A day in the life of a health visitor

THE role of health visitors is currently under review by the government, as a survey reveals the huge case load some experts are having to carry. Today KAREN HINDLE reports on the cheerful face of family healthcare in Suffolk.

A CAMPAIGN to safeguard health visitors has been launched after a survey found the number of children per health visitor varies wildly across England.

The Family and Parenting Institute survey of primary care trusts shows caseloads vary across the country from one health visitor for every 160 children under five, to one health visitor per 1,140 under

fives.

The institute also commissioned a YouGov poll of 4,775 parents which found three-quarters (76 per cent) said they wanted parenting support and advice on their under five's health and development from a trained health visitor with up-to-date knowledge. Eight out of ten said they wanted that support and advice in the home.

Mary MacLeod, the institute's chief executive, said: “Our research clearly shows that parents already value the service they receive. In some PCTs there is now a shocking lack of provision. Redbridge, (on the outskirts of London) for example, told us there is only one health visitor for every 1,142 children under five.

“This, coupled with a survey carried out by Amicus Community Practitioners and Health Visitors Association, which showed that 29pc of health visitors had concerns their caseloads were so large they were losing track of vulnerable families, paints a very worrying picture.”

She added: “Yet there is no better start for a child than having a professional at hand to help their parents give them the support and care they need. We don't need to reinvent the wheel here. Instead we need to rebuild our universal health visiting network with a new sense of purpose, a modernised career structure and a refreshed training framework.

“It's about a universal service giving support, advice and care to all. I cannot help but be concerned that this is under threat.”

In Suffolk, teams of health visitors, some led by Julia Bilotta the service manager for health visiting and school services, work hand in hand with other agencies to provide a modernised, joined-up raft of services for families.

Initial contact is made at ante-natal classes and that relationship continues with the family until any children are at least five years old.

Despite their approachable manner and easy going demeanour, Julia said health visitors are highly qualified nurses who have at least degree level expertise, with some carrying on to take masters degrees. Ongoing training is also available to bring them bang up to date on current thinking.

Julia said: “Part of the success of our health visitors in Suffolk is that they are able to go into any home and talk to someone and help them in any way they see fit. That is what they are trained to do. The beauty of them is they don't go in and talk over your head. They are highly trained to assess any situation and deal with it accordingly.

“It's great that they can come in and have a laugh and a joke and do a bit of hand holding but still have all that expertise at their fingertips.

“We are very fortunate in Suffolk because I believe the service is respected and the need for it is recognised. We have modernised it in the last couple of years so we are able to bring in any other resources such as post-natal depression, domestic violence, and so on.

“Our aim is to offer a preventative service where we work closely with families.”

PEOPLE think health visitors are old women who have six toes and warts on the end of their noses - a delightful description before the film Nanny McFee came out.

Carolynne is a far cry from that. She has an easygoing manner filled with little jokes and witticisms aimed at making nervous people more relaxed. And she has the right number of toes.

Her manner works and soon a smile appears on the faces of family members who are perched on the end of their seats wondering what is going to happen next.

Visits to families take up a large part of Carolynne's day, but so too does the paperwork that comes with it. Case notes have to be written up, as do referrals and letters regarding inadequate housing to the borough council. Then there is a child protection issue which has left a young family feeling the whole episode could have been dealt with far better, not by their health visitor, but by some of the other agencies involved.

We start our day at 9am to see a young family who have just had a new addition to their family. He is weighed, his little red book has to be filled in and Carolynne checks him over, taking over from where the midwife left off.

Once baby is checked it becomes apparent the parents are living in the husband's parents' home and things are a little cramped. Carolynne promises to write to Ipswich Borough Council to see about rehousing the family.

At family number two, where a delightful little girl with golden curls sits next to Carolynne and sticks her finger firmly up my nose. The mum is open about the child protection issues concerning one of her other two daughters and between them they agree a course of action which the parents feel more comfortable with and which they believe will be of more benefit to their daughter.

Carolynne is off to do more visiting, before sitting at her desk to write reports, referrals, and letters and that is just from today.

Claire Ireland from the Stowmarket area, has known Carolynne for two years because their eldest daughter Annabelle, aged four, has a condition in which she needs a splint on her leg and therefore has special needs.

Claire also has two other daughters: Polyanna, 21 months and Tatianna, 15 weeks. She said: “Carolynne has been tremendous. She looks after me as well as the children. She has been incredibly supportive and I know I don't have to panic when I call her, I know she will get back to me.”

For Claire it is important that the relationship is right: “It's not the health visiting side, it's whether you connect as a person and if that relationship was not right then it could not work.”