Who do you work with?

“Being a health visitor is a great job because you build up a relationship with a family, often over a number of years, and it is rewarding to see them flourish – particularly if they have overcome a problem such as depression or bonding and I know as a health visitor I have helped. I know I can really make a difference.”
Fiona Sandilands, a health visitor in Kent

How many are there and how long have they been around?
There are about 24,000 health visitors registered with the Nursing and Midwifery Council, and about half are practising (the others are retired or working in other areas, such as education). The government created the post of health visitor in 1915 to educate the public and dispel old wives’ tales.

Where are they usually located and what other workers/professionals do they work with?
Health visitors in the 21st century are all attached in some ways to GPs, usually in health centres or GP practices. Some have a caseload of mothers and young families registered with a GP or practice, while others work in a community-based team covering a geographical area.

What is their main role?
Their main role is in prevention – trying to assess risk of illness and head it off. In the 1970s and 1980s they worked with people throughout their lives but increasingly they are primarily concerned with under-fives.

Health visitors look in a holistic way at a child’s and family’s social, emotional and physical health needs then act as a sort of pivot. They advise about nutrition, immunisation, child management and safety and are very aware of emotional health and the triggers of stress within a family, such as unemployment, inexperience, or bereavement.

A health visitor might refer a child with hearing problems to an audiologist, suggest management strategies for one with behavioural problems or act as an advocate in getting early attention from the housing department where housing is the main issue.

What are the main laws that govern the work they do?
Health visitors have a responsibility to act if they feel a child is vulnerable, and The Children Act 1989 is the main piece of legislation governing their work. In particular, the act requires health visitors to work with local authorities to develop a shared information base from which they can assess the number of children in need within their geographical area and how best their needs can be met. They also have responsibilities under the Children Act 2004, the Every Child Matters agenda, and the national service frameworks for children and mental health.

How and by whom is their work funded/commissioned?
In England, their work is commissioned by primary care trusts.

What is their average salary?
£25,000

What is the normal training/qualification route?
Would-be health visitors must be accepted onto a training course and find sponsorship from a community health trust. To undertake a course they have to be a registered first-level nurse or qualified midwife and be at diploma level. They should also have one or two years’ post-qualification work experience.

What is their biggest gripe?
Health visitors’ biggest gripe is feeling their contribution is under-valued. “You only notice what health visitors do when you take them away,” says Cheryll Adams of the Community Practitioners’ and Health Visitors’ Association. If you don’t have an effective health visiting service, GPs get many more consultations, there are high levels of depression, and more behavioural problems because mothers haven’t had anyone to turn to.