Recent increases in health visitor numbers will provide a “critical opportunity” to help boost the number of disadvantaged children attending nursery, which is currently falling behind target, according to education regulator Ofsted.
But senior figures from the health visiting profession have warned that the workforce uplift is not enough to deliver change, while highlighting looming public health funding cuts which could lead to job losses in the sector.
“Promoting readiness for school is already part of their [health visitors’] role – but it should be at its very heart”
Sir Michael Wilshaw
In its annual report on early years education, the education regulator warned that around 40% of all two-year old children eligible for funded places at nurseries, pre-schools and other childcare providers had failed to take them up.
It said health visitors were the only professionals expected to “proactively” be in contact with the most disadvantaged children before the age of two and that the requirement to carry out checks for all one-year-olds mean they were ideally placed to promote nursery places.
The regulator said the recently expanded health visitor workforce – a boost of nearly 4,200 over the past few years following a pledge made by the previous government – would help drive improvements.
“What may be more challenging would be for health visitors to find the time to work with mothers who need…an advocate to secure a place in a nursery”
Launching the report this week, Ofsted chief inspector Sir Michael Wilshaw said the transfer of commissioning responsibility for health visitors from NHS organisations to local councils in October provided a “real opportunity to focus health visitors on this clear task”.
“Promoting readiness for school is already part of their role – but it should be at its very heart,” he said.
However, health visitor representatives have said the increase in numbers has only helped to fill gaps in a workforce that had been severely depleted in recent years.
Even with this increase, it would still be “challenging” for health visitors to find the time to work alongside mothers of children from less wealthy backgrounds to secure nursery places, they warned.
Forthcoming public health cuts – which it has been claimed could potentially lead to job losses among health visitors – could also threaten the workforce’s ability to improve the take up of nursery places for disadvantaged children, they added.
“It is eminently sensible for health visitors to give message to families with young children”
Cheryll Adams, director of the Institute of Health Visiting, said it was “perfectly realistic” for health visitors to encourage mothers to book nursery places for their children when carrying out developmental checks.
However, she added: “What may be more challenging – but an equally vital role for a health visitor – would be for them to find the time to work with those mothers who need the help of an advocate to secure a place in a suitable nursery.
“This [responsibility for supporting pre school children] again highlights health visitors’ vital role and why any cuts to their numbers as a result of the reduction in public health budgets will have long term consequences for not only the children and families they work with but ultimately for the society we all live in,” she said.
Dave Munday, a professional officer from the Community Practitioners’ and Health Visitors’ Association, which is part of Unite, said the boost to the workforce had only returned staffing levels to those last seen around 15 years ago.
“It’d be lovely to say: ‘We’ve never had this many health visitors before, therefore with this new number they can do more things. But that’s not the case,” he said.
“It is eminently sensible for health visitors to give message to families with young children [about funded nursery places] because it’s true they are the people that should be going to see every family…but if that isn’t in a well-resourced system it doesn’t happen,” added Mr Munday.