A new project: health visitors supporting A & E in times of need by Julia Neall

The December 2013 Health and Social Care Information Centre (HSCIC) report on A&E highlighted that the highest percentages of visits to A&E are for the very young and elderly. A large percentage of these visits are for children aged 0-5 years can most likely be attributed to minor illness or injury or represent a need for advice and guidance out of hours.

The Midlands and East Region, using the NHS England Service Transformation Bid Funding provided to regions to support innovation, developed an initiative to use the support and expertise of health visitors to reduce the burden A& E and primary care services through a more integrated approach to enabling families to better self-care for minor illnesses.

This integration has the potential to have a major impact across these services. By reducing the burden on these services which are facing dramatically increasing demands and by decreasing the number of families attending for minor illnesses, they could resolve themselves with the expertise help of health visitors A&E and GPs are freed up to focus on where they can make the most impact themselves.

The project includes a number of facets including working with NHS 111 to calls associated with issues health visitors have the expertise to address during evenings, weekends and Bank Holidays. This means that at the point of contact, families can be directed away from emergency services to the advice they need to resolve issues or, through expert assessment be referred on.

The project also includes widening access to services for those that aren’t available for health visiting appointments – or visits to Children’s Centres and other services – during the week with the introduction of a Sunday clinic.

This project is currently in pilot stage with a weekend clinic at a Children’s Centre, a telephone helpline in conjunction with NHS 111 and a Sunday clinic, and will be formally evaluated at the end of 10 weeks.

The services this pilot offers have been widely advertised at GP surgeries, the Children’s Centre and supermarkets with this work being linked to a campaign of ‘Choose Well’ – promoting the idea of choosing the right service at the right time.

So far anecdotal evidence shows these new services are working particularly for those parents who are unable to attend services during the week and therefore would normally be pushed to visit out of hour’s services.

While the link to managing minor illness and accidents is clear, this initiative has the potential to support all of the high impact outcomes through the provision of out of hours support, reassurance and advice to parents which may include transition to parenthood, maternal mental health, breastfeeding, healthy weight and child development at 2 years.

It is truly an example of the impact health visitors have as both leaders in public health, as innovators and improving the outcomes for young children and families.


Julia Neall, Health Visitor Transformation and FNP Manager,

Birmingham, Solihull and the Black Country Area Team



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  1. Comment by Linda Gardner posted on

    This is not new! In West Sussex, West Doc who provided the OOH service before the contract was given to another provider, deliberately recruited HV's. I was one of them. We massively reduced attendance at A/E by offering telephone advice and 1-1 consultations.


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