‘Critically overstretched’

Last week there were upsetting reports in the media of new mums feeling abandoned by their health visitors – a claim that has left our Unite dedicated health visitor and community healthcare practitioner members devastated.

UNITElive spoke to Hazel Grieves*, a health visitor for 10 years and a community healthcare practitioner for 15. She works in The Midlands as part of a team of nine health visitors.

“It’s hard to hear parents say they feel like they’ve been abandoned. We are trying our best to deliver with one hand tied behind our back,” said Hazel.

Sickness, redeployment and cuts to health visiting by 30 per cent has left health visitors overstretched and caring for 10 times more than the recommended number of families each.

“Nobody becomes a health visitor to be anything less than 100 per cent dedicated to their families.  The mental load is huge, you never switch off and it is unbelievably stressful. We take great pride in our work and these have been incredibly difficult times for us as the last thing we ever want is to feel like is that we have let our families down,” she added.

Government guidelines have been vague and confusing with no consistency between different healthcare trusts. How health visitors are working very much differs across the country and within the devolved nations. While some health visitors are wearing full PPE to continue home visits, others are conducting their checks over the phone or via Zoom calls.

“Within my trust we are still seeing families. However we are phoning ahead and doing all of the paperwork ahead of visits to limit how long we are in homes. Visits are meant to be 15 minutes and a quick check to make sure that mum and baby are ok. However three miles down the road another trust could be doing things completely differently and it has you questioning who is doing it right,” said a bemused Hazel.

Situations are different team to team with some hit more heavily by sickness and staff called up to the frontline to deal with Covid. “There’s support staff to try and backfill in other areas to relieve staff to go on Covid wards, but we are still critically overstretched,” explained Hazel.

Not only has the pandemic made work harder because of staff shortages but the problems health visitors are now dealing with are much tougher and more complex too. Hazel works in an area that has been heavily hit by redundancies.

‘Incredibly difficult and uncertain times for families’

“These are incredibly difficult and uncertain times for families. After furlough ends they may not have a job to go back to. They have rent and bills to pay and mouths to feed. We see the emotional impact of this when we visit families. We also see the impact Covid has had on older children too. Many of them have really suffered the costs of school closures and have been left with anxiety and even depression. All of this is outside of our own remit and requires more paperwork to ensure families are getting the support that they need from the right places,” said Hazel.

Hazel works as part of a team of nine health visitors – a support network that she has struggled without in recent months. “You don’t switch off from the things you’ve seen during the day. I often give parents my phone number and insist they call if they have any worries but mostly they don’t. It’s very isolating being home based between visits,” she said.

“Usually we would pop back to the office to do all of our follow up paperwork between visits. This time is invaluable to us and helps our mental load so much as we are able to unburden ourselves to colleagues and in tricky situations ask their option and share our expertise with each other. Just having people around you who understand the pressures of the job helps and being able to have a quick coffee and a chat is so good for your mental wellbeing,” said Hazel.

So far Covid has had a much further reaching effect than anyone could ever have imagined. We are now in a second wave and the birth rate will only rise with the peak from the lockdown baby boom set to show around January or February 2021.

“When services are cut to the bone we are already on the back foot when a crisis like this hits, but under the circumstances and guidelines we feel we have done the very best we can. We take a great deal of pride in our work and we will continue to do our very best for our families,” added Hazel.

Hazel is not alone in her concerns. Obi Amadi, Unite lead professional officer for community practitioners and health visitors, has heard from many members facing similar experiences to Hazel.

“We expressed our concern when firstly HVs were wrongly asked to visit with inappropriate PPE,” said Obi.

“Visiting was then restricted by the lack of PPE and then government guidance.  Organisations were supported with funds from the government to improve their IT so that services could be provided safely.

‘Covid measures have really challenged this’

“But employers took different stances on this and some practitioners did not get access to video calls as a substitute for visiting. Health visiting and school nursing services are much more effective when trusting relationships are built – and sadly it seems that Covid measures have really challenged this.”

Obi believes that, “It was important for members to protect themselves as well as the families they were visiting.”

But, she continues that as a result of redeployment, staff who remained had increased workloads and had to somehow manage and adjust to the new service structure.

“This was bound to have an impact as it was reactive and untested,” believes Obi. “Although they were less able to have face to face contact I know our health visitor and school nurse colleagues were able to offer and provide additional phone or video contacts as their diaries would safely allow.

“I have heard it reported that many families did not want face to face contact and if relationships were not well established that family may not have always appreciated the excellent services and support that they could have been given – which is such a shame.

“As we go into the second wave we hope the same mistakes will not be repeated and more HV and school nurse resources will be available to really give families the support they need, in particular with their mental health – as we know what a challenge this is,” Obi concluded.

*Name changed to protect privacy

 

 

 

By Jody Whitehill