Attending the National Association of Primary Care (NAPC) 25th anniversary celebratory event on 1 May 2024, I was struck by the number of times I heard reference to health visitors by GP colleagues.
For the most part, this was in recognition of their excellent skills in supporting parents, babies and children – and how much they miss seeing their health visitor colleagues, recognising that the number of health visitors has been shrinking significantly over the last 6 years.
Our GP colleagues see and feel the impact of the depleted health visiting service, with increased requests for appointments to discuss issues that would otherwise have been addressed by the health visitor. A colleague at the event told me about a health issue with a baby that would have been picked up so much earlier of there has been a health visitor seeing the baby at home.
» One of the outcomes of shadowing Queen's Nurses has been a commitment to investing in the training of more health visitors by a future Labour government «
My own experience as a grandmother has confirmed on a very personal level the impact of a lack of health visitors, with my son and his partner seeing a health visitor only once at a clinic at 6 weeks – and yet their baby is their first and is clinically extremely vulnerable.
Health visitor caseloads have had to be prioritised and re-prioritised – I understand that – and we are fortunate to be a family of healthcare professionals who can offer some of the support needed. However, whilst this has some value, it is not the same value as a local, trusted, clinically excellent health visitor, who can undertake a comprehensive assessment and who knows the local landscape and all the services available to support new families.
While my GP and general practice nurse colleagues lamented the limited nature of the health visiting service, they asked what hope there might be for reinvestment into the service, should there be a change in government. The QNI is apolitical as a charity. We offer shadowing opportunities with Queen's Nurses to all health and social care leaders and advisors, of all political parties. One of the outcomes of shadowing Queen's Nurses has been a commitment to investing in the training of more health visitors by a future Labour government.
The committed numbers are impressive and would lead to a steady growth in the numbers of health visitors in England in the coming years, recognising the significant contribution of health visitors to the health of babies, families, children and whole communities.
There is a potential flaw, however, in that there will also need to be jobs when the student health visitors qualify, which relies on significant investment into and growth of the existing services. Potentially, these could be within an NHS commissioned service, rather than a local authority public health service.
In making the case for a renewed investment into the health visiting service, we will need to clearly demonstrate our value. There is much research on this and no more currently needs to be undertaken to show the value we bring in terms of prevention, reduced GP appointments and reduced emergency department attendances.
» Making the links between health visiting and the impact on the economics, not only of the health and social care system, but the local economy as a whole, will be important to articulate when arguing for the new investment «
However, the economic case for investment may well need to be re-emphasised. It is therefore pleasing to see the International Council of Nurses launch their theme for International Nurses Day as the economic value of nurses and midwives (International Council of Nurses, 2024). Making the links between health visiting and the impact on the economics, not only of the health and social care system, but the local economy as a whole, will be important to articulate when arguing for the new investment.
And we also know that this is a long-term investment. When interviewed at the annual Queen's Nurse conference in March 2024, Wes Streeting, Shadow Secretary of State for Health and Social Care, said that he knew the health and social care systems in England could not be fixed in a short space of time – he estimated 10 years. He also recognised the importance of prevention and health promotion and knowing our communities. It is remarkable for a politician to state that achievements could be longer than a single term of office, but this shows that there is an understanding of the long-term nature of the impact of our services.
There is potentially an optimistic future for health visiting if more politicians in all parties recognise the value of health visiting. One thing is for sure though – we have support from our GP colleagues at NAPC in developing a plan for the communities we serve.