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Health visiting services struggling under budget cuts

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Health visiting caseloads are higher than is safe Health visiting caseloads are far higher than the optimum caseload average

Cuts to the public health budgets are already having a negative impact on the health visiting service, a new report by the Institute of Health Visiting has found.

According to the State of Health Visting survey, 85% of the 1224 health visitors surveyed say their workload has increased over the past two years. This is attributed to the reduction in health visitors despite the Health Visitor Implementation Plan between 2012-15, which aimed to boost the workforce.

Some 16% of health visitors reported that they now have caseloads of between 500-1000 children. The optimum avergae caseload for safe and effective practice is thought to be 250. Furthermore 80% of respondents also reported seeing an increase in domestic violence, abuse and perinatal depression in the families they visit.

Dr Cheryll Adams CBE, executive director of the Institute of Health Visiting, said that the results 'show a radical downgrading of this public health asset, which serves the most formative period of children’s lives'.

'This survey hence exposes the risks to all children and families from a decommissioning of health visitor posts, which it seems is just about to accelerate. The impact will not only be felt by children and families, there will be a knock-on effect on the NHS and other local authority services such as safeguarding services,' she added.

Due to the cuts, 70% of all families are receiving the five mandated health visitor reviews between the ages of six-eight weeks and two years old. Only 30% of families are receiving the antental visit.

Ms Adams believes that through cutting the health visiting service there will be an increased use of secondary health and local authority children’s services in the short, medium and longer term as many health and social concerns won’t be identified early enough.

Figures from NHS Digital show that at least 998 full time posts have been lost between September 2015 and August 2016, and some local authorities are planning even further cuts next year. Ms Adams says that the government must reverse the cuts to the public health budget before 'further damage is done to children's futures'.

She says that in England the service is now under threat while in Scotland, Wales and Notthern Ireland the service is being strengthened.


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