The Unique Impact of Health Visitors on Poor Families

David Parker-Radford is The QNI’s Homeless Health Programme Manager. In this blog he discusses the role of Health Visitors in deprived areas and how they can make a real difference to poor and homeless families.

This March, I will have the privilege of presenting the work of the QNI to an audience of Health Visitors at a Journal of Health Visiting event. This coming event promises to be special as I am presenting alongside one of our Queen’s Nurses, Trudi Law, Specialist Health Visitor for Homeless Families in Wolverhampton.

The conference is called Key principles in health visiting: an integrated approach. Delegates will hear from a range of speakers at a critical time for health visiting. Many health visitors are now finding themselves taking on larger caseloads, with jobs merged or reallocated. There will be opportunities for health visitors to share their experiences and concerns at the conference.

Health visitors play a key role in public health, linking services together and providing early support to families, making a fundamental difference to their wellbeing. But do they need to do more to raise the profile and impact of their work? If more health visitors aimed for CCG Board and other leadership positions, they would be in a stronger position to advocate for funding and resources to tackle the inequalities in children’s health.

Gaining Insight

I visited Leicester to find out how specialist health visitors work with homeless and asylum seeking families. Following this visit, I wrote my observations:

‘Her tiny flat…hardly furnished….dark…cold…damp….unsafe. Her toddler nowhere to play… A small empty noticeboard reflecting the emptiness in her eyes. She had tears in her eyes and worries in her heart. Too frightened to stay…not able to run away from and escape the situation… She felt trapped. Her health visitor…warm… caring, kind…gave her time…held her fears…steadily gave her options…steadily gave her hope….’

Many appointments followed the same structure. They started off with a thorough check of the child’s health and then became very focused on the needs of the mother (or both parents where father was present). The skilful health visitor saw that there cannot be healthy children without attending to the needs of the parent, particularly from an emotional and practical perspective.

Visits like these help us to get a better understanding of the health concerns of families in need across the country and of the information and support needed to help health professionals. Health visitors carry unique insights about people’s lives that others don’t – knowledge about their precarious housing and the impact this has on people.

The QNI also helps all community nurses (including health visitors) to share the innovative and creative work they do, so that it can inspire others. We are also working in partnership with organisations including Homeless Link and the Association for Young People’s Health, to create a toolkit about Homeless Families for Public Health Nurses with the aim of sharing learning more widely.

Focusing Care in Deprived Areas

The number of children in homelessness, poverty, and substandard housing is growing:

• 120,170 children were living in temporary accommodation due to homelessness in England in June 2017.
• 37% of children in the UK are expected to be living in poverty by 2022 under current policies and economic projections. In 1979, this was 13%
• Over half a million social housing homes do not meet basic health and safety standards.
• Over 240,000 homes have a category one hazard, risking occupants’ health. This includes potentially fatal hazards such as exposed wiring, overloaded electricity sockets, dangerous boilers, leaking roofs, vermin infestations or inadequate security.

Many challenges are rooted in poverty and poverty scars children for life. A scoping report by the Joseph Rowntree Foundation found that in the context of poverty, parents are at much higher risk of mental and physical ill health and addiction. This places enormous stress, and sometimes caring responsibilities, on the shoulders of parents and young children.

In 2015/16, the most deprived children were 58% more likely to have an unplanned hospital admission than the least deprived. If unplanned admissions were brought down to the level of the least deprived, this would result in a potential saving of almost £245 million per year.

As one specialist health visitor recently told me:

“Homelessness [and vulnerability] does not just affect young children but can have a devastating effect on children of all ages. Many of the families we see have not engaged with services previously and the children may not be accessing school or primary care services. Their parents often have physical and mental health problems.”

At the conference I will discuss creative ways in which health visitors across the country are linking up with other support organisations such as childcare providers, leisure facilities, homeless hostels, housing departments and others to improve support to the poorest families.

Health visitors’ work as specialist public health nurses aims to support the optimum healthy development of all children. In the context of a much reduced safety net, health visitors become ever more important for families living on a low income.

Despite these challenging times, I am looking forward to meeting energetic, positive and passionate health visitors to discuss meeting the needs of their diverse communities and tackling the public health challenges of poor housing and low incomes.

The QNI’s Homeless Health Programme

The QNI’s Homeless Health Programme has supported health visitors to get involved in a variety of ways – whether it is through our national advisory group, sharing practice at learning events, giving evidence to all-party parliamentary groups, or contributing evidence from the front line to shape national guidance.

If you want to find out more contact David Parker-Radford.

Or visit this page on The QNI website.