Today (Monday 21st August 2017) marks the start of the third Health Visitor Week (#HVweek). When, previously I led on supporting Unite/Community Practitioners’ & Health Visitors’ Association (CPHVA) health visitor members in England, I reintroduced the celebration with it running, in 2016, between the 26th-30th September. The original event occurred in 1990.
For me it was a very enjoyable, if exceptionally hectic, culmination of over 9 months of planning and preparation, and brought together 82 organisations, who each supported the aims of the week.
I also developed the #whatisaHV memes which saw over 50 participants, both parents and professionals, tell us what a health visitor was to them.
With the 2017 #HVweek, I wanted to have a think about some of the changes in the 325 days since last years event.
Today I’m focusing on the numbers.
A few numbers
The Health Visitor Implementation Plan was never just about the numbers, but for me the numbers were the most important element. I believed that without a commitment to a final number, none of the other intended benefits would ever follow. But what has happened in the last 325 days?
The first problem? It’s difficult to answer. NHS Digital has a very comprehensive website which updates the number of health visitors in NHS employment, but that has a delay inherent in collecting this type of data. So, at the time of writing, you can only get figures up to April 2017.
This tells us that there were 8,830 whole time equivalent health visitors in the NHS. Since last years #HVweek, when there was 9,521 health visitors, this means a cut of 691 or 7.3%.
Even more worryingly than this is the cut that has happened since the end of the HV Implementation Plan. In March 2015 there was 10,257. Therefore, in just 25 months, there has been a cut of 1,427 (or 13.9%).
That equates to one health visitor being cut from the NHS every 12 hours. (So we’ll lose another 8 during this years #HVweek).
I’ve recently been blogging about the number of mental health nurses and for this I looked at the number of people in England per mental health nurses. There were two reasons for this:
- I was looking at the change in mental health nurses since 2010. Over that period the population in England has increased by 5%.
- Jeremy Hunt and Theresa May repeatedly talk about the increase in (all) nurses since 2010, most recently Hunt repeated this claim over the weekend in his spat with Stephen Hawking. However when you correct for the above increase in population the number of people per nurses has gone up (so got worse) by 3.2%.
For #HVweek, I’ve looked at a similar approach for health visitors. Again, the figures don’t make this too easy as the stats for the population of England are released once per year, and the most recent is mid-2016. I hope you don’t mind but I’ve used the 2016 population figure for the 2017 calculation:
This shows that this year, we’re in a better position than we were in 2010, by 5.9%, but the benefit gained during the Health Visitor Implementation Plan is rapidly disappearing.
You might be thinking at this point, as most health visitors caseloads will focus on the under 5’s (accepting that’s not a given, and certainly not these days!), it’s not really useful to use this statistic. I’ve thought of that, and here’s the figures for the number of under-5’s per health visitor:
Again, the position in 2017 is better than in 2010, by 6.3%. However, again, this is a markedly different figure from 2015, at the end of the Health Visitor Implementation Plan, when the improvement in caseload sizes was 18.6%.
If you prefer graphs, here it is:
During the life of the Health Visitor Implementation Plan, I met with about 1,000 student health visitors, and one of the things that I impressed upon them was that if you just looked at the time period of the HV plan, you would have a significantly skewed view. After all, the whole point of the plan was to correct the historic decline that was happening in the 2000’s. I’ve therefore followed my own advice and looked back to the situation in 2000.
In 2000, there were 10,046 whole time equivalent health visitors looking after 2.98 million under-5’s. That meant an average of 297 under-5’s per health visitor. I’ve crunched the data and this is the resultant graph of number of under-5’s per health visitor:
I’m going to finish with a prediction on the numbers. If the government continues on it’s current path in resect of health visiting, by 2019, we will be in the same position as we were on the 7th February 2011. For those that don’t know, that was the day before the HV Implementation Plan was launched.
I really hope I don’t have the opportunity to test my prediction out!
And to answer my initial question… #HVweek, a cause for celebration? Too right it is!! Health visitors are totally amazing!