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Exclusive: 'Grave concerns' for hard-won health visitor gains

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It would be “absolute madness” to allow public health spending cuts to hamper hard-won increases in the number of health visitors, a leading member of the profession has told Nursing Times.

Health visiting services could struggle to deliver the most basic care if numbers drop back down, warned Dame Sarah Cowley, emeritus professor at King’s College London and trustee of the Institute of Health Visiting.

“We don’t know which will take priority – the funding formula or balancing the books”

Sarah Cowley

Her comments to Nursing Times follow a joint letter penned by a range of nursing and child health organisations, including the institute and the Community Practitioners’ and Health Visitors’ Association, noting fears about the situation. They say they are “gravely concerned” at the potential impact of £200m in public health funding cuts on health visiting jobs.

The letter – also signed by the Royal College of Nursing, Royal College of Midwives, Royal College of Paediatrics and Child Health, UK Faculty of Public Health – appeared in a national newspaper days after it emerged the government had narrowly missed its target to recruit an extra 4,200 health visitors by the end of the March this year.

“We were delighted to see the previous government’s support for a 4,200 increase in health visitor numbers and welcomed the commitment in the Conservative party manifesto to strengthen the health visiting programme for new mothers,” said the letter in The Observer.

“We are now extremely concerned as to how this commitment is to be reconciled with local authority health budgets being reduced by £200m, given that health visiting is likely to be a service under review,” it said.

Dame Sarah told Nursing Times the significant increase in health visitor numbers so far achieved was “fantastic news” but warned that public health directors and health visiting teams were now gripped by uncertainty.

Sarah Cowley

Sarah Cowley

“Two hundred million doesn’t sound much to the NHS, but when you look at the very much smaller budget for public health in local government then it’s a huge amount – something like a million pounds for each local authority,” she said.

“It’s as if [chancellor] George Osborne doesn’t know people working in local government in public health are frontline NHS staff, like health visitors, who are supposed to be protected,” she added.

Councils have been told they must ensure there is one health visitor per 300 children when they take over the commissioning of health visiting and other child public health services in October

“We don’t know what will happen,” said Dame Sarah. “All we know is the money has to be found by local government and we don’t know which will take priority – the funding formula or balancing the books.”

“Rumours and suspicion continues. The recent announcement about the £200bn savings has not helped”

Obi Amadi

If funding for health visiting was ring-fenced in some way, she said public health managers would still face impossible decisions, with vital services like school nurses, sexual health advisors and breastfeeding services all under threat.

Obi Amadi, lead professional officer for the Community Practitioners’ and Health Visitors’ Association, which is part of the Unite union, said shifting commissioning to local authorities had created “a lot of anxiety that we are all trying to manage”. 

She noted that the government and Public Health England had “worked hard to ensure a safe a transition as they think is possible”, but she warned that “rumours and suspicion continues”.

Ms Amadi added the recent announcement about the £200m savings “has not helped”.

  • 1 Comment

Readers' comments (1)

  • I would like to support these comments and concerns re health visitor numbers. A move to local authority commissioning could have many positives for health visiting and most importantly the families and children they work with. But their role will need to be understood by LA and supported not only to keep up and increase numbers but also in terms of on going development. Recently qualified health visitors need on going support to develop the skills required in practice and their ability to lead the healthy child programme and to challenge effectively. In undertaking leadership development of these new health visitors, my colleague and I have clearly seen this need. However we are also seeing a great need to develop the leadership skills of those in practice and at management levels to ensure they understand health visiting today and what is required to work effectively and jointly with local authority partners. The implementation plan achieved a great deal but from a strategic view it feels we need to go round the circle again developing those health visitors who struggled when qualified numbers were low and developed a way of practicing that was not able to address prevention and early intervention the par excellence of health visiting practice.

    Margaret Buttigieg

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