Norfolk parents are failing to get mandatory health visits for their babies, with those running the service blaming staff shortages and Covid.
Health visitors are meant to come to every family's home to check babies' development at two weeks old, eight weeks, one year and two-and-half years.
The visits can be a lifeline to families struggling with a newborn and are also important to potentially spot any safeguarding issues.
But since 2020, Cambridgeshire Community Services NHS Trust (CCS), which is paid millions of pounds a year by Norfolk County Council to provide the service, has failed to visit the vast majority of Norfolk families.
CSS is visiting all families when their babies are two weeks, but the eight-week review has been done by a video call since April 2020, while the face-to-face appointments at one and two-and-a-half have been replaced by a questionnaire since October 2020. It means that after the two-week visit, most parents will not see a health visitor again.
A report by Public Health England in February 2021 said that all four reviews must be carried out by a health visitor or delegated to a suitably qualified health professional or nursery nurse.
There is a national shortage of health visitors, but the visits are continuing as normal elsewhere in the country, including Suffolk and Essex but not in Norfolk or Cambridgeshire.
CCS, which has a £117m contract running over several years with the council, said all the visits were only being done in the most vulnerable cases.
A spokesman said: “Throughout the pandemic, we have prioritised the safety and health of children and families.
“All parents and families have been and remain able to access support and advice.”
'So little contact'
Lucy Ellice, from Wymondham, whose son Arthur has just turned one, said: “I think it is pretty awful that they aren’t coming out to do the one-year checks. We’ve had so little contact.
“I would have liked to have seen a professional who knows what is ‘normal’ for a one-year old to be doing.”
The 29-year old teacher said in Yorkshire, where her brother and one-year old niece live, a health visitor had spotted a potential issue with her niece’s hip and she was given a scan.
“It would be very reassuring to see a professional," she added. "There is a reason these checks are in place. Why does the rest of the country get them but not Norfolk?
“I think a lot of things will be missed doing it this way and it potentially puts vulnerable babies in unnecessary danger.”
Mother-of-two Molly Baldry, from North Walsham, had all the scheduled home visits before the pandemic for her daughter Lily, until she turned one.
But the teacher was never told about a two-and-half-year check and for her second child, Oliver, 11 months, she has not had a single visit, even when he was two weeks old.
The 25-year old said: “Schools are back, everything is open so it makes you think, how long can they keep using Covid as an excuse to not provide the full service?
“I’m more relaxed with Oliver because he is our second, but for Lily, the health visits were really helpful in making sure she was reaching these milestones.”
Danielle, 38, from Sprowston, whose daughter has just turned one, said: “I don’t see the logic behind not doing the visits. You can go to a restaurant or pub, but a health visitor can’t check if your baby is OK.
“They need to say when they will start doing them again.”
Alida Kuzemczak-Sayer, 36, an artist from north Norwich, is due to have a health visit for her one-year-old daughter Yeva later this month.
“It is just something you expect to happen,” she said. “I’m shocked that this isn’t being offered to all families.
“There are so many things that I want to discuss with them and having them visit will give me a lot of reassurance. I’ve used the helpline a couple of times but found it quite impersonal.”
Jenni Border, 34, also from north Norwich, did have a visit when her daughter, Rosie, was 10 months because she was concerned about her weight gain.
“They are good on the phone when you need help,” she said. “But having someone come to visit us did reassure us that everything was OK.”
CCS did not answer our question about when all parents in Norfolk would start getting home visits again, only saying that face-to-face visits will increase as pressures ease.
In the meantime it encouraged families to contact them through their helpline or to find advice on the Just One Norfolk website. The helpline is responding to over 1000 calls per week, CSS said, adding it was delivering professional advice to families.
Norfolk County Council, meanwhile, said that it has increased its annual investment into the Healthy Child Programme, of which health visits are a part, by over £500,000 in 2020/2021.
But a spokesman added: “Investment alone cannot tackle a national shortage in health visitors or the difficulties experienced during a global pandemic.”
They said: “In order to ensure that services are delivered where they are needed most, and the most vulnerable families continued to receive face to face home visits, CCS in agreement with public health commissioners, modified their offer to those considered low risk making resources available online and through a dedicated contact number for parents, professionals and family members to get direct advice.”
Risk to children
The absence of face-to-face contact has also raised concerns about the ability of reviews to pick up signs of developmental or safeguarding issues.
Several high profile cases of child abuse have been missed by public services in recent months.
In September 2020, 16-month-old Star Hobson was beaten to death by her mother’s partner after months of cruelty and abuse at their home in Keighley, West Yorkshire, which had not been picked up by social services.
In 2020/21, there were almost 200 cases of serious harm or death involving babies in England, which is a 31pc rise compared to 2019/20.
A council spokesman said: “The council and CCS do share concerns that the disruption on all aspects of services for children and young people as a result of Covid will be having a detrimental impact on their development and opportunities.”
But they added: “The health and safety of parents, children, and staff within the Healthy Child Programme are at the heart of all decisions made.”
Staff shortages
The Covid outbreak in March 2020 initially put a strain on health visiting across England, with many staff redeployed to other areas of the NHS.
But inspectors from the Care Quality Commission, whilst rating the service "outstanding", first raised concerns in August 2019 that CCS “did not always have enough nursing and health visitor staff”.
The Guardian reported in October 2020 that overstretched health visitors were being forced to care for up to 2,400 families with newborns at a time, 10 times the recommended number.
The Government’s own Early Years Review last March recognised that “workload pressures… meant it was hard for dedicated professionals and volunteers to support families in the way they wanted to”.
Moreover, the health visiting service in England entered the pandemic already suffering from a 31pc reduction in health visitors since 2015.
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