To think the 1 year health visitor appointments shouldn’t be scrapped?

[coffeeforone]

DS is 10 months and I was awaiting the appointment for his 9-12 month review. I was a bit surprised to just receive an Ages and Stages Questionnaire and a prepaid envelope to tick the boxes and return.
The accompanying letter indicates there will be no review, but just a reminder to book 1 year vaccinations and the standard contact details if we have any concerns.
Part of me thinks great - no need to get time off work, we are generally happy with how DS is doing so why waste everyone’s time when resources are clearly limited.
But another part of me thinks it’s a shame that every baby doesn’t get a one year follow up. There were some useful things that came out of DS1’s 2.5 year review (brilliant advice on potty training that worked in a few days for example). I also wanted to mention DS’s allergies and ask if they had any advice or private recommendations for as there are long NHS waiting lists (9 month wait for an allergy clinic appointment!).
Most importantly, if they actually see the child and talk to the parent they could pick up more worrying risk factors - anyone can tick the right boxes on a form!

Surely for most people, it is a complete waste of time as the majority of children develop normally. I imagine the whole point of them is to check for the children who aren’t and especially those with parents who either don’t notice or don’t do anything about it. Seems like missing a real safe guarding opportunity here that is a short sighted savings exercise.

I had countless checks and tests when I was pregnant, everything was fine so I didn’t need them and it was a complete waste of time. The checks are to catch the mothers that need intervention or special attention. Seems like a similar principle to me.

I'm in the south east and dd is having her check in a couple of weeks. Maybe it's county or hospital trust specific? Wouldn't be too bothered tbh except I'd like to get her weighed and it is a way to avoid the queues at the regular clinics. We didn't have the 2.5 yr check for DS as we moved and despite me phoning to change the address I don't think they did. He was at nursery full time so trusted them to let us know if they thought there were issues over someone we'd likely never met before.

I raised concerns at Ds 12 month check. At at a later one (three year?) I was fobbed off because he ticked enough of their boxes - he could tell her it was a duck on the card, even if he said that for half of them!

By 4 school had identified issues and the many diagnosis started to follow.

My story certainly isn’t unique so even when parents raise concerns these checks often don’t help so no I don’t see the point of doing them across the board as standard

I am a HV in the south east, we are working on about half the staffing we had 3 years ago. The new birth, 6 week, 1 year and 2 year checks are all mandated but we struggle to staff them. Support workers usually do the 1 and 2 year checks. We are also meant to do antenatal visits to every expectant mum, again we struggle to do these. We do the best we can and we always prioritise vulnerable families and those with safeguarding needs. A lot of health visitors are retiring and they are not training in them in great numbers anymore, so we have difficulty recruiting.

I thought getting mine weighed was a total waste of time as well. She ate very well. She was obviously (and still is) a totally normal weight.

I honestly feel most mothers do better if they are left to get on with it.

@vintagenurse that's interesting! I didn't realise that appointments were a thing for all expectant mums - I didn't get one for either of my pregnancies. I assume in reality, that services would be prioritised to mums where the midwife has concerns?

The risk with the one year check is that a child could have never seen a professional since they were days old, so no problems picked up and the parent could be oblivious.
For 2.5 it might not be as much as an issue, especially if they go to nursery. Maybe it would be ok to cut the 2.5 year checks on kids that attend nursery anyway but try to check on those that don't?

I work in Health Visiting. These checks aren't a tick box exercise. Watching a 27 month old build a tower for example isn't just watching them build a tower. We're looking at many other things - eye/ hand coordination, any shaking, grip, fine motor skills, processing information, following instructions, social skills, the relationship between parent and child etc. Home visits allow a holistic assessment of the child and family as a whole. It's a chance to check in with parents who may be really struggling but don't want to make a fuss or don't that there is support available.
Often parents have concerns they think aren't important enough to bother the HV with but could be indicative of something significant. Many parents just wouldn't bother filling in a questionnaire or may have difficulties with literacy, may not be English speaking or have learning difficulties. All these children would be missed. These checks are generally done by highly trained and experienced Nursery Nurses whose expertise is in children's development.

The risk with the one year check is that a child could have never seen a professional since they were days old, so no problems picked up and the parent could be oblivious.

I think we have to have more faith in ourselves as parents than this.

Again, it's the kids with intelligent involved parents that will more likely be OK because someone will flag concerns that will be OK and the more vulnerable who could miss out

The risk with the one year check is that a child could have never seen a professional since they were days old, so no problems picked up and the parent could be oblivious.

Or, as has happened to a few people I know, parents raise concerns and the HV says all is fine so the parents relax and ignore things which don’t feel right more.

@herculepoirot2herculepoirot2 I very rarely visit a family who have absolutely no questions, worries or niggles! So many children fall through the net as it is I think stopping these routine development checks would be a disaster. It means a child wouldn't be seen by any professionals from birth until starting school.

My 5 year old DTDs had one at 10 months. The HV asked to see DTD2 again at about 18 months to check her development, and that was when I asked that she be referred. She was diagnosed with autism at 3y4m. We're in the SE of England.

Yes any antenatal mums who are vulnerable are referred separately to us by the midwives so we would prioritise those.
HV checks are not mandatory and you can decline them - this can mean a child could in theory go from shortly after birth to school with no profesional seeing them.

@herculepoirot2herculepoirot2 I very rarely visit a family who have absolutely no questions, worries or niggles!

I think we’re programmed to have worries and niggles, and the fewer visits there are, the more relaxed new mothers will be.

I'm in the south East ( Kent) and received the appointment for DD 1 year check in the post this morning.
It came with the questionnaire as well. I don't feel that DD needs this appointment how my sister's baby ( lives in South London) didn't have any follow up and my sister was more or less a teenage single mother in real need of a bit of help and guidance.

Unfortunately as with many of these things a lot of people that need the help are being missed.

I’ve always personally found HV appointments pointless. I have four DC and when the HV last came she was offering weaning advice as if I hadn’t already weaned three other children. I’ve never had any help from a HV, they don’t tell me anything I don’t already know.

Sorry, I sound arrogant. I’m aware they’re invaluable to many parents but I feel as though it should be an opt out system for those who genuinely don’t need any assistance.

Oh and I know you can technically opt out now but I think it’s frowned upon and a potential red flag of abuse.

I feel as though it should be an opt out system for those who genuinely don’t need any assistance.

There is.

I think it’s frowned upon and a potential red flag of abuse.

Someone said this the other day. It isn’t. You just say you don’t want the HV to come and they tell the GP so if you go there, they can offer you the checks. That’s it.

My girl hasn’t been seen since 6 months old (health visitor referred her to eczema clinic as the GP was reluctant) not through lack of trying.

We tried to book her 1 year review and our health visitor said they were busy so it would be around 1.5. So it comes to 1.5 years and I contact them and she says a nursery nurse would be in contact. They never contacted and we moved (only 5 minutes away but needed to change GP). So I update my GP and ring the health visitor to say we’ve moved and I’m concerned about gross motor issues (she’s 2.5 at this point) and I get no reply. I call and apparently my health visitor has now left so I’m reassigned a new one.

Then her 3 year old immunisations come through for our old GP so I ring them and they say they can’t do it as she’s not registered there and our new ones won’t as the appointment is from a centralised system. Apparently my address wasn’t updated when I contacted.

At the end of all this I had to beg the practice to do her immunisations anyway, her preschool has referred her for speech therapy and the Gp has her under review for gross motor skill issues. we still haven't seen a health visitor since 6 months regardless of trying to contact.

I didn't even get a 9-12m questionnaire, though I did get a questionnaire + appointment for the 2 year check. The 2 year check I thought was really good, I chatted to the health visitor and her assistant sat with DS and did activities.
I only HV one appoitnment at home, at 10 days I think. I did go to the baby weighing clinic regularly though.

Am now pg in a different city so who knows what the appointments will be like.

Health "visitor" is a totally inaccurate term in our area anyway, they don't come to visit you at home, you have to go to them!

The post upthread from an HV is interesting and backs up my impression of the service. It just feels like they're ridiculously overstretched and cut to the bone. Why are we limping on with it? Either fund it properly or cut the funding altogether and give it to GP surgeries or hospitals or something.

I didn’t have any with my eldest, we slipped through the cracks some how. I had just moved to the area no support etc. With hindsight I really needed that support, although listening to subsequent stories of questionable advice I think I may have been better off.

I was amazed that I could have done anything with them and no one would have known. We didn’t do nursery there was no “check”. If I’d wanted to harm my child, it would have been very easy.

My DD is 14 months, HV never got in contact to arrange her 8 month check (which I was told she would). I took DD to the HV department to be weighed and hopefully speak to someone about some concerns I had. No HV's to be found each time I went. BUT i did get a letter in the post from my HV offering to visit me to talk about my baby which isnt even born yet

I declined, clearly they are very busy, but WHY they find it more useful to visit expecting parents to discus unborn babies rather than check on babies who are already here is beyond me... especially when midwives visit new mums and can offer support and advice straight after birth.

I have since found out that all checks on babies after 4 months in my area has been cancelled!!

I hope we still have the one year appointment here. My health visitor has been the single most supportive and helpful person since I had my baby. I was actually wondering today if it would be any use writing a letter to praise her somewhere.

She was the only person who really listened to me and supported me in a concrete way. It made all the difference to us and our baby.