Health Visitor turned up after I declined appointment

[AliceBeazley]

So, the Health Visitor. I understand it can be a valuable service to some, and it's good we have this available to us if we need it.

That said, I've never really felt the need myself. I had a visit from one once or twice after my first son was born, and she was very nice but it wasn't especially useful and just took up my time when I would rather have been doing something else.

Whenever I've been sent an appointment, I've gone through the checklist and never had any concerns. I've also got various books on child development in the early years and am proactive about checking whether milestones are being met. I've therefore cancelled all HV appointments that have been sent, and other than the office staff seeming a little puzzled, I've never had an issue doing this.

Roll on to baby number 2. I declined the checks from the start, other than arranging for the HV to come and weigh him when he was a few weeks old. When the 1 year check appointment came through I called the office and cancelled again. The woman said she would pass the message on to the HV.

The HV called and left a message to say she had my message and that's fine, but she could come and do another weigh if I wanted to, yada yada yada.

Feeling the matter was resolved, I forgot about it.

This morning the HV turned up at the door for the 9-12 month check. I explained it had been cancelled, and she sort of made noises as if that was a surprise. I said hang on, did you say your name was "Emma", wasn't it you who left a message for me to acknowledge I'd cancelled. She then said "Yes but as I said, it would be nice to meet you both". I said "Well there's lots of people it would be nice to meet, but you can't just turn up at people's doors uninvited". It was this point she obviously could tell I was annoyed at her intrusion and decides to scuttle off again.

I'm pretty annoyed by this to be honest. She knew I wasn't interested but she tried to disregard my wishes and try and come in anyway. I know a lot of people think HV appointments are mandatory and they don't do anything to point out the contrary. I feel like she just wanted to railroad me into letting her in whether I wanted to see her or not. This tactic probably works on some. I have to say I find it quite disturbing that someone acting on behalf of a government funded organisation can decide to turn up at your house and ask to see your children and intrude upon your privacy without any mandate or justification. As if the state knows better than me and I am unable to opt out.

Am I being unreasonable? I feel like complaining about this as its a complete overstep. I've no idea who to complain to or if it would even do any good. I'd appreciate other's thoughts on it. TIA.

Who changes beds in the UK if not Nurses?

Health care assistants. Nurses are way too valuable to change beds. As I said, complete ignorance about UK healthcare.

As a nurse who worked in an NHS hospital until recently, I changed beds, toileted patients, helped with feeding because these things need to be done and when there is only one HCA between 3 nurses then you all have to get stuck in. Nurses are not "too valuable" to touch their patients.

I have plenty of experience in medical areas, but I do not have any formal medical training (other than the medicine management module at university). Yet, I can go do a 1-year HV course to become a health visitor, even though my background is adult nursing. And sure, a lot of nurses have advanced degrees, but they are not compulsory to be a HV. A nurse is a nurse. A doctor is a doctor. There may be overlapping skills, but they are not interchangeable.

Come on then TalkingCat tell us what you do so we can tear you apart from the behind the safety of a computer screen . You do not know that is what the HV actually said, she may have interpreted that way. You wonder why so many nurses & midwives are leaving the profession… take at look at yourself & what you have written.

Think you will find every women is asked that question at her pregnancy booking appointment , if it is unable ( due to partner being present) to be asked it will be asked at a later date. 65% of all DV are pregnant or new mothers.

@Musicalmaestro If she’d asked me if I was afraid of him when I was alone it would have made more sense! It seemed like a weirdly aggressive way to get back at him for frowning at her after she had told him to “palpate his balls” to save our child from being orphaned. It was truly bonkers, she was more like someone from a secret camera show then a HCP.

Such ignorance, yes doctors and nurses have their own distinct, and equally important roles, but nurses don't simply 'carry out orders' and conversely I don't know any doctors who claim to know it all and who don't ever seek support or input from nurses.

Health visitors are only human, some are shite yes- doesn't by any means mean that makes the entire system redundant or pointless. There are also some fantastic ones and many who are okay and do the job to a level that works for the children and parents in their care and that's okay.

Your picture of a nurse is extremely outdated. Nurses don’t help doctors, nurses run the ward and have responsibilities for patients 24/7. Nurses work in partnership with other HCPs, including doctors.

Many nurses are qualified nurse prescribers. The training and the exams for this qualification are to a very high standard.

As a HV you manage a caseload autonomously. You can refer to many other services without ever “asking” a doctor. You can refer for hearing and eyesight tests, hip dysplasia, speech and language, social care, the Community Paediatrician.

In response to your last comment, I’m extremely cynical about anything I read in the media, especially Internet forums. That’s what a university education does for you. It teaches you to question things. Even where “evidence” is posted I question who did the research? Was the methodology to a good standard? What did the subject sample look like? Were the results valid and reliable?

What university taught me was to take very little notice of anecdotal information posted on the internet, as there is no way of following up these claims to test their validity. that’s a shame because often anecdote is the first indication of a problem, and multiple anecdotes that describe difficulties with a service can lead to very real problems being uncovered sometimes in departments run and staffed by university educated professionals. (You can’t have failed to read the heartbreaking reports of babies and mothers lost in the papers recently).
Theres a huge difference between healthy understanding of how valid a source is and seeking to silence women describing their experience because it threatens your perception of the health visitors service and how it is delivered up and down the country. It DOES matter that you make some womens first months/years of motherhood harder, sadder or more exhausting. It’s not ok to just shrug that off as collateral damage.

I completely agree with you. Anecdotal evidence can give us clues for further research and and yes of course women shouldn’t ever be silenced.

However, as you will know, some comments written from behind the anonymity of a forum like this should be read with caution. Some of the comments on here stem from practice received years ago. Others are somewhat goady, and some are from people who clearly haven’t a clue about nurses, Health Visitors or even doctor’s roles in today’s NHS.

shat Has changed in the HV service in the last 20 years? Is it the same role or has it morphed into something else?

it’s actually really hard to criticise HC professionals or entertain the idea that your experience was not kind/ok. It overshadows a very important time in most women's lives. A time most would like to have been lovely.

@5zeds the absolute truth is, both the NHS and Health Visiting has changed so much, I wouldn’t know where to start. I will be the first to admit that many changes have not been for the right reasons.

Governments, regardless of politics see the NHS as a political tool, a vote winner in fact. How many times have we heard that if you vote for “them” they will change the NHS! It’s well known that major institutions take five years to recover from changes made, so sadly we’re left with an NHS that struggles.

Health Visiting does not escape from government changes and the way Health Visitors are trained has changed dramatically, as now all HVs have a degree in public health and all HVs come out of their training as nurse prescribers. At one time HVs were also for the elderly but now the focus is young families.

Health Vistors no longer have their title in our regulatory body, which has also changed from the UKCC for Nurses, Midwives and Health Visitors to the Nursing and Midwifery Council. Health Visitors are now in effect Public Health Nurses.

Over the years, there have been many Government White Papers, directing care provision for public health. Each time a paper is published we have to respond and adjust practice. The Working Together paper told everyone working with children, that we had to work much more collaboratively with all agencies. This has resulted in a huge workload for HVs in Safeguarding. Every child under five on a child protection plan, has a HV with extra responsibilities. We’re also tasked with making assessments on every family on our caseload, for signs of child abuse. This has, of course, always been part of our role but in recent times there has been far more emphasis on this aspect. We’re responsible for every child on our caseload and we spend much of our time tracking down hard to reach families. Much of this type of work is stressful and takes us away from the parental support we actually want to give.

I could go on but even I’m bored now. Thanks for reading if you made it this far.

So you’ve lost the elderly but now most of your caseload is safeguarding rather than direct support to parents. Do you think this is a good way of protecting children from abuse? In your experience IS it HVs who uncover most abuse? Do they do that by home checks when babies are very young or at developmental checks later on?

I’m sorry your bored, it’s a horrid feeling. Don’t answer if it’s too boring. I’m interested.

Yes, without a doubt it is HVs who do the most to safeguard children from harm. This is from our referrals to children’s Services and also our visits where there is a Child Protection Plan. Where a family is hard to reach and doesn’t engage with playgroups or nurseries, the HV is the only person who might see that child.

You might think that a visit wouldn’t necessarily pick anything up but it does. Our training equips us with the necessary knowledge and skills. You notice things that are actually quite obvious, when you know what to look for.

No wonder health visitors don't have time then to properly support new parents and their babies if their remit has extended out so much. Such a shame.

So why not just say it’s a safeguarding visit?

That’s a decision that’s made way above my pay grade.

What university taught me was to take very little notice of anecdotal information posted on the internet, as there is no way of following up these claims to test their validity

Somewhat unrelated example, but if the Post Office had spent more time listening to (and crucially acting on) anecdote they might not have ruined so many postmaster' and postmistresses' lives accusing them of fraud. Anecdote is important.

Then that is shocking and very irresponsible. Doctors are the only ones that should be allowed to prescribe. No wonder the NHS (which is a wonderful service) is in such dire straights were non-professionals are prescribing drugs

I disagree with this. Nurses (and paramedics) with the appropriate training are very capable of prescribing drugs. You don't need to see a doctor for say a skin rash if a nurse can prescribe a steroid cream. And a nurse will know if it needs further investigation and refer on.

Whilst anecdotal evidence can give us clues about what to research further, taking random posts off an Internet forum is not ideal. I’m sure you will agree that some of the views posted on here are not relevant as they are very out of date. Others are just goady and some are from people who are clueless about the roles of doctors and nurses.

The post office scandal is an utter disgrace.

There is a shortage of HVs so you are less likely to see one, and if you see one they are less likely to chase you if you miss appointments.

It does however depend on where you live. Like all NHS services it is a postcode lottery.

My health visiting team is run by a community interest company. They operate in children's centres in my borough. As I live in the only part of the borough without one near by they operate out of rooms they hire in my GPs practice. They hire the same rooms as the community midwives but use it on different days. The reception area is different and the GPs receptionists have absolutely nothing to do with either of them. If it's one of the nicer receptionists they will point you to the area. The HVs are the ones who send me notifications of my DDs immunisations and help sort out her opthalmology referral. (GPs have actually never seen my DD who is 3 - it's been nurses, HVs and hospital doctors. There as GPs they have seen me in that time.)

I know in another borough the services are run in community hospitals and the services are run under the umbrella of a children's hospital. They do lots of safeguarding so while parents can self refer most children are referred by other HCPs. (The OP wouldn't be chased in this borough.)

The difference with the PO issue is that the PO were involved with real people who they could identify who they trusted for years. On internet forums people go under anonymous usernames.

While there are a handful of posters I know who they are in real life on forums, I don't know who most posters are.

I do suspect some people on MN though when out and about due to the behaviour of certain family members around them. I then remember they may be that poster so keep my mouth shut. Luckily nothing has escalated.

In a lot of areas HVs have been contracted out and aren't part of the NHS anyway. When I had my baby the council had contracted out HVs to a private provider who were meant to be providing a minimum level of service, eg the six week postnatal visit and developmental checks at 12 and 27 months. What they were actually doing was saying that they provided this, then making it almost impossible for anyone to book one of these (other than the postnatal visit). They no longer ran clinics in GP surgeries, which also meant GPs no longer had access to the baby weighing scales they had previously had shared access to. So someone with concerns about their baby's growth/developmental first of all had to convince a HV to weigh the baby. If you showed up at the GP they couldn't check that. HVs no longer provided the postnatal support group they had done until they were contracted out and also no longer offered any mental health support eg for PND or anxiety.

The private provider also provided some other services eg wheelchairs and I know of a case where child was referred for a wheelchair (this keeping money in the private provider's hands) when their child was v slow to develop walking skills rather than for physio (which private provider didn't provide) to strengthen muscles etc.