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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 think that this was a missed opportunity, because I can see the benefit, for example, of integrating the Community Protection functions of Local Councils, with some of what were the formerly, NHS Public Health arrangements. The same goes, for example, with Health Visiting and 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 Interview Questions, above, comparative Outcome Audit planning was not sufficiently discussed; also I'm not clear whether the annual money "from Health" has been reduced by the NHS, or if it remains the same and is being invested, by the Council, into a different design of a service,but for the same client group. 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 hypothesis 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. A detailed, summarised and evidenced hypothesis should form part of every consultation processes. 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 experienced Health Visitors and Social Workers, at our peril; and practitioner competences in the two professions, whilst overlappping, are not completely interchangeable. In other words, until new and realistic hybrid practitioner training evolves, enough workers from both professions are required. The need for continued face-to-face activity, with children, might be the same for School Nurses. If this instinct/experience based assumption of mine is correct, I hope that it's not discovered in the now time-served, sad. way...Poor outcomes will also damage Local Authority run Public Health services. I hope, in due course, that it turns out that I'm wrong; that my instincts, therefore are/were incorrect; and that this proposed new arrangement turns out, eventually, to provide audit-based evidence, good enough for these proposals to become a blue print for more effective and value-for-money protection and care of the children in our UK communities.

Posted date

16 October, 2016

Posted time

3:43 pm