Figures show drop in health visitors in North Yorkshire and more appointments done virtually

There's been a big drop in the number of health visitors across parts of Yorkshire, and more appointments are being done virtually instead of in person.

Health visitors are trained nurses or midwives who work with families from pregnancy through to age five, and are there to give support and information during the early stages of parenthood.

The mandated contacts by health visitors are an antenatal visit before the baby is born, a new birth visit at 10-14 days, and reviews at 6-8 weeks, 9-12 months and 2-2 ½ years.

Figures we obtained from the Harrogate & District NHS Foundation Trust – which provides the service for North Yorkshire and Wakefield - show there were 53.36 fulltime health visitors in 2022, compared to 43.62 in 2024. During the same time the number of families on the system rose significantly, suggesting caseloads grew by 50 per cent in the space of two years.

The Trust also routinely offers the 6-8 week and 9-12 month checks virtually instead of in person in North Yorkshire, whereas in Wakefield all visits remain face to face. The Trust says that if a concern is identified, a face-to-face contact is then arranged.

Across other parts of Yorkshire, there were similar rises in caseload in Sheffield, Leeds, Bradford and Kirklees, with the 6-8 week checks now routinely offered by phone in Kirklees. In part of Leeds, video calls are being piloted for the antenatal check.

Yorkshire mum Victoria needed mental health support after the birth of her baby but was only picked up because a GP decided to follow up and ask if she needed help after seeing her for the initial post-birth 6-week check. She reckons it's becoming easier for problems to slip through the net:

“It’s luck unfortunately with a lot of these services. It was just because I saw one GP more than once. And I feel like if somebody knows you, even a little bit, even if they’ve only seen you once, they can pick up when something’s not right. It’s that continuity of care that unfortunately, both in health visiting services and the NHS, we don’t really have any more.

“I know that because I’m confident and don’t take no for an answer I got the help I needed, but a lot of people possibly wouldn’t. So I think unless you know something is out there or know to push for it, it’s really hard.”

We spoke to Victoria at a breastfeeding group where some of the mums gave us their thoughts on the idea of some health visiting appointments being offered virtually rather than in person:

“You could tell that they’re checking out the surroundings while they’re there as well,” said Tracey.

“Like my health visitor asked where my daughter was sleeping and things like that. They need to see the baby definitely, I work in social care and you just need eyes on people sometimes. Also just to put a face to the name, I wouldn’t have felt as comfortable asking questions if it had been over the phone. Particularly around breastfeeding, that is quite a physical thing in terms of to show and check it was right.”

Evangeline said: “It might be your only contact with humans that you’ve had in a while. Some mums don’t get out much straight away, I know I didn’t with my first.”

Rebecca runs the group and told us they’re picking up lots of mums who didn’t find much support elsewhere: “For so many people when it’s your first baby, you have no idea what you’re doing. You don’t know if your baby’s getting enough or if they’re happy. And there’s not that many spaces where parents can go just to check in and get that reassurance that they’re doing okay.

“I think if parents have real clear and urgent mental health needs, the perinatal health team tends to be good. But there’s a huge amount of parents who have some mental health difficulties that might not seem to be urgent and pressing, but actually for themselves and their babies and their families they are. They might not quite meet what’s expected to fit in the perinatal mental health team but they are struggling and we pick up a lot of those people here.”

In a joint statement, Harrogate and District NHS Foundation Trust and North Yorkshire Council said:

"In North Yorkshire we provide a universal service for all families in accordance with the mandated elements of the Healthy Child Programme. In order to provide an offer that meets both the requirements of the programme and the demands of the geography the service is delivered across virtual and in person contacts. Every family receives a minimum of two in-person health reviews. The use of virtual delivery enables the service to deliver targeted and specialist support to those most in need.

"Numbers of health visitors have reduced nationally in recent years and the North Yorkshire service has been affected by this.

"If any concerns are raised during a virtual contact, subsequent follow up would be arranged. In this way, the service can ensure they are providing a good level of support for all families in the most practical way possible and are particularly focussing on the most vulnerable families.

"Outside of mandated Health Reviews there is a Monday to Friday daily virtual health visitor clinic, a single point of contact telephone line, information and advice available on the Children’s Health Services app and website including an interactive chat function."