Health visiting in primary care in England: a crisis waiting to happen?

Bryar, Rosamund; Cowley, Dame Sarah; Adams, Cheryll M.; Kendall, Sally; Mathers, Nigel

doi:10.3399/bjgp17x689449

Cited by 26 publications

(21 citation statements)

References 5 publications

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“…Public health services are inadequately funded, with a £700 million cut in real term funding between 2014/15 and 2019/20. This has resulted in large cuts to community services, including school nursing and health visiting servicesf [41, 42], and the decommissioning of district immunisation coordinators [43]. The lack of a dedicated immunisation coordinator in local areas means that there is limited oversight of the immunisation programme in the area, and reduced scrutiny of immunisation coverage in underserved communities.…”

Section: Discussionmentioning

confidence: 99%

Responding to measles outbreaks in underserved Roma and Romanian populations in England: the critical role of community understanding and engagement

et al. 2020

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Since 2016, the European Region has experienced large-scale measles outbreaks. Several measles outbreaks in England during 2017/18 specifically affected Romanian and Romanian Roma communities. In this qualitative interview study, we looked at the effectiveness of outbreak responses and efforts to promote vaccination uptake amongst these underserved communities in three English cities: Birmingham, Leeds and Liverpool. Semi-structured in-depth interviews were conducted with 33 providers involved in vaccination delivery and outbreak management in these cities. Interviews were analysed thematically and factors that influenced the effectiveness of responses were categorised into five themes: (1) the ability to identify the communities, (2) provider knowledge and understanding of the communities, (3) the co-ordination of response efforts and partnership working, (4) links to communities and approaches to community engagement and (5) resource constraints. We found that effective partnership working and community engagement were key to the prevention and management of vaccine-preventable disease outbreaks in the communities. Effective engagement was found to be compromised by cuts to public health spending and services for underserved communities. To increase uptake in under-vaccinated communities, local knowledge and engagement are vital to build trust and relationships. Local partners must work proactively to identify, understand and build connections with communities.

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Section: Discussionmentioning

confidence: 99%

Responding to measles outbreaks in underserved Roma and Romanian populations in England: the critical role of community understanding and engagement

et al. 2020

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“…With fewer nurses specialising in the health visiting role, this has led to an inevitable reduction in services. These changes have resulted in loss of contact for some of the mothers, impacting the opportunity for mothers and health visitors to form an effective trusting relationship, based on familiarity and continuity of care (Bryar et al., 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, this change in funding and service provision may have had an unintended consequence. The health visitor's role and ability to support and promote the prevention of illness and promotion of health may be weakened at a time when prevention could help decrease service demands (Bryar et al., 2017). To address these shortfalls many GP practices are joining together and forming ‘federations’, to share resources and centralise services.…”

Section: Discussionmentioning

confidence: 99%

“…In the UK, they are the only nurses who have a specific role with young children and families, promoting positive health outcomes and prevention of illness (Peckover & Appleton, 2019). Health visitors have exclusive access to young families through early intervention programmes and home visiting, enabling them to identify health needs early (Bryar, Cowley, Adams, Kendall, & Mathers, 2017).…”

Section: Introductionmentioning

confidence: 99%

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The influence of perceived accessibility and expertise of healthcare professionals, and service austerity, on mothers' decision‐making

Bosley

Appleton

Henshall

et al. 2020

Health Soc Care Community

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Mothers often make key decisions regarding their children's health. They hold core beliefs and attitudes towards healthcare providers, relying on healthcare services to provide support, advice and reassurance. It is crucial that health providers form authentic relationships with families with young children, in order to effectively provide healthcare, support and information as needed. In this paper, we explore mothers' views on the accessibility and expertise of healthcare professionals caring for their child's health. A case study, using a geographic post code as the case boundary was used. Focus groups and semi‐structured interviews with mothers of children aged under five years old were conducted. Participants (n = 33) were recruited from local playgroups and six focus groups (19 participants) and 14 individual interviews were conducted. Qualitative data were analysed using thematic analysis. General Practice (including general practitioners [GPs] and practice nurses) was considered to be the preferred option when seeking timely healthcare advice and information. Participant mothers were open to accessing professional advice concerning their child's health, from a range of health professionals and understood the role and potential contribution of various health professionals. However, some factors, influenced mothers' decision‐making. These were captured in three themes: maternal perceptions of GPs as accessible experts; practice nurses as approachable and reassuring sources of advice; and difficulty in accessing health visiting services primarily due to service funding cuts. Further investment in primary care services, including expansion of the practice nurse role and an increase in health visiting service provision, may help to provide sufficient support for mothers seeking healthcare advice. In addition, healthcare service strategies, which engage with mothers and ensure nurses are recognised as knowledgeable, accessible, supportive and a suitable alternative to GPs, would be beneficial.

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“…In England, there are only five core contacts, with one of these being in the antenatal period; some children and families do not even have access to these. Health visiting in England has been described as ‘a crisis waiting to happen’ (Bryar et al ., , p. 102). Yet health visitors' home contacts with children and families to assess health needs are crucially important in recognising when early intervention work with children and families is required and can be central to the prevention of child abuse and neglect.…”

mentioning

confidence: 97%

Promoting Best Practice in Assessment and Intervention: The Challenges of Working in Times of Cutbacks and Change

Appleton

Sidebotham

2018

Child Abuse Review

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Health visiting in primary care in England: a crisis waiting to happen?

Cited by 26 publications

References 5 publications

Responding to measles outbreaks in underserved Roma and Romanian populations in England: the critical role of community understanding and engagement

Responding to measles outbreaks in underserved Roma and Romanian populations in England: the critical role of community understanding and engagement

The influence of perceived accessibility and expertise of healthcare professionals, and service austerity, on mothers' decision‐making

Promoting Best Practice in Assessment and Intervention: The Challenges of Working in Times of Cutbacks and Change

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