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Health visitor retention strategy must use 'values assessment'

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Health visitors should be assessed for their professional values and given opportunities to see what the role involves in practice before being recruited, according to new research.

This would help managers meet the “challenge of recruiting the right people who feel psychologically connected to the health visiting role” said the paper.

The government-commissioned research was carried out by the Florence Nightingale Faculty of Nursing and Midwifery at King’s College London and the School of Community Health and Midwifery at University of Central Lancashire.

“The future success of investment [in growing the workforce] now rests on continuing to recruit the right people and retain a workforce”

Research paper

It was set up because previous research involving the recruitment and retention of health visitors was viewed as having focussed on wider nurse issues, leaving a gap in understanding about how to support the professional aspirations of this specific part of the workforce.

The paper – called Making a difference for children and families: an appreciative inquiry of health visitor values and why they start and stay in post – also noted the government’s “unprecedented focus” on health visitor training and recruitment in recent years, which increased workforce numbers in England by almost 50% between 2010 and 2015.

According to recent NHS survey data, the workforce rise has coincided with an improvement in health visitor motivation at work. However, other research found service demand had also increased, meaning individual workloads have not been reduced, noted the study.

“There have been ambitious policy and financial investments made in health visiting in England…The future success of these investments now rests on continuing to recruit the right people and retain a workforce ready and capable of working to the [government’s] Health Visitor Implementation Plan,” said the paper.

The study of 17 students and 22 qualified health visitors found that in both groups their main reason for being in the role was because they wanted to “make a difference to children and families”.

Participants in the study said they valued professional autonomy, being able to work with other professionals, making use of knowledge skills and experience, and the privilege of being able to connect with families.

To ensure the “right” people are recruited and retained, managers should check if candidates’ values reflect those found in the study, said the study authors.

“To reduce mismatched expectations…policies enabling practices that facilitate informed career choice should be introduced”

Research paper

“In addition, to reduce mismatched expectations that could contribute to a breach of psychological contract, policies enabling practices (such as shadowing) that facilitate informed career choices and realistic role expectations should be introduced,” added the authors.

When in post, health visitors should be supported to work to these values as this is likely to enhance job satisfaction and motivation to stay in the role, they said.

The paper – due to be published in the Health and Social Care in the Community journal – also recommended “effective communication” with staff by managers. It said this should which focus on sharing values to “engender a trusting culture, which for health visitors would provide a helpful environment for exercising professional autonomy”.

Health visitor commissioning has recently moved from the NHS to local authorities, at the same time local councils are to receive an in-year 6.2% reduction to their public health grant. As a result, concerns have been raised that recent increases in health visitor numbers could be lost due to service cuts.

Local authorities were recently issued a briefing by the Institute of Health Visiting about the important role health visitors have to play in preventative healthcare.

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