Health visitors are concerned that the needs of children have
been missed due to staff redeployment to support the Covid-19
workforce and increased caseloads, according to a new UCL survey.
A survey of 663 health visitors in England, conducted
between 19 June and 21 July 2020, found that 41% of respondents
in teams that lost staff had between 6 and 50 team members
redeployed between 19 March to 3 June 2020.
In approximately 10% of teams, which experienced a loss,
this was a redeployment of at least half of their staff. Few
teams (9% among those with staff redeployed) gained additional
staff to fill the gaps.
This meant that 253 respondents (38%) had their caseload
increase, some with an increase of 50% or more, and 73% of those
that experienced a change reported that their caseload had not
returned to its usual size.
Dr Gabriella Conti, Associate Professor (UCL Economics and
Institute of Fiscal Studies) who led the survey, said:
“Whilst all families are impacted by Covid-19, the most
detrimental effects are felt by those who are already
disadvantaged - in particular, our most vulnerable infants and
children whose needs are often hidden from sight.
“Increased caseloads for a significant proportion of health
visitors, along with reports of a lack of PPE for home visits,
has created a lot of additional stress and anxiety, during a time
of great uncertainty and difficulty.”
The survey, supported by the Institute of Health Visiting,
was carried out using the online survey platform
Qualtrics. Participants (98% female, 88% White
British or Irish, and average age 50) were from the Institute of
Health Visiting databases. Data collection is still ongoing and a
full report will be released later this year.
Many health visitors are concerned about the knock-on
effects among children and families, particularly those that are
vulnerable, with 96% of respondents concerned about children in
homes at risk of domestic violence and abuse. The majority were
also concerned about missed needs in relation to the
child’s growth (83%) and development (79%),
parental mental health conditions (92%) and
breastfeeding (75%).
The survey also finds that health visitors continued to
provide some face-to-face meetings following risk assessment, but
were still at risk of contracting Covid-19 due to any close
contact with symptomless clients and inadequate personal
protective equipment (PPE).
Among those who delivered face-to-face visits, 35% reported
they did not have appropriate PPE at some point, even basic items
such as masks, aprons and hand gel.
The increased workload and pressures have had significant
negative impacts on staff wellbeing and mental health, with 67%
reporting that their stress levels had increased in the past
year.
The researchers make a number of policy recommendations,
including for:
-
Health visiting services to be reinstated (where not
already happening) to provide vital support and a safety-net
for children, with appropriate measures put in place, including
the use of PPE, to reduce the spread of the virus.
-
An evaluation of the use of virtual, non face-to-face
service delivery methods to determine their effectiveness for
identification of vulnerabilities and risks, impact on child
and family outcomes and reducing inequalities to inform future
digital change.
-
A clear workforce plan to ensure that the health visiting
service has sufficient capacity to manage the backlog of missed
appointments, as well as demand for support due to the
secondary impacts of the pandemic.
-
A proactive plan to ensure staff wellbeing during the
restoration of services.
Research assistant Abigail Dow (UCL Economics), said: “A
cross-government strategy is needed to reduce inequalities and
“level-up” our society. This will require investment to
strengthen the health visiting service which plays a crucial role
in the early identification and support of the most disadvantaged
families.”
