Fewer and farther between: health checks for babies and toddlers

close up of baby

Almost two thirds of children in some areas do not receive crucial mandatory health visitor checks at age two and half, according to new research from the Children’s Commissioner for England.

 

Before the Covid-19 crisis, the Commissioner’s Office contacted local authorities to find out whether the two and a half year check was being delivered. They found that overall, 20% of children did not receive this check.  

 

This paints a worrying picture. Health visitors are uniquely placed to identify where families may be struggling, and signpost them to appropriate services to prevent issues worsening. Missing these two and a half year checks means that families’ needs will not have been spotted, and may have escalated. Children who were behind in their development will not have received support to help them catch up. If they continue to fall behind, this could impact their future.

The research also revealed the high chance that the needs of vulnerable children are being missed. Only 13% of the local authorities were able to tell whether children who missed the checks were from disadvantaged families. It is particularly crucial for health visitors to have contact with families already facing challenges. These new figures show that many disadvantaged children could be slipping through the net.

 

The Covid-19 crisis has made the situation even worse. A new report, ‘Babies in Lockdown’, found that just 11% of parents of under twos had seen a health visitor face-to-face during lockdown. Health visitors have largely had to work virtually or over the phone, making it harder to spot any potenial problems families may be facing.

Many health visitors have also been redeployed, meaning greater workloads for those still providing visits. A UCL survey of health visitors in June and July found that 79% were concerned about needs being missed relating to children’s development.  

 

To stop this crisis escalating, the government must act fast. In the recovery from Covid-19, government must enable health visitors to catch up on missed visits and the workforce must be sufficiently resourced to identify any hidden needs emerging from the pandemic.

  

In the longer term, government must structure health visiting to ensure hidden needs are not missed. Action for Children has called for two extra visits under the Healthy Child Programme, to ensure that the gaps between contacts with families are not too large. The impact of Covid-19 has made this more crucial than ever.

The declining number of health visitors has been a concern for years, with the workforce in England shrinking from 10,309 in October 2015 to 6,693 in April 2020, according to data from the NHS. The workforce must be expanded so that health visitors have capacity to undertake visits and ensure they are of high quality.

Data sharing between agencies must also be improved so that frontline professionals are able to identify families who are struggling. As we have highlighted, the integration of health visitors and children’s centres could be one way to do this.

  

If the government really wants to level up, it must begin with its youngest citizens. Health visitors have a unique ability to support the most vulnerable families: government must resource them to do so.