Online health visitors

A new website gives parents 24-hour access to Health Visitors.

The Websites founders, Chamaine Lovett and Liz Costagliola, explain why their service is so effective.

"Our Internet-culture expects innovative and technology-led options in health. Modern parents are often expected to work long hours. That's why we started Healthvisitordirect.com - an on-line parenting service - to improve the health outcomes of UK children"

Over recent years, there have been far fewer Health Visitors. They struggle with increased caseloads. As resources are focused in the most deprived areas, many parents have little contact with their family health visitor. A report from the CPHVA (Community Practitioners and Health Visitors Association) said: "Health visitors now have a far higher number of families to care for. There has been an 85% rise in case loads in the past year alone. In the latest health visitor report, 60% of health visitors had over 500 children to look after (the maximum recommended is 400). About 70% of health visitors said they don't have the time to help even the families most in need."

Healthvisitordirect.com offers 24-hour access to a health visitor. Parents can email questions about their children anonymously and receive an answer/support from a qualified health visitor without feeling judged. Health visitor direct aims to reach all parents.

Research and development

Through our clinical IT experience, we were surprised how few on-line health options were available to parents. Before starting the project, We spent a lot of time researching the web support available. There are numerous parenting and child care advice websites - but only two that have trained health visitors involved. Netmums.com is an excellent website, where parents can share advice in forums. Netmums has many visitors. However, users can't directly ask a health visitor a question - health visitors only comment on long forum threads.

Many other parenting forums and websites exist - but their advice is not research-based and can be detrimental. Often advice in magazines presented by (self-professed) untrained parenting experts is biased and unsafe - for example, advising early weaning. There is one other health visiting website - but parents have to pay £5 for every question they ask, and the question may not be answered for a week. We decided the only ethical option was to provide a free service. This free service is available to all parents, and helps children irrespective of financial situation or socio economic group. The aim is to answer all questions within 24 hours - because clinical experience and research showed that parents want a speedy response. The service meets the needs of client groups known not to access traditional health care services.

Social networking is a new and innovative way of engaging parents. Dads and younger mums are using social networking groups to link to and find information from Health Visitor Direct.

As not all parents are experienced in Internet use, the website is simple to use. Parents can read numerous parenting books and search the Internet, but still need to ask a question. Because of this, the website focuses on parents asking direct questions with some articles as extra information. For example, there is an article about fussy eaters - but the site still gets questions on this issue.

The aims of the service are:

• To provide 24-hour Internet access to a qualified health visitor to all parents.
• To make the service accessible to client groups who don't access traditional health visitor services - particularly dads, parents of disabled children, parents from lower socio-economic groups and young parents.
• To work towards the Every Child Matters outcomes - in particular ‘Be Healthy and Stay Safe'.
• To work alongside other government initiatives like ‘Change4Life' and the ‘Five a Day' campaign.
• To support parents in all aspects of parenting.
• To support and advise mothers and fathers on the prevention and management of post-natal depression.

Evaluation and clinical governance

As part of the evaluation and clinical governance process, the service regularly surveys site users. Every two months, the service sends out a questionnaire to 30 parents who have used the ‘Ask a health visitor' service. It asks questions like:

• How quickly did you receive an answer?
• Did you find the answer useful? If not, how could it have been more helpful?
• How do you think the service could be improved?
• Why did you use our service?

We have a response rate of about 40%. So far, feedback has been 100% positive - with comments like: "It's such a relief to be able to talk to someone at a weekend" and "I've already noticed some positive changes". As new government initiatives are introduced, the service will develop and grow - ensuring all practice is current and evidence-based.

One of our biggest start-up problems was finding money. The project was self financed - with a very limited budget to set the service up and promote it. Through sponsorship, the service has recouped the financial outlay and grown within its first year.

In the first year, we visited parliament and the DCSF and had discussions with NHS Direct. Meetings with the health visitor union (CPHVA) were very productive. The service is working with external partners to offer support on other websites and in the media and ensuring research and evidence based advice is distributed to parents.

This article was published in Every Child Matters journal February 2010

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