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NMC reviews public health nursing role


The Nursing and Midwifery Council has announced a review of public health nursing.

The NMC said the review would look at whether its registration conditions for health visitors, school and health protection nurses and sexual health advisers were “appropriate for modern public health nursing”.

There are 25,800 registrants under these categories, known collectively as the “third part” of the register, and 20,000 of them are health visitors.

At present there is no direct entry to the third part and registrants must be qualified nurses or midwives then move with extra qualifications or experience.

However, the NMC’s move follows Nursing Times’ revelation last week the government is considering fast tracking health visitor training to meet the Conservative election pledge to employ an extra 4,200 by 2015 (news, page 1, 14 September).This prompted fears the health visitor role will be “dumbed down”.

NMC chief executive Dickon Weir-Hughes said he planned to announce a review timetable soon and was “committed to thinking radically” how regulation of health visitors should work.

Unite, which hosts the Community Practitioners and Health Visitors Association, welcomed the move. Lead professional officer for the health sector Obi Amadi said: “Health visitors’ knowledge and skills are quite distinct and in some areas employers require that other roles do things that they are not qualified to do. For example, it’s not safe for a nursery nurse to make a new birth visit.”

Association of Directors of Public Health chief executive Nicola Close said there should be no dilution of the roles on the third part of the register.

She said: “These people are front line and they should have proper training.”


Readers' comments (7)

  • We all need proper training-it has long been a problem for all of us that accessing the correct training at any level is hard-being released from work . getting the funding, being allowed to develop competency-why are we the church mice always struggling to achieve the training we need??

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  • It is great that the NMC are to conduct a full review of the third part of the register, which has been flawed from the start because of the way the Nursing and Midwifery order is worded. We must be able to recruit more widely to the health visiting programme, which itself needs to be better suited to the role. And that means looking at direct entry, and improved standards, and what that change for health visitors means for everyone else on the third part.

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  • Health Visitors have been rammed into a narrow role, they should be more active, and suitable trained to be reducing obesity, and not just through weaning talks, now frequently carried out by nursery nurses, and address prevention of chronic diseases such as coronary heart disease or diabetes, working with all age groups, they should maintain the ability to prescribe. They need to be using more of their nursing skills alongside health visiting skills, not as it seems is being proposed to dumb down the role. If a change to the register meant me, as a HV loosing my nursing registration, or being further down graded as a HV, or my role further 'silo-d', I would choose nursing - would I be alone in doing so?

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  • The main issue is that Health Visiting has never been properly evidenced as improving health. Anecdotally we know it works. Proving it scientifically requires a programme of at least 5 years duration. Governments won't wait that long because they have to be re elected at that stage.

    Health Visitors have a very wide based training and, certainly when I trained, were expected to identify health targets and work towards improving the health of the community they worked in. In fact, due to staff shortages they became 0-5 child health workers and since then skill mix has suggested that this is something others can do as well. It matters little how we argue about this as succesive governments look only at the goals within their tenure.
    It seems to me that health visitors no longer defend their position as strongly as we did and so we are at the whim of whatever government or policy makers decide. Hall being a prime example.
    I am glad now that I am nearing the end of my career but I am so sorry that so much ground has already been given and I can only see the role being reduced further and eventually being revised into something along the American model of Community Health.
    I disagree completely with direct entry unless there is some prolonged training beforehand.
    Health visitors have always managed change, but it has to be reasoned and it has to be worthwhile. Much of the recent changes seem to be made for change sake and are poorly evidenced in themselves.

    Health Visiting or Nursing? It shouldn't be that simple but yes, I think I'd choose nursing rather than being pushed into a corner where my skills and effective work are limited by narrow minded policy makers trying to make political points.

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  • I welcome the news that the NMC will be reviewing public health nursing. I think many people forget that Health Visitors are meant to be public health nurses. Charged with trying to search out health needs and helping to improve the health of the community in which they work. I left health visiting a year ago when my role had been reduced to supporting the desperately overworked social workers with child protection cases. All the public health work including child health clinics, chronic disease management clinics and community development work had been eroded. I was told they were not priority work and clinics could be run by nursery nurses. Given the chance Health Visitors can make a huge difference. A few years ago a foward thinking manager allowed us to run with some ideas. This resulted in 2 amazing projects which made a real difference to the lives of the community. One of these projects was roles out nationally.
    I would urge the NMC not to dumb down health visiting, but to encourage the Government to invest in this undervalued and powerful group of nurses. Allow us to show you our potential!

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  • I agree with a number of the comments given No we should not dumb down the Health Visiting role, and we need to think long and hard about the direct entry. I use my nursing skills frequently in my profession as a Health Visitor and the fact I worked as part of a team on the ward and developed my confidence as a nurse are part of those skills I was able to transfer to Health Visiting. I also am seriously considering leaving the profession as I feel we are being used as "Glorified Social Workers" and that is NOT what I trained to do and more importantly is not what I want to do. We need to increase the number of Health Visitors in training by a huge percentage then we will be able to replace the numbers leaving the profession (mainly due to the stress of being utilised as Social Workers) and those leaving due to retirement. I also disagree with the comments regarding research showing that we are very able to support families, the research is out there, but we now have the likes of Lorenzo and Paris (to name two) that are basically time and motion to support us!! We got rid of ContactPoint due to safety but are keeping more details on these systems (which potentially could be hacked into or lost) that Big Brother springs to mind!

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  • your all correct-and too late.
    the state funding of the NHS is far too low for the demand for services.
    ergo-either reduce service,reduce demand or increase funding or get efficiencies from staff.

    remember when you needed to be an RM,an RGN and then an HV?

    did it work-yes.
    was it cost effective-no.

    so out went the midders part.
    now out goes the nurse part.
    family community support worker-come on down, only a few NVQS later and a twenty something yoof will be at your door to explain their understanding of child developement.

    good luck with thta.

    I work in Asia now.
    In community/public health. free at the point of care.
    My community of 30 thousand is well cared for by my 30 plus staff for emergancy response,public health,occupational health and primary care.

    what to do in UK.
    either increase tax.
    lower provision.
    trying to do more with less is smoke and mirrors and makes staff the fuse that blows.

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