Quarter of health visitors have caseloads exceeding 750 children

According to Institute for Health Visitors' (IHV) figures for 2021, the high caseloads in England compare particularly poorly with Scotland and Wales, where no health visitors have caseloads of this size.

England's rate is also three times the IHV’s recommended caseload limit of 250. Just nine per cent of health visitors in England have caseloads that meet this limit, compared to two thirds in Scotland and Wales.

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Just under four in ten health visitors say they feel so stretched that they “worry there may be a tragedy in their area”. A similar proportion fear they “can’t do enough to safeguard babies and children".

The figures are from a survey of 1,291 health visitors and published in the IHV’s 2021 annual report, which warns that “many health visitors are concerned that they are only reaching the top of the iceberg of need”.

Survey confirms babies, young children and families’ needs are increasing in the postcode lottery of support. Findings from iHV annual survey captures experiences of frontline #HealthVisiting practitioners working with families across UK in wake of C-19 https://t.co/oSZdO0qFnQ pic.twitter.com/zIqtKFZnKF

— iHV (@iHealthVisiting) December 1, 2021

Eight in ten health visitors reported an increase in domestic abuse among families they visited. While 72 per cent said there was an increase in poverty and 71 per cent said there was a rise in child safeguarding concerns over the year.

In addition, just four per cent of health visitors say they can offer a continuity of care to families and only three per cent say they are able to provide “an excellent service”.

The IHV’s annual report says health visitors’ concerns come amid a backdrop of successive funding cuts and the Covid-19 crisis.

“The pandemic and its ongoing impacts have affected health visiting services across the UK this year, exposing pre-existing inequalities,” states the report.

“We are so proud of health visitors who have demonstrated the breadth of their professionalism, expertise and leadership skills through adaptations and innovations to ensure that as many families as possible were supported.

“However, despite health visitors’ best efforts, families still face a postcode lottery of support across the UK, with the devolved nations and a handful of local authorities in England investing in health visiting, whilst other areas face ongoing cuts.”

Royal College of Paediatrics and Child Health president Camilla Kingdon said the IHV figures are “extremely worrying”.

“Health visitors play an incredibly important role to look after babies, children, young people and their families, and to keep them safe," she said.

“To see more than a quarter of health visitors in England reporting that they are responsible for over 750 children – more than three times the recommended limit - is inexcusable.

“We are facing a cross-roads for child health. We need a fully backed health and care workforce plan in place, working alongside a cross departmental child health strategy to ensure every child has the best start in life. Without this the inequalities gaps will widen.”

In October, MPs called on ministers to ramp up support for new parents, to ensure they receive a visit from a health visitor before the end of the year.