'It's been very challenging': A day in the life of a lockdown health visitor

Maura Appleby, 58, is the service leader for the health visiting and school nursing service in Stockport, Greater Manchester. She says:

8.30am: The day starts for our health visitors and they are relieved to be working in the clinics again and doing more home visits.

There are still restrictions about the number of staff we can have in the clinics at one time. We have a team of more than 60 full and part-time staff and we are managing social distancing rules by allowing each team member to work here once or twice a week, rather than from home.

It feels like a positive and safe move forward.

I’ve been a health visitor since 1987 and in this current role for five years. It’s a fantastic job and we feel very privileged to be able to offer support to new parents and babies, with their physical or emotional health needs.

We help parents understand their baby’s health and development and work with them to support their confidence as parents. But over the last fourteen months, it’s been very challenging.

Watch: Tips for new parents during the pandemic

10.00am After catching up on paperwork, planning and liaising with colleagues, my team go out on their first visits of the day. One of the biggest difficulties during the pandemic was not being able to visit new parents face-to-face.

It’s been so sad to see headlines and read stories from new parents when say they feel ‘let down’ by lack of face-to-face contact with their health visitor and we’ve done all we can to mitigate it.

When the pandemic hit and we were forced to work from home, Public Health England issued guidelines that said we could only visit for ‘compelling reasons’ – examples include if the baby was vulnerable due to prematurity or an illness or where there was an issue with the parental mental health.

It meant our face-to-face visits reduced by 80 per cent.

We also had to stop the child health walk-in clinics where parents can pop in to have their baby weighed and ask questions about anything from breastfeeding to sleeping.

This was a huge loss to parents and very concerning for all my team. We set up a Health Visitor Advice Line where parents could ring us and ask for advice and support. We advertised it on Facebook and via the post-natal wards at our local maternity unit and thankfully, it proved very popular.

We recognise that a virtual visit or a call is never the same as being able to come into a clinic or see your health visitor at home, but thankfully, we’re now able to see parents and babies by appointment in clinics again.

Read more: Midwife reveals how she overcame post-natal depression

12.00pm: Most appointments with new parents last around 60- 90 minutes so we manage one or two each morning before lunch. The main feedback we’ve had from new parents during lockdown is that they’ve missed the ability to socialise with other new parents – that’s one reason why we started offering virtual postnatal group sessions.

Anecdotally, our health visitors have reported more anxiety amongst new mothers. We are looking out for the signs, such as a mother being a little withdrawn, and try to give new parents the chance to talk about how they feel.

Interestingly, we’ve also found that during lockdown, without the constant pressure of having to fit into their jeans and be perfect to the outside world, some mothers have been able to relax more with their babies and because they have more time with them, the breastfeeding rates have risen slightly.

2.00pm: We’re onto our afternoon appointments and we’re back to seeing all our new patients face-to-face now, along with around 70 per cent of other cases. One of the biggest challenges we've had to adapt to is using PPE.

When you’re in someone’s home, trying to gain their trust and build up a relationship is all the more difficult when you have to wear mask, apron and gloves. It feels very strange, but people understand why we have to do it.

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3.30pm: Our last visit of the day. We can normally fit in around four home visits a day, and hope to be back up to 100 per cent very soon. Naturally, it’s been disappointing not to be able to provide our full service in the usual way for new parents, and we may well be seeing some problems in the future as a result of the lockdowns.

There are already reports that babies and toddlers are struggling with their speech and language and that’s one area we hope to tackle with Book Start, Little Talkers groups and Early Days groups, helping parents to read to children and teaching them how to share nursery rhymes and songs.

5.30pm: The day ends with us writing up records on all our visits. During the last year, our teams have not had the ability to support each other in the usual way by being together in the office.

Working from home has been hard and it's more difficult not to take work ‘home’ with us in an emotional sense. We know the last year has not been perfect, but we did our best to respond to families' needs.

Now the restrictions are easing further, I’m looking forward to our teams being able to fully return to the job they do so well.

Watch: Post-natal depression 'can last for up to three years'