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Fast track training needed to hit health visitor target


The government is considering fast tracking health visitor training in a bid to meet its pledge to employ an extra 4,200 health visitors by 2015, Nursing Times has learnt.

Options being considered include allowing hospital nurses to train at work and validating nurses with relevant hospital based experience to work alone as health visitors in the community.

‘Is the current training for health visitors overelaborate - is it really needed?’

The proposals - thought to be the only means by which the government can meet its target to boost the workforce by more than 40 per cent - have led to concerns about the “dumbing down” of the health visitor role.

Health visitor numbers have fallen dramatically. In 1988 there were 10,680 full time equivalents but by September 2009 this had fallen to 8,519.

Royal College of Nursing chief executive and general secretary Peter Carter told Nursing Times: “We think it’s a great thing if we can get 4,000 new health visitors. But we’re talking with the government and [are] wanting to ensure we don’t dumb down the standards.

“They wouldn’t use that expression. But it is a concern we have.”

Current rules stipulate that health visitors must be qualified nurses, generally with at least two years’ practice, who have completed a post-registration degree level course of at least a year.

Skills include working independently - in contrast to hospital nursing - and leading a team. Courses cover management and leadership, research, public health and prescribing.

Mr Carter said discussions at the Department of Health centred on questions such as: “Is the current training overelaborate - is it really needed?”

He said the college and others were having lots of “dialogue” with the government and hoped to avoid health visitor training and skills becoming compromised. “We are hoping we can have significant influence,” he said.

However, Nursing Times has been told the DH is exploring how nurses working in hospitals may be given a health visiting qualification through an “accredited prior learning” model or “on the job” training.

Direct entry courses are also being considered, in which students could train as health visitors without needing to obtain a nursing degree, similar to some midwifery courses.

Nursing Times understands the DH is looking at a new model of health visitor training being used at Cornwall and Isles of Scilly Primary Care Trust.

There, community nurses are able to train to become health visitors while practising alongside qualified health visitors.

Anne Hall, lead health visitor at Cornwall and Isles of Scilly Community Health Services, told Nursing Times that the trainees were not asked to do anything beyond their competence and worked under qualified health visitors.

Ms Hall added it was now significantly easier to recruit. She said: “There were people out there wanting to come into the community once we opened the door.”

But a senior community nursing source told Nursing Times the Cornwall model would only be safe if the assessments at the end of practical training were robust.

The source pointed to the recent history of nurse mentors unwilling to fail poor student nurses on degree placements.

A DH spokeswoman confirmed it was exploring options to make it easier for people to qualify as health visitors.

She said: “We are working with the Nursing and Midwifery Council and professional bodies, looking at how the entry standards can be achieved through more flexible ways of training.”

The government is committed to increasing the number of health visitors to ensure that families get the services they need led and provided by highly skilled professionals.


Readers' comments (14)

  • I have been trying to enroll on a specialist nurse practitioner Health Visitor degree course for the last 3 yrs with no success
    I am a duel traines Adult/Paediatric nurse with 17 years experience in A&E as a paediatric sister i have a special interest in safeguarding children.
    if we are so short of Health Visitors why can't I get a place on a course hen it is something I've worked towards for the last 6 years.

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  • I can't understand why you have not been sucessful in gaining secondment for training with your experience. Perhaps the problem with recruitment is more to do with inadequate interviewing of canditates than that no-one wants to train. Also PCTs have so few places available to offer secondment.

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  • Health visitor training is not over-elaborate; in many respects it is inadequate (too little about mental health, child development, family processes etc). However, it is is too long because of the pre-requisite of being a registered nurse, when some, but by no means all, of that knowledge is useful (perhaps about a third of the three year training?). What is essential, Peter Carter is right, is to have some very clear standards by which the qualification can be judged. That doesn't apply know, because the dedicated health visiting register was closed in 2004, so this could be a good opportunity. Let's re-open the health visiting register and establish proper standards for programmes to enter that register, then decide how to recruit and educate to that level. That would avoid dumbing down and boost recruitment and give us fast-track opportunities: two year Masters programmes for psychology graduates for example? Three year degree in health visiting for those with no prior academic qualifications, but lots of essential experience?

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  • Steve Williams

    Oh my oh my, don't you just know where this one is eventually going to end up.... The Torys proposing HCAs do a six week bridging-course to enable them to work as health visitors. Well why not? 'Nu-Lubber' tried their damnedest to substitute RNs with HCAs during their stint, why are this lot any different.

    Politicians are like incontinence briefs – they need to be changed very frequently – and for exactly the same reason!

    Yup, it may seem ridiculous at the moment – just wait though. The party that (pre-election) said it wanted to abolish targets set itself some targets – and now, like a dog chasing its tail (post election) is going to go into a tailspin trying to fulfil them. Bahhh!

    “Circular logic always makes you dizzy Doctor” (Peri to the 6th Doctor Who - copyright BBC.)

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  • As a Health Visitor, i feel that my nursing knowledge and experience is entirely relevant and would not like to see direct entry. Direct entry midwives are stuck on that part of the register and that in itself has led to problems.

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  • Oh please -NOT hospital nurses frightening because they are so institutionalised and cannot think outside the box.
    The Government should consider bringing in part time semi retired Specialist practitioners. Community Nursing is a whole different ball game needing those specialist skills of discerning assessment and logical problem solving skills. Sorry but your average ward nurse will be way off the mark and considering the role they will need to play in terms of supporting young single mums this is a positively risky strategy. Lord preserve us all including the young families of Britain!!

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  • I too have tried unsuccessfully to get onto the specialist practioner health visitor training course but i'm not sure changing the way health visitor's are trained is the answer. The training is hard work because it needs to be! The qualified Health Visitor has to be an autonomous practioner in the community - a great responsibility. The problem is that there is not enough funding for training - my local university interviewed for 3 days to take on 9 health visitor students, 9 district nurse and 9 school nurse students.

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  • After the horse has bolted springs to mind! Nurse educators have been very shortsighted in the forward planning for this speciality. As a Practice Facilitator I recently battled to get pre registration Health Visiting placements within a cirriculum, to no avail. I know for certain that nationally very few pre registration nursing programmes have Health Visiting experience incorporated. How can we expect our nurses of the future to want to be SCPHN's, if they have no idea of the role? It is now time to be proactive and give student nurses HV experience and encourage a profession in Health Visitng, instead of having to be reactive in these situations, and having to tackle the shortage within this specialism.

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  • Whilst it's good to see the government look for ways to honour their pre-election pledge of an additional 4,200 HVs by 2015, some of the options discussed are misleading. Cornwall, for example, has commissioned further places this year for training health visitors on the established, NMC approved, SCPHN programme. HV students continue to work alongside mentors and health visitors in locality teams, but responsibility for assessment lies with practice teachers, in line with current NMC standards. Community nurses, on the other hand, are able to access of 2 modules taken from within the SCPHN programme which can later be transferred across to the established training, although the competencies completed during the practice element are reviewed by practice teachers to ensure the evidnce produced is of a high enough level, and can be mapped to proficiencies. The Cornwall model referred to compliments services but does not replace HV training for part 3 of the register.
    The pros and cons of direct entry have long been a topic of discussion and could provide an effective means of reducing the length of training. Our priority however, has to be in protecting the public and ensuring practitioners are given the right skills at the required standard to provide safe and effective care. The best way to achieve this, I believe, is for us to lobby ministers and push for health visiting to return to statute.

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  • I am another one who tried for several years to get onto the Health visiting course. Eventually I gave up.
    It appeared to me that because of the limited places available, health organisations had people earmarked for this training years in advance.

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