The future for Health Visiting

Campaigns Nursing
The pace of change in health visiting over the past few years has been hectic, traumatic at times and stressful, but have the rewards promised been delivered?
Health visitors welcomed standards and national recognition but the next phase is not certain at all. We, as with our School nurse colleagues transferred to Local Authority Commissioning this year. We have worked hard to ensure commissioners were ready for us and know what we do, how we respond to populations and need. Lots of good standards have been written down but sadly this is where I fear the wheels fall off.
 Government cuts have hit Local Authorities. Hard. The honeymoon period has been short for our school nurses who now find themselves an expensive service that no one wants. Commissioning is looking at getting a complex professional service but finds there is not the money to pay for dedicated, well educated  professional SCPHNs.

Is this the future also for Health Visiting?

Currently many health visiting services are finding that managers are looking at how they deliver the service that is being “paid for” and “counted” rather than the comprehensive complex relationship building, nurturing service that health visitors are trained to do. Yes I celebrated the enshrinement of the 5 mandated contacts and the 4,5,6 model but this is a bare minimum, what if a provider interprets that as a set service delivery standard? Do we continue to anticipate need? A core principle of health visiting is the search for health needs

I’m a Health Visitor in the NHS. My job is to provide a universal service to children until they go to school that will monitor their health and well being and safeguard them

The safeguarding of children depends on so many factors. But it’s not just the job of health visitors to protect children, it’s the role of families and families currently are under massive pressure.  Cameron’s government talked about Troubled Families but those of us working day to day are finding families in trouble, they have more stress than ever before. Mums and dads are working 2/3 part time jobs. We are there to support them.
 These children and their parents have little expectation of us. They become lost to services and when, as we have heard so much recently, they are living in fear there is no one to trust, no one to support them. Safeguarding children does not start with social workers, it’s about visible children supported in their communities but we need commitment to maintain universal services from Health Visitors and School Nurses to ensure our children are never unseen or unheard.

No one else will

So, we move forwards to the here and now.
health visitor
Is this is it? I’m in consultation phase and I’m at risk of being down banded or made redundant. So too are my colleagues across England.  So have we lost the fight? Do we give up now, go back to our areas and tough it out, having our own individual battles? When it’s done do we reflect on when things were good, what we could have done who’s at fault?
Just the sound of this is too awful to imagine.
So what do we do?  We look for inspiration. Whether it be current or past. The Practice teacher that inspired you, the mum that fought against the odds for her child, women like Marie Stopes, the women that started us off in 1862, those that went on to do their bit for women’s suffrage.  We take their example and adapt, we owe it to our children and communities to stand up and fight these cuts to a service we built for them.
It’s not just a job. It’s a service that will disappear unless we shout out. We are the invisible support. There’s a presumption we will always be there from our colleagues in Health and Social care and by the public.
In Worcestershire recently we raised the “What if” question and were bombarded by mums and families asking what if their health visitor had not been there, asked, enquired? They showed how much health visiting affects families.
Last week I heard stated that we shouldn’t worry about the lack of follow ups a and chasing contacts. She cited the example that “no one else does, a GP wouldn’t call to see why an appointment is missed”. But that’s exactly the point. No One else does. The under 5s are too easily invisible and we have seen again and again the tragedy of invisible children, lost from the eyes of their neighbours.  Women with post-natal depression are not wont to shout for help, we know that often unless the health visitor asks no one else does. The Domestic Abuse question, so vital to women and children, if no health visitor who will ask? No one.
I could go on, but I think I’m preaching to the converted.  I know you get the importance and significance of the job. So how do we go forward?
The only way I know is by raising awareness, sharing experiences and campaigning.  We are not reinventing the wheel. So many nurses have had to fight for services in the past.  Health visitors fight daily for housing, safeguarding, GPs to listen to concerns they raise. This should be simple for us. Why so careful?
We have leaders who have given us inspiration, Professor Dame Sarah Cowley spelled it out for us and continues to do so, Dame Elizabeth Anionwu coins the phrase the Radical Health Visitor. It’s my belief that if we aren’t radical we aren’t fulfilling the job description!  They weren’t Dames when they did their work, they were you and me, turning up, doing their best. Use the resources you have, your voices and your Union as so many before have done. No one does this alone.
Support each other, speak out, speak up, challenge, organise and don’t give up. It’s a nothing to lose moment, were in good company with the rest of our NHS and Local Authority colleagues.
So, I’m at the March in London on March 4, I want a block of red ❤️YourHealthVisitors up front – indulge me!  If we don’t fight this No One will.