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Health visitor practice teachers swamped with students

Some health visitor practice teachers are being asked to take responsibility for up to six times the recommended number of students in a bid to meet government targets to expand the profession. 

The Department of Health’s “Call to Action” on health visiting set a target last year to increase the workforce by 50% by 2015. It is estimated 6,000 new health visitors need to be trained to meet the target.

A snapshot survey of health visitor practice teachers has found more than a quarter are currently responsible for three or more students, with 2% responsible for six or more.

Health visitor and Plymouth University lecturer Penny Franklin carried out the survey on behalf of the Unite Community Practitioner and Health Visitors Association.

Presenting the findings at the union’s conference in Brighton last week, she said some health visitors had reported full caseloads on top of teaching responsibilities, and there was a risk of “unsafe practices” in terms of who has signed off students.

She highlighted that some practice teachers were signing off not only their own student, but also students being supervised by practice teachers in training, or those being supervised by experienced health visitors acting as mentors.

This “long armed” approach was backed in a Nursing and Midwifery Council education circular, issued in September 2011 to support the government’s health visitor strategy. But the circular said it was a “matter of professional judgement” for the practice teacher to decide how many students they had.

Formal NMC guidelines, published in 2008, had previously recommended practice teachers should only support one student at a time.

Unite professional officer Dave Munday told Nursing Times the NMC circular had confused things by suggesting the “long armed approach” was acceptable, but without clarifying how many students teachers could oversee in this way.

“Some organisations have come up with a model that might not be perfect, but is workable; but some organisations are doing things that are wholly inappropriate,” he said.

DH director of nursing Viv Bennett told Nursing Times there were positives to the long armed approach, as students had input from more than one experienced health visitor but accepted a safe balance needed to be achieved.

Earlier in the conference, professor Bennett thanked practice teachers for their contribution to achieving the DH’s health visitor vision. “I am eternally grateful to all of the practice teachers who stepped forward to make sure we can train all of these students.”

Readers' comments (5)

  • A big rush to get 6000 new HVs, will they be able to get support and there are reasons why teachers/mentors should not take on too many students. Sounds like there are practice teachers working their socks off to help implement this change, but a lot of inconsistencies out there that could lead to unsafe practices from trainers and trainees (+maybe poor rolemodelling of taking on too much to cope safely).
    Also how many of these new students are experienced nurses and midwives? and would they be replaced when they become HVs? then who plugs the gap left - HCAs + new students?

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  • That's okay, it seems to be the norm since nurses can be expected to look after up to 6 times the number of patients that is considered safe. What can possibly go wrong?

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  • This is complete overloading. The current HV courses are about half the length students really need to learn the volume of new material. It's a radical change of profession from nursing to health visiting - much more of a change than just the same nursing practice in a different context. This means that practice teachers have to teach their HV students a wider range of professional skills and knowledge because the colleges can't cram it all in.

    All of these teachers are also individually responsible for a case load of families on top of their teaching duties. I worry about whether care to families is suffering because of this teaching overload. Surely something has to give?

    All this stems from the mad idea of ending HV registration - until the government realised what was happening to public health when the HV workforce collapsed.

    The same thing happened to nursing in Romania under Nicolae Ceau?escu. He abolished nursing training and the resulting poor standards of care were an international scandal. Our governments have tended to follow some pretty lousy examples....

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  • As a present novice Practice teacher it has become quite a balancing act between caseload management, sickness and vacant caseloads and teaching your allocatedSCHPN student. This present time is a very stressful time for all practice teachers, as after the completing of the course has not been promided to be awarded with the relevant AFC grade.

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  • over the past nine months I have mentored my first Hv student.It has been very difficult as at the same time running a four day HV post undertaking THE FLiPP COURSE AND RUNNING A COMMUNITY EVENT .
    I DO NOT FEEL WE AS MENTORS WERE ADEQUATELY SUPPORTED I have at times felt totally out of my depth despite 11yrs experience as a HV

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