Health visitor consultations to take place by phone or online due to budget cuts

Budget cutbacks could see checkups for Derbyshire mothers and babies happen less frequently, only given to those most at risk and being carried out by phone or video.

A public consultation launched by Derbyshire County Council seeks feedback on options to significantly reduce the health visitor service for families of children aged up to four.

This reduction represents a bid for the service to be able to run within its budget, without the need for continued annual “uplifts” of additional money alongside “so many financial uncertainties”.

Health visitors assess the health and wellbeing of babies and toddlers as well as assisting with the overall welfare of mothers and their households, including physical and mental health checkups.

Visits are either increased or decreased – outside of the statutory milestones – based on the need of the baby or wider family and can be carried out in person at the family’s home or a registered nearby centre.

Options put forward by the county council, with the health visitor service run by the Derbyshire Community Health Services NHS Foundation Trust on its behalf, largely focus on reducing overall coverage to instead concentrate on support for families deemed most in need of support.

The service had a mandatory obligation to carry out the following five reviews:

1. Antenatal review – this is delivered between 28 and 34 weeks of pregnancy
2. New Birth Visit – This is usually completed when the baby is between the age of 10 and 14 days
3. 6-8 week review – This is completed when the baby is between the age of 6-8 weeks
4. 12 month review – This is usually completed after 9 months and before the child reaches their first birthday
5. 2-2.5 year review – this is completed between the age of 2 to 2.5 years

In Derbyshire, health visitor reviews are also carried out up to 3.5 years of age before children start school, with county officials claiming this is not mandatory and “is not routinely offered in other areas across the country”.

It is to consider six different options in order to cut costs.

Through the consultation, the council is considering reducing the 2.5-year review to focus on the people who have known vulnerabilities (15 per cent of the current caseload), with an identified health need to justify the assessment.

Similarly, the 3.5-year review could be reduced to focus on the families with “known health or development needs” identified on or after the 2.5 year review.

The council is also considering scrapping the 3.5-year review entirely, which it says has already raised concerns from people and organisations involved in the service, with officials preferring the option to reduce this to families identified in the 2.5-year review.

Reducing the antenatal appointments to focus on the mums most in need (50 per cent of the current caseload), which would include first-time mums, expectant mums of multiple babies and those having their second or third babies etc, and those with known vulnerabilities, is also being considered.

The council is also looking at delivering antenatal reviews through a mixture of home visits, phone calls or virtual video phone calls, with this change preferred to reducing the antenatal appointments to only focus on the most in need.

Finally, the council is considering reducing the 12-month review to focus on the families where there are known vulnerabilities (15 per cent of the current caseload), with feedback already showing this is the “least preferred proposal due to the level of risk identified”.

The council says this plan would be scrapped from consideration unless changes are made to mitigate the impact on equalities.

It concludes: “DCHS, like the majority of other 0 to 19 public health nursing service providers across the country, is facing significant cost pressures and is having to review the way services are being delivered.

“We’ve been working with DCHS to identify proposals to change the way the health visiting service can be delivered that will both help reduce costs, whilst at the same time maintains a high-quality service for Derbyshire residents.

“The health visiting service includes health visitors and community nursery nurses that support the families of children aged between 0 and 4 years.

“The proposals included in this consultation are common ways of working in health visiting services within other local authority areas.

“We invite the views of the public on the six proposals under consideration to change the way the health visiting service is delivered.”

A public consultations will be carried out in person at:

• Monday 16 September 2024 from 9.30am to 11.30am at Buxton Library, Kents Bank Road, Buxton, SK17 9HW

Two online events will be held on the following dates and times, by emailing the email address below, detailing the date you wish to attend:

• Tuesday 17 September 2024 from 1pm to 2pm
• Thursday 26 September 2024 from 4pm to 5pm

For more information visit www.derbyshire.gov.uk/council/have-your-say/consultation-search/consultation-details/proposed-changes-to-health-visiting-services.aspx or email asch.publichealth.commissioning@derbyshire.gov.uk.