Children harmed by decision to redeploy health visitors, Covid inquiry hears

NHS decision The redeployment of health workers during the pandemic was “fundamentally flawed” and “children have suffered” as a result, the head of a health visiting charity has told a Covid inquiry.

At the start of the pandemic, many healthcare visitors were sent to work elsewhere in the NHS.

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

NHS England chief nursing officer Duncan Burton told the inquiry that safety measures had continued throughout the pandemic, despite staff being redeployed to critical services.

Medical visitors almost Two thirds of trusts in England were reallocated in March 2020, according to research from University College London.

They were expected to go to work in hospitals to care for seriously ill patients, but some were sent to perform administrative duties, deliver packages and answer telephone calls, the investigation heard.

Some health visitors who remained on post were left with 750 children or more, far exceeding the recommended 250, evidence given to the inquiry by Professor Catherine Davies of the University of Leeds showed.

“We have failed families,” Ms Morton told the inquiry, saying babies were not being protected and that “some children pay the highest price”.

The inquiry heard research from the Child Protection Expert Group determined that Covid adaptations such as virtual visits as opposed to home visits by nurses were factors in deaths and serious incidents in some children.

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

“This practice is harmful to children,” she said.

“This had life-changing and deadly consequences for these children, they were the canaries in the coal mine and we needed to listen to them and take their voices into account even after they died.”

“For me, the saddest part of the pandemic has been how we have failed these children,” Ms Morton added.

Wellness Visiting Institute – a charity and professional organization that works to improve the quality and consistency of health visiting practices – said it was in regular contact with the government in the summer of 2020, raising concerns.

The report said England's chief nursing officer wrote to trusts in October 2020 saying the redistributions should stop.

The inquiry reported that the body also had to intervene “strongly” to prevent another redeployment of forces in December 2020.

Over the next two weeks, the inquiry is due to hear evidence from those in government at the time.

Earlier, Duncan Burton, England's chief nursing officer, told the inquiry that the NHS was dealing with a new virus at the start of the pandemic and staff had to be freed up to help with critical services.

He said NHS England's protective response did not stop throughout the pandemic but it has changed.

“For example, we made sure that testing center staff were trained on safety measures and what they might need to look out for.

“And as more clinical encounters took place online, we needed to ensure that online guidance took into account children's protection needs.”

The inquiry also heard about the NHS's decision to exclude children from the health service unless absolutely necessary and to suspend elective procedures for children in March 2020.

The NHS was focusing on freeing up intensive care unit beds and Mr Burton said “we need to focus on that”, the inquiry heard.

Mr Burton said they were not proposing to stop anything urgent, but “there was a balance of priorities”.

During the recovery from the pandemic, children's waiting lists grew twice as fast as adults. Data from NHS England that was provided during the investigation is indicated.

Mr Burton's evidence noted that pediatric procedures were considered “lower priority compared to, for example, adult cancer treatment”, which was one reason for the increase in the size of pediatric waiting lists.

He said the fact that pediatric surgeries are mostly carried out at more specialized hospitals and have fewer staff could also lead to delays.

Some of the largest waitlists are for enrollment in speech and language classes. Schools are seeing a huge increase in the number of students needing extra help.

Children have been “immensely, and in some cases irrevocably, damaged” by the indirect effects of the pandemic, Professor Steve Turner, from 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 less of a priority during the pandemic and recovery, Professor Turner said.

This part of the Covid inquiry looks at the impact of the pandemic on children and young people and whether they were taken into account in key government decisions.