oversight of health visitor recruitment and to encourage joined-up workforce planning across the maternity and early years workforce, it is imperative that responsibility for the health visitor workforce is returned to the NHS and that adequate funding is made available to tackle the shortages of midwives and health visitors.”

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