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Health Visitors Workforce Planning

Health Visitors Workforce Planning

Rebecca Boore, Health Visiting Project Lead


This year has been an exciting one for the health visiting workstream, as work has progressed despite the challenges presented by the Covid-19 pandemic. Health visitors from across Wales have continued to contribute to this project, whilst having to adapt and change their ways of working ensuring they are able to be responsive to the dynamic needs of children and families during a pandemic.

The health visiting work stream group consists of senior representatives from each Health Board and Trust across Wales. This project follows an evidence-based approach to create robust methods, tools and techniques to determine appropriate nurse staffing levels within health visiting services across Wales to help deliver A Healthier Wales.

There is an emphasis and passion to progress this key piece of work for the benefit of children, families, and staff. One of the best aspects of this project is the enjoyment I get meeting with health visitors from across Wales and discussing their role, including the highs and lows. It is an extremely rewarding profession, but as with other areas of nursing it comes with its challenges. Sharing work, best practice, ideas, considering the future of the profession and workforce, what the current challenges are, and potential solutions is what I find most rewarding. 

Guiding principles

This year the health visiting workstream group have been working on the interim nurse staffing principles for health visiting. These are workforce principles that;

  • provide valuable intelligence by establishing a detailed baseline picture of the existing nursing workforce in our health visiting teams
  • identify the resource gap between the current position and full compliance with those principles
  • and close that gap over time by gradually increasing compliance in preparation for any future regulations to extend the Nurse Staffing Levels (Wales) Act 2016.

Mapping the health visitor workforce in Wales

To support the development of the principles the group have completed a workforce mapping exercise, identifying the current workforce makeup across Wales. This has proved a useful exercise that has opened further discussions around sustaining the workforce going forward, adopting a ‘grow your own’ approach to the health visiting profession, teams with a varied skills mix, and specialist and consultant roles for health visitors. This exercise will be repeated annually to identify any changes in the workforce and support short, medium, and long-term workforce planning.

A tool for professional judgement  

The first draft of the Welsh Levels of Care tool has been developed and is due to be pilot tested over the winter of 2021 and early 2022. This tool will support health visitor’s professional judgement in consistently identifying child and family acuity and dependency across Wales.

A professional judgement workbook has been developed, with a goal of facilitating health visitors in articulating their professional judgement on staffing levels and skill mix. The group have also identified quality indicators, immunisation uptake, the Healthy Child Wales Programme, breast feeding rates and staff and client satisfaction.

The future for health visiting services

Further work is needed to ensure health visiting services have the IT infrastructure in place on an All-Wales basis to support them in gathering and collating data. This includes data on staffing levels, the Welsh levels of Care, professional judgement, and the quality indicators. The data needs to be collated across Wales in a standardised format so we can calculate nurse staffing levels and allow opportunities for comparison and bench marking. 

The dedication of the health visitors across Wales has allowed a huge amount of work to be completed, but there is still a lot more to do! This is an exciting time for health visiting as the profession strives to match the workforce to the needs of the population of Wales. I look to the future with optimism and excitement for what lies ahead.

More information about the health visiting workstream can be found on HEIW’s website.