Lack of funding, dwindling numbers and heavy caseloads: the health visiting profession has suffered from all three in recent years.
Shockingly, around one in five health visitors now have a caseload of more than 1,000 families, five times the level recommended by health union Community Practitioners' and Health Visitors' Association (CPHVA).
Dr Cheryll Adams, lead professional officer of CPHVA, says: "The problem is that health visiting has been left up to local commissioners, which has produced a postcode lottery for services."
She says that too often primary care trusts fund the most cost-effective option, and not what is best for families. "Less skilled roles such as nursery nurses can work well alongside health visitors in a team," she says. "But in some areas these roles are being brought in as a cheap option to replace health visitors."
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