Intended for healthcare professionals


Health visitor shortages are risking child health and piling pressure on other services

BMJ 2022; 378 doi: (Published 28 September 2022) Cite this as: BMJ 2022;378:o2189
  1. Emma Wilkinson, freelance journalist
  1. Sheffield

Understaffing is leaving parents “abandoned” and exposing babies and children to safeguarding risks, late diagnosis, and other problems—and the consequences can be “catastrophic and life-changing.” Emma Wilkinson reports

When Phillippa Guillou had her daughter in 2020, she was determined to breastfeed, but it was painful and there were problems with latching. She tried calling and texting her health visitor for help but got nowhere. Two months later she received a response and a referral for tongue tie, but by then she’d had to start using formula milk. “I was really upset about breastfeeding. I didn’t have any friends or a network that could help me—and when I called a charity, they said there aren’t any services locally, can you pay for a private consultation? But it was £200, and I didn’t have the money. I’m still sad about it.”

Guillou, who lives in west London, had also struggled with post-traumatic stress disorder from the birth and did not see the health visitor again until the baby’s one year review—which was done by video call due to continuing covid-19 restrictions and felt stressful. She says that she felt ignored and consumed with worries about her daughter, who Guillou was concerned was late to crawl and walk. “There are way worse stories than mine; I know parents who fought for months to get their babies seen because they thought there was something wrong.”

At the time, health visiting services in England, already woefully understaffed from years of budget cuts, were also dealing with staff being redeployed as covid-19 hit. Alison Morton, executive director of the Institute of Health Visiting (IHV), says that cuts in training places, a chipping away of the public health grant after it moved to local authorities in 2015, and the pandemic have left services on their knees.

An …

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