Almost two-thirds of health visitors in England have warned workforce shortages are hampering their ability to support families in need, a new report has revealed.
The Institute of Health Visiting (iHV) has today unveiled the findings of its UK-wide annual survey of the profession – adding weight to concerns over increasing and more complex workloads alongside a ‘postcode lottery’ of support.
Health visitors have reported working under immense and growing pressure, with unmanageable workloads, high caseloads and a longstanding workforce crisis that they fear is threatening the sustainability of services.
Four in 10 health visitors intend to leave soon
Of the 1,392 practitioners that completed the survey towards the end of 2024, more than half (58%) said they experienced work-related stress and 54% said they regularly worked unpaid hours.
Concerningly, some 40% of health visitors said they were intending to leave the profession within the next five years – with reasons given including retirement (35%), lack of progression (14%) and because of concerns the role was moving away from preventative public health (12%).
Almost two-thirds (73%) of health visitors in England said workforce shortages had impacted on their ability to support families when a need for identified, compared to 58% in Scotland, 53% in Wales and 51% in Northern Ireland.
And only 45% of health visitors in England said they were able to provide continuity of carer to families ‘all or most of the time’. This was considerably less than the other UK nations – with 90% reporting this in Scotland, 86% in Northern Ireland and 85% in Wales.
Soaring increase in demand
Across the UK, 84% of respondents said the demand for health visiting support had increased over the last 12 months, with perinatal mental health problems being the top reason.
Health visitors also reported soaring demand for support for child behaviour problems, including growing concerns about neurodevelopmental issues such as autism and ADHD.
In England, respondents suggested that their practice was ‘dominated’ by social concerns – with 86% stating that poverty affecting families was a major issue for families that required extra health visiting support.
Some 82% of those in England also said that children with safeguarding concerns below the threshold for Children’s Social Care was a ‘major reason’ that families needed extra health visiting support.
Last year, sector leaders including the iHV warned a ‘huge number’ of school nurses and health visitors were struggling to use their public health expertise because they are increasingly taking on safeguarding responsibilities.
Workforce ‘cut beyond the bone’
Today, iHV chief executive Alison Morton said the report’s findings showed the ‘urgent need’ for investment in health visiting, and stressed how health visitors want to deliver ‘high-quality’ healthcare to all families.
‘We need to get the basics right and this requires action to rebuild the health visiting workforce that has been cut beyond the bone in too many areas,’ she said.
‘The needs of babies, children and families must lie at the heart of all service transformation – currently too many have been left waiting too long without the support that they need, which we know can make such a big difference to their outcomes.’
Ms Morton added that while ‘the current picture is bleak’, the health visiting workforce is ‘ready, willing and able’ to ensure the UK has a ‘world-class’ health visiting service.
The report underscores the need for government intervention to address these critical issues, warning that without ‘immediate action’ to increase health visitor numbers, the health and wellbeing of countless families and children will be put at risk.
The iHV warns that despite the government’s commitment to raise ‘the healthiest generation of children ever’, and ‘strengthen health visiting’, significant work is needed to achieve this.
The iHV has called on the government to deliver a ‘realistic and accurate level of funding’ which reflects the scale of need in health visiting.
It is also urging ministers to ‘train, retain and reform’ the health visiting workforce across the UK.
In England specifically, the iHV wants the government to deliver the national long-term workforce plan ‘in full’ in ensure service demands are met.
The Department for Health and Social Care has been contacted for comment.
In November, Nursing in Practice reported on the government’s plans to develop a new NHS long-term workforce plan for this summer.
At the time deputy chief public health nurse for England Professor Jamie Waterall said conversations were already taking place around the need for school nursing and health visiting to be ‘centre’ of the plan.
