Health visitors have seen their relationships with general practitioners “destroyed” in recent years, as they have increasingly become based in children’s centres instead of working with local practices, nurses have warned.
Community practitioners said the move, which coincided with “corporate working” – in which health visitors share geographical caseloads instead of being attached to a specific GP list – meant safeguarding issues were not being picked up quickly enough.
Nurses at Unite’s annual Community Practitioner and Health Visitors Association in Manchester warned meetings with doctors were difficult to arrange due to working patterns, especially for part time staff.
“I work part time…I can’t remember the last time I had a face to face chat with a GP. We leave messages for each other”
One health visitor said in her area safeguarding meetings were attended by just one nurse who passed on updates from the team to the GP, which risked information being lost or misinterpreted.
Leading a session on the issue, former health visitor and Oxford Brookes phD student Suzanne Watts said recent research on referrals that she had conducted with GPs and health visitors in three regions of England had revealed their “fragmented” relationship.
Ms Watts said they felt they had lost “corridor conversations” with the other professional, which had previously helped them get to know families that still required support but did not qualify for social services interventions.
One doctor told her that the breakdown of communication had recently left him unaware of a safeguarding issue with a child that had been alerted to the health visitor by the school nurse, but had not been passed on to him.
Ms Watts noted the government’s push for health visitors to share caseloads geographically had in part been driven by a shortage of practitioners, and that the strategy had not been evaluated.
“There is no evidence for this – that moving health visitors out of GP practices or out of health centres into children’s services – is an effective way of delivering the service or is of benefit to families,” said Ms Watts.
One nurse from Scarborough attending the session said corporate working had “completely destroyed” the relationships with GPs in her area.
“I work part time…I can’t remember the last time I had a face to face chat with a GP. We leave messages for each other,” she said.
Another said her health visiting team found it “really hard” to keep up relationships with GPs, while another said she was “not convinced” about using corporate working for safeguarding and found the strategy to be a “difficult” structure for frontline workers.
A UK study looking at the problems with relationships between health visitors and GPs and identifying good models of practice will be led by Ms Watts over the coming months.