17 May 2021

Kirsteen McDonagh, Specialist Health Visitor for Homeless Families in Camden Central and North West London NHS Foundation Trust shares her experience of working during a pandemic.

Spring 2020

It started with a whisper, a quiet concern about a virus with outbreaks in Asia and then soon it was in Italy. The whispers became louder and by March 2020 they were a roar, the virus was here. People were sick and people were dying.

Lockdown came and with it, most of the country, including all our Health Visiting staff, woke up to find the world had changed.

The pandemic meant that services were rapidly reorganised to care for the most vulnerable. Looking back, it was a blur.

NHS England had instructed most of the children’s routine activity to be stood down, with vulnerable children remaining a priority. For me, it was clear that I needed to carry on supporting the families stuck in tiny hostel rooms with their children. Vulnerable women and children for the most part scared with no outside space, no freezers to fill to avoid daily trips to supermarkets, and no extra money to bulk buy when living on Universal Credit.

Parents told me of local shops doubling the price of formula and were scared about COVID outbreaks in the small hostel spaces. In truth, so was I.

My managers helped, of course, and assigned a colleague from our Community Nursery Nurse team to help and, together, we got stuck in. We brought food parcels, nappies, vitamins, prescriptions, toys for every child, and an ear to listen to the worries. It was a busy time.

Autumn and Winter 2020

In August there was another issue approaching our shores, this time it was families fleeing war, persecution and trafficking who had made it to the UK and were being housed in empty hotels while their asylum claims were managed.

So, we re-grouped again. I contacted colleagues in the Homeless Health network who got me a chance to speak at a meeting with Government staff and ask questions. We gained access to the information we needed from that meeting, to find and help the children that nobody yet knew about. We found out about scores of families with health needs, such as children with serious unmet physical health issues and adults suffering from the after-effects of trauma which we tried to address through local services in Camden.

As numbers of families have grown, we have set up a service and a bookable clinic to meet families, assess need and put together plans of care for the refugee families. As the needs of these families became clearer, we were also supported by Paediatricians, infectious disease doctors and GPs to create an additional MDT clinic to provide a broader range of care needed.

We seem to find it’s often needed. Our team has grown to include a third HV, another Nursery Nurse and two Camden Council Family Workers – a wider team that has allowed us to meet the specific needs of the refugee families at the same time as providing our business as usual service to Camden’s homeless families.

Spring Again

Recently, I’ve become aware of social media discussions about where the Health Visiting service has been during the pandemic, with some parents voicing concerns about the lack of input from postnatal services in the past 13 months. I have seen comments about HV services being invisible, having ‘bowed out’, and that they ‘are hiding’. So, it’s time to be open about where we have been and what we have been doing:

We didn’t stop. We won’t stop

We prioritised the most vulnerable, the homeless, the isolated, the young parents, the refugees. We know all new parents can be vulnerable, but we had to prioritise the neediest amongst them.

In the homeless families HV team, we understandably had to stop our busy drop-in clinic due to the restrictions. We continued to see babies at home, and in booked appointment clinics, talked on the phone, met other professionals on Zoom. We didn’t stop. We won’t stop.

  • We saw a rise in safeguarding issues.
  • We mentored our students.
  • We learned how to Zoom, use Teams and how to use mute!
  • We sent our children to school, with some anxiety, so that we could continue to provide a service.

We provided support for a multitude of public health issues. We gave advice about play in the home and talked to our families about the importance of going out for daily walks, and arranged private play opportunities at local community gardens for families without a safe space.

We put on our PPE and knocked on families’ doors – no big clinics for a while now but plenty of ways of keeping in touch.

We got vaccinated and encouraged you to do the same.

Going Forward in 2021 and Beyond

I am proud to be a Health Visitor and proud of our team, Anneke, Emma and Sara and our managers, for all we have achieved this past 14 months. My hope is that, as the pandemic leaves us, we can look forward to building back all our health visiting services across the country and get back to supporting all parents, as we are well aware that not only the most vulnerable need us to be there for them.

We must be vocal about how our service contributed to the COVID response, but more so, how we are vital in dealing with the aftermath of it.