Funding cuts will mean the loss of a third of Nottinghamshire's child health workers, which an insider within the service claims will have devastating consequences for young families.
Health visitors are specialised support workers in the community, who are usually fully-trained nurses who provide care in the community up to the age of 19.
Responsibility for the service, that parents have to opt into, was taken over by Nottinghamshire County Council in October and now the services have been tendered out to Nottinghamshire Healthcare NHS Trust.
Now a source at the trust which ran the service previously, who has asked not to be named, claims 38 health visitors will lose their job,s out of a total of around 100.
The news follows a progression of funding cuts from the Department of Health, down to £15.3m this year and continuing to fall to £13m in 2019-20.
The anonymous source said: "There's going to be huge changes to the service, mainly losing health visitors and it's very dangerous.
"A lot of what we do is anti-natal, going into people's homes to see the conditions.
"Baby clinics are stopping form January, and other services are being cut.
Another change, said the source, is that all health visitors will have to interview to re-apply for their jobs.
"Job specs and job descriptions have changed and everyone is having to interview to keep their jobs.
"These are drastic changes and we don't feel safe. People are so demotivated and upset."
But more importantly is the impact on clients, added the source.
"It's going to mean children are at huge risk because visitors aren't going into families' homes.
"It's going to mean safeguarding issues go unchecked. It's going to take a child losing their life for them to take this seriously, but everything at the moment is geared towards keeping Surestart going."
Nottinghamshire County Council announced changes to the service in October as the new partner took over operations to usher in a 'holistic' new service under the Healthy Child Programme and the council confirmed redundancies would be coming.
The council said: "Following engagement and consultation with a range of local key stakeholders, and in line with national direction, Nottinghamshire County Council has commissioned these services together as an integrated ‘Healthy Child Programme and Public Health Nursing Service’.
"This new service brings together the Family Nurse Partnership Programme, Health Visiting, School Nursing, the National Childhood Measurement Programme (NCMP) as well as breast-feeding support into a single programme to provide holistic health and well-being information and guidance.
"Following a reduction in the public health grant provided to Local Authorities by the Department of Health, the funding available to Nottinghamshire County Council to commission these services has reduced.
Dr Kate Allen, Consultant in Public Health at Nottinghamshire County Council, said: “As part of the procurement process Nottinghamshire Healthcare NHS Foundation Trust has identified how the workforce will be redesigned to meet the requirements of the new service. This will include a remodelling of the current workforce resulting in workforce reductions in some areas of the service, and increases in others. Nottinghamshire County Council and Nottinghamshire Healthcare NHS Foundation Trust are working closely together over the coming months as the services transform.”
Coun Joyce Bosnjak, chair of the Nottinghamshire Health and Wellbeing Board, welcomed the new service.
She said: “This service will support parents and promote healthy choices for the children, young people and families of Nottinghamshire. It will be integrated and provide wrap around care and support so families will hopefully see an immediate benefit.”
Professionals will work across the 0 to 19 year old age range in locally based teams so they can better know and support families."
Paul Smeeton, Executive Director for the Nottinghamshire Healthcare NHS Trust, said: “The Trust has started a review of staffing and posts and will work with staff found to be at risk to minimise job losses and ensure they are redeployed within the organisation wherever possible. We currently have a number of vacancies and will work closely with staff to support those who want to stay working for the Trust.”
The Trust assures that it will continue to deliver safe services for its children, young people and families and will remain committed to identifying and responding to safeguarding concerns under the new contract, in line with local safeguarding procedures.