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'This is an opportunity for health visitors to lead the way'

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Anne Hall and Rebecca Ryder are supporting local ways to recruit health visitors and raise the profession’s status

Health visiting is a tough profession, derided by the media when it makes mistakes and taken for granted when it gets things right.

The government is keen to change both the perception and reality of the profession, and to increase the workforce by 50% or 4,200 health visitors by 2015. It also intends that health visitors should regain their professional autonomy and determine the best approaches to working with families and communities.

That eagerness for change is well personified in Anne Hall, health visitor/school nurse countywide lead for Cornwall’s Children’s Directorate at Cornwall Partnership Trust, and Rebecca Ryder, academic education lead/workforce at Cornwall and Isles of Scilly Primary Care Trust. The PCT has been chosen by the Department of Health as an early implementor site, where new approaches to health visiting will be tested.

“This really appealed to us,” says Ms Hall, who has been a health visitor since 1990, and in her current role since 2007. “The issues surrounding the workforce in Cornwall were particularly pertinent because we are a peninsula. It is hard to recruit. This new way of working to recruit and retrain health visitors will really help.”

The site, one of 20 nominated by strategic health authorities, is in a rural location with high social deprivation.

Despite or maybe because of the area’s problems, the duo and their team have already set up an innovative way of growing its own health visiting workforce. It enables qualified nurses, working at band 5 in wider public health community teams, to access professional development through achieving six modules and Skills for Health practice competencies. The University of Plymouth is currently delivering the programme.

This system is aligned to the specialist practitioner requirement but does not lead to registration on part 3 of the Nursing and Midwifery Council register. However, the study and practice elements can be used for accreditation of prior experiential learning (APEL) to reduce the time that it takes to qualify as a health visitor.

The duo has also developed a pathway for band 4 staff. Cornwall and Isles of Scilly PCT has invested over the past two years and is continuing to do so. “Once we have a full workforce with the increased numbers of health visitors and the additional DH training, the service will go full steam ahead,” says Ms Hall.
The duo welcome the DH’s intervention to promote health visiting as a career.

“There are some cultural barriers, and the NMC’s document debunking the myths will help, as will the flexible routes into health visiting,” says Ms Ryder.
“The key one for me is that the NMC has said the applicants don’t have to be on part 1 of the NMC register - they can be a registered midwife and apply. The applicant also does not need two years’ post-registration experience. The NMC has made it clear that practice experience can be viewed as part of APEL.”
Once the workforce is in place, Ms Ryder and Ms Hall are clear what they would like them to achieve.

“The US model has proved how intensive visiting can really help children, and we’d like to replicate that here with family nurses and a small caseload so we can see the benefits of early intervention,” says Ms Hall.

“There’s lots of evidence that targeting vulnerable families and giving them more support and supervision has great outcomes, and these additional staff will enable us to focus on those families and offer cohesive community services.”

“This is a massive investment,” says Ms Ryder. “It is an opportunity for nurses to expand their skills and knowledge and take part in a robust new education plan, and for health visitors to lead the way.”

Ms Hall agrees: “This is a great opportunity to join health visiting. We’re looking for people who have been nurses to retrain or for new people.
“Among all the stories of cuts and doom and gloom, this is a positive story.”

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