Hucknall: Children’s health may have ‘fallen through the cracks’ after NHS home visits reduced during the pandemic

The health of some young Nottinghamshire children may have "fallen through the cracks" after NHS home visitors dropped some in-person calls during the pandemic.

NHS guidelines say from late pregnancy to a child reaching the age of around two-and-a-half, a family should get five in-person health visitor reviews.

But since during much of the pandemic many Nottinghamshire families instead had around three of the five reviews done by telephone.

During a meeting about the issue, some local councillors who are also new parents told personal stories of being "left with babies" with only phone calls from health visitors as opposed to the usual in-person visits.

The problem was talked about during the Nottinghamshire County Health Overview and Scrutiny Committee meeting on March 28.

Kerrie Adams, Senior Public Health Manager at Nottinghamshire County Council, said the teams involved were following national guidance.

Vice chairman councillor Bethan Eddy (Con) raised concerns the welfare of some children could have "fallen through the cracks" because they had not been seen in-person enough.

She said: "There's a couple of us who come from a very personal place with this who had children during the pandemic.

"My daughter was three months old when we went into lockdown. Both her reviews were done over the phone and a questionnaire through the post.

"I am very worried that there are going to be children and mothers who during that time won't have been picked up because we weren't seen face-to-face.

"As a new mum, it was a very scary time.

"My daughter hasn't been seen since she was six months old."

Ms Adams said that during lockdown arrangements were led by NHS England.

She said the six to eight week check involved a telephone call and a "short visit" to weigh the baby and check in with the mum.

She said the system worked differently for families identified as vulnerable, who would have had more contact.

Ms Adams said: "In terms of the children that may have fallen through the cracks, the team did undertake an audit of a group who were born at the height of lockdown and we established that those children will have had all their mandated reviews.

"That provided the assurance that there were no children that had not been seen for at least one face-to-face visit during that period of time."

Cllr Sue Saddington (Con), chair of the committee, said: "I am not wholly sure in my mind that answers the questions.

"I am not a new mum but I am certainly an old granny and I can see the problems.

"I was actually told by a member here that they had been into a school and there was a child of five walking around in a nappy.

"It isn't until they get to nursery that it will be found out that plenty fell through the cracks."

Cllr Michelle Welsh (Lab) also told of her own struggles including resorting to weighing her baby using kitchen scales at home.

She said: "I think health visitors are one of the most profound professions you can have and that's why I wanted you to come here because it's such a valuable service.

"I've had concerns about the health visiting service, I don't think support during the pandemic was good enough.

"As someone that had their baby in the first week of lockdown, nobody was picking up the phone at the health visiting service.

"I had no follow-up phone calls. Even the midwife asked me to get my partner to check my scar.

"Women were left with young babies. It wasn't good enough and women were left very vulnerable.

"Heaven forbid it ever happens again, but there are huge lessons to be learnt."

Cllr Welsh also questioned why in Rushcliffe, 734 families were seen face-to-face for birth reviews in 2020/1 whereas in Gedling only 208 families were seen.

She added: "I remain concerned about those women that had babies during lockdown because post-natal depression hasn't been fully addressed."

Ms Adams said children born during lockdown will now be at a stage where they are visited again, in person, for a review for two-year-olds.

Nottinghamshire Healthcare NHS Foundation Trust representative Sheryl Dudley, operational development lead for healthy families, said: "There's no question it was extremely challenging to get that communication out to the teams.

"Certain teams implemented the guidance with immediate effect and clearly in Rushcliffe, it wasn't implemented as robustly as we'd expected them to.

"We were in unprecedented times.

"Your lived experience really matters to us that this is the experience you had, we need to learn lessons.

"We will be better prepared if we were in this situation again, there's no doubt about that."

Cllr David Martin (Ind) referenced the report which states there are "capacity pressures" in Bassetlaw, Ashfield, Gedling and Broxtowe.

He said: "Does this mean that families in Ashfield are without a health visitor or a longer wait for them? 

"The issue I have with this is, areas in deprivation need health visitors more than other areas.

"Health visitors help, for example, to spot signs in autism in under-fives – can we have a categoric guarantee that the issues, particularly in Ashfield will be addressed going forward?"

Joseph Sullivan, director for children and families, Nottinghamshire Healthcare NHS Foundation Trust, said: "We do have unprecedented staffing challenges.

"We are pleased to say there has been significant improvements across the county in terms of staffing.

"Despite the challenges the performance data is still improving and growing.

"What I would say is that the people that work within the trust are the most critical part of making a difference to our children and families."