The Health Visitor Implementation Plan, published in February, promised to recruit an extra 4,200 health visitors to add to the 8,092 that were practising in England as of May 2010.
But more than eight months since the government revealed its plan, official statistics analysed by CYP Now show the overall number of health visitors in the country has dropped by 213 to 7,879.
The implementation plan set out a provisional target to have trained an extra 1,135 health visitors by the end of March 2012. This was broken down into regional targets for each strategic health authority (SHA) to achieve.
Regional health chiefs have insisted sufficient numbers of training places are being commissioned to make the ultimate target achievable.
Numbers diminish
But seven out of 10 SHAs have seen the number of health visitors diminish, as the first target to increase trainees looms in six months' time.
The exceptions were Yorkshire and the Humber, which increased its full-time-equivalent posts from 880 to 888; the East Midlands boosted numbers from 629 to 660; and the North East went from having 481 health visitors to 568, already ahead of its March 2012 target.
At the other end of the scale, London has lost 77 posts, the East of England 76, the South West 64, the North West 63, South Central 27, the West Midlands 20 and the South East Coast 12. Some of the decline can be attributed to high numbers of health visitors nearing retirement age.
Obi Amadi, lead professional officer at the Community Practitioners' and Health Visitors' Association, said the number of health visitors qualifying this year had been "disappointing".
"We know that workforce numbers haven't really increased," she said. "We know that in terms of the targets set by government, generally areas are falling short. Within some primary care trusts (PCTs) the number of health visitors has fallen, because they have made savings across the board. So the health visitor budgets have been affected as well, even though they shouldn't have been."
Amadi urged the government to consider ringfencing health visitor budgets to meets its pledge. "The government gave areas an extra three per cent on top of baseline funding for health visitors, but it seems like it hasn't been used," she said. "They need to take a good look at ringfencing budgets, otherwise the money is not going to be spent on what it should be in every area."
Dr Cheryll Adams, a former health visitor and independent adviser on the profession, backed the call for ringfencing. "At a time of tightening of belts, it's very easy to use money elsewhere as there are so many worthy places to put money in the NHS," she said. But she claimed that plans to enlarge the workforce are on track, adding that the intake of health visitor trainees starting training this academic year has greatly increased.
"Increasing the workforce in this very significant way requires a huge cultural change for the NHS, which has been reducing posts quite significantly since 2004," she said. "Obviously, to increase your workforce by 50 per cent over four years is a huge target. I personally think they are well on the way."
NHS South West's chief nurse Liz Redfern is a member of the government's health visitor taskforce. She argued that the area is prepared to increase its workforce to a total of 1,207 health visitors by 2015.
"This year more than 200 additional training places have been commissioned for health visitors in the South West as part of the national drive to recruit 4,200 more health visitors," she said.
"This is an ongoing process and in the first wave of applications, more than 120 people were interviewed."
Good progress
A spokesman for NHS London said the region is making good progress toward its target. "This year, 157 new recruits will be starting training in the capital," he said.
Clare Messenger, associate director for children and young people at South Central Strategic Health Authority, added: "We have 112 student health visitors starting their training this month and all 34 qualifying students have been employed as new health visitors."
In Yorkshire and the Humber, 41 per cent of health visitors are over the age of 50. A spokesman said its regional strategy aims to end the decline in the workforce, while increasing posts and training capacity in the short term to boost the overall number of health visitors in Yorkshire and the Humber region by 964 by 2015.
