A STAFFING crisis is threatening implementation of the controversial named persons scheme for every child under 18.

So-called state guardians are due to be in place from August but there is a shortfall of hundreds of health visitors needed to take on the role.

Some of the biggest health boards are struggling to recruit enough qualified staff to offer more support to families as part of the Health Visitor Pathway. It sets out the bare minimum core home visiting programme to be offered to all families by health visitors.

Pressure on the scheme intensified yesterday as Labour leader Kezia Dugdale backed Tory calls for the named persons scheme to be “paused”, claiming the policy is an “absolute mess”.

There are shortages of practice teachers for the nurses and midwives to take on a health visiting role, hampering attempts to hire staff and reduce caseloads ahead of the changes to the role of frontline workers.

Greater Glasgow and Clyde is committed to hiring 200 more health visitors to almost double its current complement of 236. But so far it has only put 60 staff through training, although another 90 will start courses in the autumn.

Lothian reported in January that 19 per cent of its health visitor positions were unfilled, including a 44 per cent vacancy rate in Midlothian. The vacancy rate has fallen to 16 per cent and 29 per cent in that area but the board is still well short of the 61 additional staff it needs.

Grampian is 26 short of the 157 full time posts it requires, a 15 per cent vacancy rate.

Royal College of Nursing Scotland Director Theresa Fyffe said it backed both named persons, and the Health Visitor Pathway.

But she added: “We do have concerns about the current capacity of the health visiting workforce. Some health boards are unable to recruit enough health visitors now, let alone the additional ones they will need to implement the named person, the universal new pathway and replace those many staff coming up to retirement.”

While an additional 500 specialists will help they will not be available right away, Ms Fyffe said. “Health boards are having to work hard to negotiate this transition period and we know that many of them are considering passing some health visitors’ work to others and changing the way teams operate, simply to juggle workload with available staff.

“But the health visitors’ role cannot be de-valued. Gaps in the workforce cannot be used as an ongoing excuse to give work to other staff that should be undertaken by a qualified health visitor.”

The pathway policy was introduced in October and has already begun to increase workloads. The Scottish Government has invested millions of pounds in a programme to train 500 more workers.

The new health visitor pathway will see all families receiving 11 home visits, eight within the first year after a child is born and three more before a child is five, as many as seven more than at present. The scheme is gradually being rolled out but already applies to all new mums.

In recognition of this and the named person plans the Scottish Government announced £40m of funding to recruit 500 additional health visitors by 2018.

Other boards insist they have enough health visitors or are on track to achieve recruitment targets.

In some areas staff have been asked to take on greater caseloads, relatively junior health visitors are being asked to take on the role of practice teachers in some areas, and some work is being given to non-health visitors.

Gavin Fergie, professional officer at the Community Practitioners and Health Visitors Association, part of the union Unite, said: “We think 500 is not enough and they need 800. These workers need suitable education not just training, including good clinical education from a practice teacher.”

He too said the named person role was welcome, but said more resources were needed. “All our members support named persons in principle as that’s what they do already.But at the moment we have big caseloads, and some boards haven’t been able to recruit enough anyway, and are really struggling now.”

Joanna Smith, programme director of Stirling University’s health visitor training programme said recruitment was “challenging” given the timescales, but added: “We haven’t had a problem recruiting. The boards we have a partnership with are on target with their workforce planning numbers,” she said. “There is a slight shortage of practice teachers, but all the universities are working together to ensure the Scottish Government training programme works.”

Training includes specific elements on the role of the named person, she said, but it would be little different from that of a traditional health visitor. “The reality is the NP role fits very well with that of a health visitor

“It is not about a snooping role. It is about supporting and promoting children’s wellbeing, which is what health visitors have always done.

A spokeswoman for NHS Grampian said: “We will be in a position to provide the new universal programme from next year.”

Professor Alex McMahon, Nurse Director, NHS Lothian, said: “NHS Lothian, in common with other boards in Scotland, has a number of vacant health visitor posts.

“Ensuring a safe and effective service for children and families through our health visitor service is a priority for NHS Lothian and we have put several measures in place to achieve this. An intensive training and recruitment programme is underway.”

An NHS Tayside spokesperson said, “For the past two years, NHS Tayside has been working towards an agreed workforce trajectory for the education, training and development of an additional 68 health visitors.

“These additional posts will allow NHS Tayside to implement the new Universal Health Visiting Pathway and the named person requirements from August 2016.”

A spokesman for Greater Glasgow and Clyde said “NHSGGC currently has 236 Whole Time Equivalent (WTE) health visitors and over the course of the next three years aim to increase this by up to 200 WTE.”

Forth Valley said 20 new health visitors were needed by 2018 .

A government spokeswoman said: “This policy is aimed at protecting children’s well-being and is about supporting, not diminishing, the role of parents.”