Increasing poverty is the cause of greatest concern to health visitors according to research, which found the vast majority reported a rise in the number of families affected by the issue in past 12 months.
Almost nine in 10 health visitors surveyed said they had seen an increase in the use of food banks, while half reported more families skipping meals as a result of the cost-of-living crisis.
The Institute of Health Visiting (iHV) described its research as the largest survey of frontline health visitors working with families with babies and young children across the UK.
Lamenting the worsening situation, it said health visitors are a “vital voice for our youngest citizens and an important warning signal for policymakers who are prepared to listen”.
Some 1,186 practitioners – including health visitors and health-visiting team members – completed the 10th annual survey by the organisation in October and early November last year.
While it was a UK-wide survey, 90% of respondents were from England, with 5% from Wales; 4% from Scotland; and 1% from Northern Ireland, so the iHV said its report presents findings from England.
It found that 93% of health visitors reported an increase in poverty affecting families over the past 12 months.
Results also showed just over three-quarters (78%) of health visitors reported an increase in perinatal mental illness, affecting a mother during pregnancy or in the first year following the birth of a child, and more than two-thirds (69%) reported a rise in domestic abuse.
The iHV said health visitors, through their work on the frontline, had seen deterioration in babies and young children’s safety, health and development, with 82% reporting an increase in children with speech, language and communication delay and three-quarters seeing a rise in child behaviour problems.
Some 81% of health visitors reported an increase in children with safeguarding concerns that now fall below the threshold for a children’s social care system, which the report described as being “saturated with need”.
The report warned that services are “focused on ‘firefighting’ rather than prevention, identification and early intervention”.
Health visitors are described by the NHS as specialising in working with families with a baby or child up to five years old to identify health needs as early as possible and improve health and wellbeing by promoting health, preventing ill health and reducing inequalities.
Alison Morton, iHV chief executive, said: “Consistently, health visitors have told us that parenting has become much harder for many families over the last 12 months. Health visitors are in a privileged position, they see firsthand the struggles that families with babies and young children are facing, often hidden behind front doors and invisible to other services.
“Sadly, despite policy promises, more and more children are not getting the ‘best start in life’ and the situation is getting worse with more children falling behind with their development and widening health inequalities.
“As babies can’t speak for themselves, health visitors provide a vital ‘voice’ for our youngest citizens and an important warning signal for policymakers who are prepared to listen. It doesn’t have to be this way, change is possible.”
Among its recommendations, the organisation said there must be a greater focus on prevention and early intervention, and a national plan to strengthen health visiting in England with long-term investment, full delivery of the long-term workforce plan and concerted efforts to “end the current postcode lottery of health visiting support”.
A temporary measure taken during the pandemic to count virtual and non-face-to-face health visiting among the mandated visits within the Healthy Child Programme must be brought to an end, the iHV said.
It also called for a cross-government commitment that prioritises and invests in the first 1,001 days of a child’s life.
A Government spokesperson said: “We continue to help families with the cost of living with support worth on average £3,700 per household, including raising benefits by 6.5% from April and increasing the Local Housing Allowance.
“Children are five times more likely to experience poverty when living in a home where no-one works, which is why this government has reduced the number of workless households by 700,000 since 2010.
“We are also taking significant action to improve children’s health by increasing investment in Family Hubs and the Start for Life and Healthy Child Programmes.
“We plan to increase health visitor training places and have provided local authorities £3 billion to fund health services to make sure children get the best start they need.”
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