Facing the future: a review of the role of health visitors What do you think

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Facing the future a review of the role of health
visitorsWhat do you think?

• Community Practitioners and Health Visitors
  Association Professional Team

http//www.amicus-cphva.org/pdf/Facing20the20Fut
ure20-20HV20report.pdf
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The presentation will cover

• Why the review was commissioned
• The process
• The main recommendations
• The implications for health visiting if these are
  endorsed
• Issues CPHVA think are critical for a
  professional view

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Why the review was commissioned

• As a result of lobbying of Patricia Hewitt by
  Unite/CPHVA
• To respond the CPHVA concerns re the crises in
  health visiting
• To provide a road map for the future of the
  profession
• To consider the unique role health visitors can
  offer the NHS

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The process

• 10 Lets talk about health visiting workshops, one
  in each strategic health authority area
• High level steering group met 4 times
• Electronic feedback invited by Chris Beasley,
  Chief Nurse
• Survey of commissioners PCT and practice based

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What was it asked to do?

• Provide a new role for health visitors which
• Delivers measurable health outcomes
• Provides a rewarding and enjoyable job
• Has the support of families and communities
• Delivers government policy for children and
  families, reducing inequalities
• Fits new commissioning systems of choice and
  contestability through new providers
• Can adapt to changing needs and aspirations
• Attracts a new generation to the profession

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CPHVA View

• Concern that the current service has been imposed
  and isnt the service health visitors would chose
  to deliver.
• Feel health visiting has been subjected to many
  service and educational philosophies over the
  past 15 years and isnt responsible for its
  current situation
• With improved professional leadership the review
  should never have been necessary

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Recommendation 1

• The core elements of health visiting should be
• Public health and nursing
• Working with the whole family
• Early intervention and prevention
• The value of knowing the community and being
  local
• Pro-active in promoting health and preventing ill
  health
• Progressive universalism

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Recommendation 1 cont

• Safeguarding children
• The value of working across organisational
  boundaries
• Team work and partnership
• Readiness to provide a health protection service
• Home visiting

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Recommendation 2

• Focus
• The focus of health visitors should be early
  intervention, prevention and heath promotion for
  young children and families as this is where
  their nursing and public health skills and
  knowledge can have the greatest inpact.

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Recommendation 3

• Priorities
• Preventing social exclusion
• Reducing inequalities
• Tackling the key public health priorities,
  particularly obesity, smoking, drugs and accident
  prevention
• Promoting infant, child and family mental health
• Supporting the capacity for better parenting by
  improving pregnancy outcomes, child health and
  development, parents self-sufficiency,
  safeguarding children, addressing domestic
  violence etc

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Recommendation 4

• Commissioning
• Commissioners should commission early
  intervention, prevention, and health promotion
  services for all young children and families

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Recommendation 5

• Level of practice
• Responsible for the difficult things
• Managing risk/decision making in conditions of
  uncertainty
• Building therapeutic relationships and addressing
  difficult issues in families with complex needs
• Leading multi-skilled teams
• Working across sectors and putting health into
  multi-agency work
• Delivering population level outcomes
• Assessment and identification of existing and
  future vulnerability
• Engaging hard to reach groups and individuals
• Translating evidence into practice

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Recommendation 6

• The primary role of the heath visitor should
  be either
• Leading and delivering the child health promotion
  programme using a family focused public health
  approach
• Delivering intensive programmes for the most
  vulnerable children and families

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Recommendation 7

• Additional areas of practice
• There are 2 further packages of services that
  health visitors or other nurses can provide
• Wider public health packages
• Primary care nursing service for children and
  families

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Recommendation 8

• Organisational options
• Key part of integrated childrens services
  whether located within childrens centres or the
  primary care team should be determined locally

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Recommendation 9

• National policy should support the implementation
  by
• Issuing national guidance which strengthens and
  updates the NSF std on the Child Health Promotion
  programme, bringing together screening, early
  detection, health promotion, health protection
  and parenting support into one programme

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Recommendation 9 cont

• Assembling the relevant research findings to
  support a 21st century child and family health
  promotion service
• Strengthening the commissioning of early
  intervention and preventative services for
  children
• Leading the development of the workforce through
  Modernising Nursing Careers to support current
  and future HVs to undertake the roles
• Clarifying and promoting the contribution of
  health in the governments policy on parenting

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• What are your first impressions?

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A possible implications for health visiting if
intense visiting pilots are mainstreamed

• Focusing on 2 most vulnerable using intensive
  visiting would leave little resource for
  remainder of families could take half of
  workforce using model currently being piloted
• Question If this would reduce social exclusion
  is it a price worth paying?

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Areas we need your feedback onGeneral

• Do you support these recommendations if not,
  which and why not?
• Areas requiring additional work?
• What should CPHVA be lobbying for?
• How could health visiting training be improved?

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Areas we need your feedback onGeneral

• What shape should progressive universal services
  be?
• What are the career development implications
• Could these proposals lead to a fragmented
  service?

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Specific issues CPHVA think are critical for a
professional view

• Are multi-skilled teams working? If not why not?
  What needs to happen to make them work?
• Should health visitors only focus on the first 2
  years of life?
• Are the Principles of Health Visiting still
  important as a framework for health visiting
  practice?

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• Should health visitors chose a specific role
  either working with the socially excluded or
  leading the delivery of the child health
  programme as suggested by the review?
• Where should health visitors be based? What
  works and why (advantages and disadvantages)
• Who should employ health visitors health, local
  authority, other?

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• Other comments you would like to make

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• Dont forget the review and many more key
  practice issues of concern to you will be
  discussed and debated at CPHVA Annual Conference
  in Torquay, October 31st to November 2nd
• For more details look at the CPHVA website
  www.amicus-cphva.org

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