Children harmed by decision to redeploy health visitors, Covid survey finds

An NHS decision The redeployment of health visitors during the pandemic was “fundamentally wrong” and “children were harmed” as a result, the head of a health visiting charity has told the Covid inquiry.

Many health visitors were sent to work in other parts of the NHS at the start of the pandemic.

Alison Morton, CEO of the Institute of Health Visiting, told the inquiry it was “inappropriate” because they “were most needed on their own front line”.

Duncan Burton, chief nursing officer at NHS England, told the inquiry its shielding response had not stopped throughout the pandemic, despite staff being diverted to essential services.

Health visitors in almost two thirds of trusts in England were redeployed in March 2020, according to research from University College London.

The intention was that they would work in hospitals to support seriously ill patients, but some were sent to do administration, deliver packages and answer phones, the inquest heard.

Some health visitors who remained in post found themselves with caseloads of 750 children or more, well above the recommended 250, according to evidence provided to the inquiry by Professor Catherine Davies, of the University of Leeds.

“We failed families,” Ms Morton told the inquest, saying babies were not protected and “some children were paying the highest price”.

The inquiry showed research from the Child Protection Practice Review Committee which identified Covid adaptations, such as virtual visits as opposed to health visitor home visits, as factors in some children’s deaths and serious incidents.

Children like Star Hobson and Arthur Labinjo-Hughes – who were both killed by their guardians during the pandemic – have made headlines, but there have been many others, Ms Morton told the inquest.

“These practices have harmed children,” she said.

“This had life-changing and life-ending consequences for these children. They were the canary in the coal mine and we needed to listen to them and make sure their voice mattered even in their death.”

“To me, that’s the saddest part of the pandemic, the way we’ve failed these children,” Ms Morton added.

Visit to the Institute of Health – a charity and professional body which works to strengthen the quality and consistency of health visiting practice – said it had been in regular contact with the government during the summer of 2020, raising concerns.

He said a letter was eventually sent by England’s chief nursing officer to trusts in October 2020, saying redeployments must end.

The organization also had to carry out “a strong intervention” so that there was no new redeployment in December 2020, the investigation indicated.

The inquiry is due to hear evidence from those who were in government at the time in the next two weeks.

Earlier, Duncan Burton, England’s chief nursing officer, told the inquiry that at the start of the pandemic the NHS was battling a new virus and staff needed to be released to help with essential services.

He said NHS England’s response to safeguarding activities did not stop throughout the pandemic but that has changed.

“For example, we ensured that testing center staff were trained on protective measures and what to look for.

“And as more and more clinical contact happened online, we needed to ensure that the type of advice online took into account the protection needs of children.”

The inquiry also heard about the NHS’s decision to keep children out of the healthcare system unless essential and to suspend elective procedures for children in March 2020.

The NHS was focused on freeing up intensive care beds, the inquiry found, and Mr Burton said “we needed to focus on that”.

They didn’t suggest stopping anything that was urgent, Mr. Burton said, but “there was a balance in prioritization.”

Waiting lists for children grew twice as fast as those for adults during the post-pandemic recovery period, Data from NHS England which was presented to the inquiry indicated this.

Mr Burton’s testimony highlighted that procedures for children being seen “as lower priority compared to, for example, cancer treatment in adults” was one of the reasons for the increasing size of waiting lists for children.

He added that the fact that children’s operations were mainly carried out in more specialized hospitals and there were fewer staff could also have made the delays worse.

Some of the longest waiting lists are for speech therapy appointments – with schools seeing a huge increase in the number of pupils needing extra help.

Children have been “severely and in some cases irreparably damaged” by the indirect consequences of the pandemic, Professor Steve Turner, of the Royal College of Paediatrics and Child Health, told the inquiry.

“They make up 25% of the population and receive 11% of NHS spending.”

They are not treated equally in our society and have become a lower priority during the pandemic and during the recovery period, Professor Turner said.

This part of the Covid Inquiry examines the impact of the pandemic on children and young people, and whether they have been considered in key decisions made by the Government.