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What does a health visitor do?
A health visitor is an NMC-registered midwife or nurse who specialises in community public health nursing. They are known as specialist community public health nurses (SCPHN) and have to undergo additional training to carry out the role. They work specifically with families with children aged five and below to prevent illness, promote health and minimise inequality.
As the name suggests, SCPHN health visitors are predominately community-based and work with families in their own homes. However, they can work in other settings, such as healthcare centres, community clinics or GP surgeries. Health visitors will work with parents with new babies and families with pre-school children. They may also work with at-risk or deprived groups, e.g. travellers, addicts, asylum seekers, refugees and the homeless.
Health visitors will have many duties, including establishing relationships with families, assessing children’s health needs, providing information, support and advice to parents, working with other professionals to protect and safeguard children, and organising clinics. The role will also have an element of administrative work, such as keeping detailed records and writing reports.
A health visitor’s main aim is to ensure that young children have the best start in life by providing appropriate support to parents and families at the earliest opportunity. They have an important role in education and improving the health and wellbeing of children. Overall, health visitors have a positive impact on communities.
Health visitors can work alone with many different families and children (aged five and below). They may also work closely with their colleagues, e.g. other health visitors, assistants, midwives and nurses. They may also need to liaise with external stakeholders, including GPs, social workers, early years practitioners, children’s social care professionals, other health professionals, Sure Start Centres, school nurses and the police.
Health visitors mainly work for larger organisations, such as the NHS or local authorities. However, they can work for other smaller organisations, such as private healthcare providers, community interest companies and charities.
A health visitor will have many different responsibilities, which may include (this list is not exhaustive):
- Establishing relationships with parents, their children and families.
- Providing support to parents during pregnancy, when their baby is born and after (up to five years old).
- Identifying risk factors, vulnerability and any other areas of concern, e.g. abuse or neglect.
- Assessing children’s growth and supporting parents with their development needs.
- Advising new parents on various childcare issues, such as feeding, weaning, changing, sleeping, hygiene, home safety, immunisation, behaviour management and development.
- Organising and managing specialist clinics and sessions.
- Coordinating immunisation programmes.
- Providing emotional support for a range of issues such as postnatal depression, anxiety, bereavement, disability and domestic violence.
- Supporting children with special needs.
- Advising parents on preventing and reducing the risk of illnesses, accidents and injuries.
- Promoting healthy eating, nutrition and weight in babies and young children to prevent obesity.
- Supporting government public health initiatives, e.g. child obesity and poverty.
- Carrying out health reviews, e.g. two-year health review and ready for school.
- Working closely with other services and agencies to safeguard and protect children, such as social services.
- Keeping accurate records and writing reports.
The exact responsibilities will depend on a health visitor’s role, specialist area, who they work with and their type of work setting.
A health visitor can expect to work 38-40 hours a week, but the average tends to be the standard 37.5 hours per week. Their shifts will be on a rota and may also include evenings to work clinics and run specialist sessions. Health visitors may need to do additional hours if they are involved with particular projects.
Flexible working is possible for some health visitors, e.g. part-time hours or a job share. There are even working from home opportunities with certain roles, and some health visitors may choose to do bank work for an agency.
Travel throughout the day will be required for health visitors, as they will be visiting families in their local community and attending clinics. There may be a requirement to cover health visitors in other areas. Overnight stays and overseas working is uncommon for health visitors.
What to expect
Being a health visitor and supporting families and young children is extremely rewarding. Health visitors can go home at the end of the working day knowing they are making a difference by ensuring that all children have the best start in life, especially at-risk and deprived groups. Not only does health visiting have a positive impact on families, but it also improves the health and wellbeing of the whole community.
There is no shortage of health visiting roles, and there are jobs available nationally. The salary is also good, particularly if employed in the NHS or privately.
Boredom will never be a problem for health visitors, and no two days will be the same. They will see and support a diverse range of families and children. One moment may involve helping a new mother with breastfeeding, and the next, running a specialist clinic on baby massage. Of course, this will depend on a health visitor’s specialist area and role.
Even though being a health visitor is rewarding, and there are many positives associated with the role, they may also face challenges, for example:
- Becoming qualified – individuals not only need to be a registered midwife or nurse, but they will also need to complete a Specialist Community Public Health Nursing – Health Visiting (SCPHN) course. The whole process can take up to five years.
- High workload – health visitors will have to juggle different demands, and work schedules can often be erratic. There is also a significant amount of administrative work involved in the role, e.g. writing or typing notes.
- Frequent travel – as health visitors work in the community, there is a lot of travel involved. This can make the working days longer, especially if there are traffic issues and other delays.
- Mental demands – being a health visitor can be emotionally demanding, especially when dealing with at-risk and deprived groups, e.g. parents with addictions. Working with families and young children can be challenging and stressful. Health visitors may also be exposed to difficult scenes and trauma, e.g. child abuse or neglect, which can be distressing.
- Work-related violence – unfortunately, there is a risk of verbal and physical abuse in health visiting. Some parents and families do not take kindly to visits, and some may see it as interference or look on the visit suspiciously. Working alone with at-risk and deprived groups, e.g. those with addictions and cases of abuse or neglect, can also increase the risk. Employers have a duty to reduce and manage the risk of work-related violence, so there are ways of prevention. However, health visitors must be aware of the risk.
There are pros and cons in every career choice, and prospective health visitors must know what to expect before deciding whether the role is for them. There is no doubt that working in health visiting is challenging, mentally demanding and stressful. However, there are many positives too and helping families and children is very fulfilling and will give health visitors a sense of purpose. Health visiting can protect children and, in some cases, can actually save lives.
When considering whether to be a health visitor, individuals should look at the pros and cons. They should also ensure they have the necessary personal qualities to carry out the role and responsibilities required.
Personal qualities needed to be a counsellor
Some of the personal qualities a health visitor requires will include (this list is not exhaustive):
- Knowledge of neonatal care, childcare, public health, sociology, mental health and psychology.
- Knowledge of related legislation and standards.
- Knowledge of health and safety.
- Knowledge of equality and diversity.
- Knowledge of confidentiality, data protection and GDPR.
- Having a caring attitude, compassion, sensitivity, empathy and understanding.
- Having confidence, patience, tolerance and a reassuring manner.
- Having a non-judgemental approach.
- Having an interest in children, public health and the local community.
- Excellent interpersonal skills, i.e. the ability to deal with families, children and other healthcare professionals.
- Excellent communication skills, both written and verbal.
- Excellent active listening skills.
- Good observational skills.
- Good organisational skills and time management.
- Good problem-solving and decision-making skills.
- Good influencing skills.
- Being motivated and committed to helping people.
- Being thorough and having attention to detail.
- Being flexible and open to change.
- The ability to work well with others and alone using own initiative.
- The ability to organise own workload.
- The ability to understand individuals’ reactions.
- The ability to be resilient and mature in emotionally demanding and challenging situations.
- The ability to gain peoples’ trust, respect and confidence.
- The ability to work well under pressure and remain calm in stressful situations.
- The ability to use IT equipment and software competently.
- The ability to follow policies, procedures, instructions and risk assessments.
To become a health visitor, individuals need to be qualified and registered with the Nursing and Midwifery Council (NMC) as a nurse (adult, child, mental health or learning disability) or midwife. For further information on how to become a nurse or midwife, see our articles.
Individuals will need to undertake the health visitor training programme known as the Specialist Community Public Health Nursing – Health Visiting (SCPHN – HV) course. Once a nurse or midwife is registered, they can apply for the SCPHN – HV course. There is not a requirement to have a certain amount of experience beforehand.
The SCPHN – HV training programme courses are at degree level (undergraduate or postgraduate) and approved by the NMC. They can take 1-2 years, depending on the type of degree and whether it is a full- or part-time course. The length of the course may be reduced if an individual has relevant experience. This is known as an accreditation of prior learning (APL), and it takes into account previous learning and/or practice-based learning. This will depend on the university entry requirements, and individuals should check before applying.
There is also an opportunity for registered nurses or midwives to apply for a specialist community public health nurse (master’s) degree apprenticeship. It usually takes 18 months to complete and includes 50% academic study and 50% work-based learning. GOV.UK has further information on apprenticeships on its website.
There is financial support available for those wishing to study for a health-related degree. Further information about funds and eligibility can be found on the NHS website.
Work experience and volunteering
To become a health visitor, individuals will need to be qualified and registered as a nurse or midwife, as mentioned. However, other options can help individuals work towards entering the profession, for example:
- Work experience – an individual will already likely be working as a nurse or midwife whilst studying for the SCPHN – HV course. Individuals can also get a paid role in healthcare, childcare or social care before applying.
- Volunteering – gaining practical experience through volunteering can help towards becoming a health visitor. An individual can volunteer at their local NHS trust or a charity. Alternatively, there may be work placement opportunities in community clinics. Information on volunteering and local opportunities can be found on DoIt, NCVO and Volunteering Matters.
Individuals may have an opportunity to shadow an experienced health visitor to find out more about the role and see if it is the right career path.
Individuals must already be registered with the NMC as a nurse or midwife to be accepted onto the SCPHN – HV course. On successful completion of this course, individuals should update their details and record the qualification.
Registration must be renewed every three years to continue to practise, which is known as revalidation. However, health visitors must maintain their registration as a nurse or a midwife. They will not be able to renew their registration only as an SCPHN.
There is a cost to become registered, update qualifications and maintain registration.
Learning does not stop with experience or once someone becomes qualified. Attending relevant training courses and having additional certifications can help health visitors enter the profession, enhance their employability and keep their knowledge and skills current.
Most colleges and accredited private training providers provide training courses. Some examples of relevant courses that may be useful for health visitors include:
- Safeguarding children and vulnerable adults.
- Deprivation of Liberty Safeguards (DoLS).
- Mental health and capacity.
- Domestic violence.
- Managing behaviour that challenges.
- Child sexual exploitation.
- Child neglect awareness.
- Foetal alcohol syndrome awareness.
- Substance misuse awareness.
- COVID-19 awareness.
- Equality and diversity.
- Health and safety, e.g. work-related violence and lone working.
Professional bodies and associations, such as the Institute of Health Visiting (IHV), the Royal College of Nursing (RCN) and the Royal College of Midwives (RCM), can advise on reputable training courses. They also have events that can help health visitors and give them the means to continue their professional development. Continuing professional development (CPD) is a mandatory requirement for NMC revalidation.
The type of training required will depend on what employers are looking for, the areas of health visiting individuals want to work in and the CPD requirements for registration. As well as looking on professional body websites, it is also worth looking at several job advertisements to identify the courses required and other training needed for specialist roles. Jobs can be found on NHS Jobs, Nurses.co.uk, HealthJobsUK, RCN Bulletin Jobs, and other job sites, such as GOV.UK find a job service and Indeed. Also, look at recruitment agencies, e.g. Pulse.
Having more relevant training and competence will open up more opportunities for health visitors. Refresher training will also be required, as it is a legal requirement under legislation and mandatory for registration revalidation. It also keeps knowledge and skills up to date.
Criminal records checks
Health visitors will be required to undergo a criminal record check, as they will have contact with children and vulnerable adults. Having a criminal record, caution, warning, or conviction may put off prospective employers. However, they should account for the seriousness of the crime, when it occurred and its relevance to the role.
The organisation that holds criminal records will depend on the country within the UK, for example:
Health visitors will be required to drive as part of their role, as they will be working predominately in the community. Therefore, they should have a full clean driving licence.
Where do health visitors work?
Health visitors can work in many different settings, including (this list is not exhaustive):
- Families’ homes.
- Community and outreach clinics.
- Sure Start Centres.
- Their own homes, e.g. virtual meetings.
- Hospitals, health centres and GP surgeries.
- Children’s homes.
- Shelters and women’s refuges.
They can work for public bodies, private organisations and agencies, for example:
- The NHS.
- Health and social care trusts.
- Private health care providers.
- Specialist agencies.
- Local authorities.
- Charities and not-for-profit organisations.
Most health visitors will work for the NHS.
How much do health visitors earn?
If a health visitor decides to work for the NHS, their salary is subject to a band pay system (agenda for change pay rates). For example (these are a guide only and are subject to change):
- Typical starting salary for health visitors (band 6) – between £32,306 and £39,027.
- Specialist/senior health visitors (band 7) – between £40,057 and £45,839.
The exact salaries for health visitors will depend on the role, location (London supplement), specialisms, qualifications and years of experience. As health visitors progress in their careers, there may be opportunities to enter more senior positions, and the band will increase. The NHS also provides a training salary for trainees (known as annex 21).
There is potential for health visitors to earn more if they work in bank or other settings, e.g. private organisations. However, the NHS does provide generous benefits, e.g. pension scheme, sickness and maternity. Experienced health visitors may also earn higher salaries if they combine health visiting with training or research.
As an apprentice, the salary will depend on an individual’s age and how long they have been in their apprenticeship. Apprentices must earn at least the current National Minimum Wage (NMW). Some employers will pay more than this, but it will depend on the organisation and role on offer.
Types of health visiting roles to specialise in
Not only are there opportunities for health visitors to move up the career ladder and work in various settings, but there are plenty of opportunities for them to specialise in different areas, for example (this list is not exhaustive):
- Asylum seekers, refugees, migrants and travelling families – specialising in working with families and children within these groups and ensuring they are treated with equality, dignity and respect.
- Children with additional and complex needs – providing support to families with children with special educational needs and disabilities (SEND) and other complex needs.
- Homelessness – specialising in working with homeless families. Health visitors usually work across a wider geographical area.
- Infant feeding – supporting and advising parents on feeding their infants, e.g. breastfeeding.
- Perinatal and infant mental health – supporting and improving the emotional wellbeing of pregnant women and new mothers with mental health issues, such as postnatal depression. They also provide mental health care to children, partners and families.
- Substance misuse – supporting families and children affected by substance misuse. They also help those accessing drug or alcohol treatment and recovery.
- Teenage parents – specialising in working with young parents.
- Transition to parenthood – specialising in the transition to the parenthood period and supporting parents during this time.
There are many different health visiting roles and specialisms. Some health visitors may decide to specialise in one area or group, and others may work in different areas and with various groups.
All different health visiting roles will require differing knowledge, skills, experience and qualities. Some may need specific qualifications and additional training for specialised areas and groups. Most health visitors will need to know how to build relationships with different people, assess children’s needs and development, provide information, advice and support on various childcare issues, identify risk factors and areas of concern, and promote health and wellbeing. Any additional areas of expertise will depend on what an organisation is looking for in a health visitor and the type of work a health visitor wants to carry out.
If health visitors do not carry out their role effectively, it can put children and their families at risk and, in worse cases, may even cost lives. Therefore, whatever the type of role, health visitors must have the necessary competence (knowledge, skills and experience) to carry out the work professionally and safely. They should also know the limits of their competency and not take on responsibilities if they have not been trained and are not competent.
Health visiting standards, guidance and laws are updated regularly. Therefore, health visitors need to keep abreast with the latest developments and changes in legislation to remain legally compliant and ensure they carry out their roles effectively and safely. CPD gives health visitors the knowledge and skills to keep up to date with these changes and understand their responsibilities. It also helps them stay registered and allows them to progress their career.
Joining a professional body can help prospective and current health visitors enhance their skills and overall career. The Institute of Health Visiting (IHV), the Royal College of Nursing (RCN) and the Royal College of Midwives (RCM) offer different levels of membership, CPD, advice and support, access to industry contacts and networking events.
There is ample opportunity for career progression within health visiting, and it is a diverse field. With more qualifications and experience, a health visitor can become a team manager or community matron. They can also decide to focus on a specific area of health visiting, such as mental health or infant feeding. Alternatively, they may choose to work for an agency as a bank health visitor.
Having knowledge, skills and experience in health visiting can also lead to a career in different areas. For example, a health visitor may want to work in training, operations management or research. They may want to work in other industries, such as mental health and education. Finally, they may decide to combine health visiting with other roles, such as nursing or midwifery.
Get started on a course suitable for health visitors
Safeguarding Vulnerable Adults (SOVA) Level 3£49 + VAT View course
Domestic Violence Awareness£20 + VAT View course
Mental Health Awareness£20 + VAT View course
Safeguarding Children Level 3 (Designated Officer course)£49 + VAT View course
Foetal Alcohol Syndrome Awareness£20 + VAT View course
Equality and Diversity£15 + VAT View course
Substance Misuse Awareness£20 + VAT View course
Postnatal Depression Awareness£20 + VAT View course