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Exclusive: Council plans radical public health nurse shake-up


The responsibility for Public Health, in Wales, has not been devolved to Local Authorities. I thought that this was a missed opportunity, because I could see the benefit of inegrating the Community Protection functions of Local Councils, with what were the formerly, NHS Public Health arrangements. The same goes, for example, with Health Visiting with Child Social work. Well run, single management structures reduce duplication, in nearly every respect and improve communication, offering the benefit both of efficiencies and improved outcomes for service users. These proposed Cumbria County Council service changes seem to reflect these ideas about integrated working; but in the Q&A above, comparative Outcome Audit planning was not discussed; also I'm not clear whether the money "from Health" has been reduced by the NHS, or if it is being invested, by the Council, into a different design of a service, aimed at the client group currently being served. Change is a permanent fact of professional life; and practitioners and local managers should not protect the status quo, for its own sake. So often though, proposals and plans for change aren't backed by a reasoned hypothessis or published evidence; nor are the effects of significant and very disrupting organisational change, sytematically audited and reported, as part of Public Health and Local Government reporting. An evidenced hypothesis should form part of this consultation process. So often, this is not the case. One thing, though, that my instinct/experience and some evidence seems to support (because the reliability and availability of Change evidence is so poor) is that we reduce the amount face-to-face family contact with Fully Qualified Health Visitors, at our peril. This might be the same with School Nurses. If this instinct/experience based assumption is correct, I hope that we don't discover this, in the time-served, sad. way... Such an outcome would also damage Local Authority run Public Health services. I hope, in due course, it turns out that I'm wrong, and that my instincts, therefore are/were incorrect; and this proposed new arrangement turns out to provide audit-based evidence, good enough to provide a blue print for more effective protection and care for, and within, young families.

Posted date

16 October, 2016

Posted time

3:12 pm