RE: weighting caseloads/workloads

September 27, 2001

Mike tried hard last year to impose his caseload weighting system on us in Bath

& NE Somerset but I felt very strongly that to wade in with the questions would

threaten my relationship and to hazard a professional guess would be dangerous.

I also thought that to store a piece of paper with such a scoring + postcode

that had not been agreed by the family would be ethically unsound (and possibly

litigious). However, I agree that the best way to tackle health inequalities is

to know what, where and when and HVs + others have the info.

I would be interested in your 'birth book' system Xena - and have copied the

ref. to a file and will look it up.

Xena Dion wrote:

> The debate around caseload weighting and equitable distrubution of HV' is a

subject I had to sort out here in East Somerset. I have a very simple 19

question form that establishes the 'core' caseload of HVs, its simple to use

and with introducing uniform 'birth book' pages that collects the relevant

information over the year, the clerical assistants can now fill in the form and

HV's don't have to waste time on it. Each year we can issue a report that

demonstrates shifts in weighting and ends up showing the debit or credit in

terms of HV hours. Its a snapshot of basic workload that helps plan services.

Over and above that further work can be taken into consideration like HVs

covering the women's refuge, working with travellers/refugees etc. and those

that do hosp. liaison. Much of it comes from work from Crofts et al (Hitting

the target ..) Jnl of Public Health Med. 22 (3) 295-301, Spens' work

in Eastleigh and my own mathematical genius!! (I am hopeless at maths). Anyway

it has given us what we wanted. I do not believe we should be going into

families with questionnaires asking questions that would have me for one showing

the HV the door! we are meant to be building relationships not ruining them.

Public health data is a different story and I agree with the Bristol

approach is not conducive to good relations. Although we need to feed back some

public health data it is hard to justify it, even if it feeds into planning

better services in the long term. there are other ways of getting data.

>

> If anyone is interested in our caseload profiling, let me know and I will send

it on,

> Xena Dion

>

> >>> sarah@... 10/12/01 02:24pm >>>

> Yes, it would be useful to look at Nick Steele's work; I heard him present

> it at UKPHA conference in March, and it looked much simpler than Mike

> Shephard's work. Simplicity has both benefits and problems (can overlook

> key/important issuees; but takes less time and may be equally robust in the

> end).

>

> I worry about the Bristol approach, because I have seen questions that are

> entirely appropriate in researching deprivation in areas used as assessment

> tools in clinical practice (not, I hasten to add, that that is advocated by

> the Bristol team). That can lead to health visitors being expected to go in

> on one visit asking very insensitive questions about things like domestic

> violence, drug use, bereavements etc, when there has been no time to assess

> the readiness of the client to discuss issues; it closes topics down instead

> of opening them up, and can seriously alienate clients. Best wishes

>

> v.drennan@... wrote:

>

> > Dear Charlene ,

> > Yes I'm interested in the reference - having developed and

> > researched systems of workload/caseload weightings as resource

> > management tools in the early nineties - I'm fascinated by the way

> > different areas develop their own - so would welcome any info. as I

> > cant place this reference.

> > I'm also interested in the way these tools get used in different

> > financial and policy environments .It seems to me that in times/areas

> > of financial growth - they are a way of arguing for more resources or

> > allocating money already earmarked for growth - in times of financial

> > cut backs/or policy climate that is negative to health visiting

> > and school nursing they get used to take money out of particular parts

> > of the primary care health system .

> >

> > Rarely when people write about using them do they describe the real

> > world issues of making change happen - in changing practice, changing

> > posts , addressing the inequities these tools expose .

> >

> > So I'd be interested in hearing your experiences .

> > Vari Drennan

> >

> > In @y..., " Charlene Lobo " <charlene@c...> wrote:

> > > Gill Newell,

> > >

> > > Gill, on behalf of Nina Heaps and myself we must thank you for a

> > wonderful

> > > study day on the 9th. It was inspiring, and supportive and gave us

> > so much

> > > food for thought.

> > >

> > > There seemed some discussion around weighting of HV caseloads. Has

> > anybody

> > > seen Nick Steele's work published in one of the public health

> > journals? I

> > > shall find the reference and pass it on if anyone is interested. we

> > are

> > > using it in West Norfolk as a spring board for reviewing HV

> > services.

> > >

> > > charlene

> >

October 1, 2001

The website address did not work for me . Could you check

it again please?

Bidmead wrote:

Those

interested in the work of Berry Brazelton might like to look at the following

website.www.childrenshospital.org/brazelton/ab2,htmlFor

training and courses contactDr.

Johanna HawthorneThe Brazelton

Centre of Great BritainBox226NICUAddenbrookes

NHS TrustHill Rd,CambridgeCB2

2QQ

Re: weighting caseloads/workloads

>

>> Here is copy of birthbookp ages. I thought it would be a painful

process

>implementing them as we all have our favoured systems. However

it was well

>received as it was issued around the same time as the caseload profile

>questionnaire and they saw how time saving it would be it it is kept

up to

>date. there is a column 'comments' that allows for any further

information

>to be collected and/or to easity identify 'high' or 'medium' dependency

>families.

>> regards, Xena

>>

>> >>> ruthngrant@... 09/27/01 07:56pm >>>

>> Mike tried hard last year to impose his caseloadw eighting system

on us in

>Bath & NE Somerset but I felt very strongly that to wade in with

the

>questions would threaten my relationship and to hazard a professional

guess

>would be dangerous. I also thought that to store a piece of

paper with such

>a scoring + postcode that had not been agreed by the family would

be

>ethically unsound (and possiblyl itigious). However, I agree

that the best

>way to tackle health inequalities is to know what, where and when

and HVs +

>others have the info.

>>

>> I would be interested in your 'birth book' system Xena - and have

copied

>the ref. to a file and will look it up.

>>

>> Xena Dion wrote:

>>

>> > The debate around caseload weighting and equitable distrubution

of HV'

>is a subject I had to sort out here in East Somerset. I have

a very simple

>19 question form that establishes the 'core' caseload of HVs,

its simple to

>use and with introducing uniform 'birth book' pages that collects

the

>relevant information over the year, the clerical assistants can now

fill in

>the form and HV's don't have to waste time on it. Each year

we can issue a

>report that demonstrates shifts in weighting and ends up showing the

debit

>or credit in terms of HV hours. Its a snapshot of basic workload

that helps

>plan services. Over and above that further work can be taken

into

>consideration like HVs covering the women's refuge, working

with

>travellers/refugees etc. and those that do hosp. liaison. Much

of it comes

>from work from Crofts et al (Hitting the target ..) Jnl of Public

Health

>Med. 22 (3) 295-301, Spens' work in Eastleigh and my own

>mathematical genius!! (I am hopeless at maths).

>>

>> Anyway it has given us what we wanted. I do not believe we

should be

>going into families with questionnairesa sking questions that would

have me

>for one showing the HV the door! we are meant to be building relationships

>not ruining them. Public health data is a different story and

I agree with

> the Bristola pproach is not conducive to good relations.

Although we

>need to feed back some public health data it is hard to justify it,

even if

>it feeds into planning better services in the long term. there are

other

>ways of getting data.

>> >

>> > If anyone is interested in our caseload profiling, let me know

and I

>will send it on,

>> > Xena Dion

>> >

>> > >>> sarah@... 10/12/01 02:24pm >>>

>> > Yes, it would be useful to look at Nick Steele's work; I heard

him

>present

>> > it at UKPHA conference in March, and itl ooked much simpler than

Mike

>> > Shephard's work. Simplicity has both benefits and problems

(can

>overlook

>> > key/important issuees; but takes less time and may be equally

robust in

>the

>> > end).

>> >

>> > I worry about the Bristol approach, because I have seen questions

that

>are

>> > entirely appropriate in researching deprivation in areas used

as

>assessment

>> > tools in clinical practice (not, I hasten to add, that that is

advocated

>by

>> > the Bristol team). That can lead to health visitors being

expected to

>go in

>> > on one visit asking very insensitive questions about things like

>domestic

>> > violence, drug use, bereavements etc, when there has been no time

to

>assess

>> > the readiness of the client to discuss issues; it closes topics

down

>instead

>> > of opening them up, and can seriouslya lienate clients.

Best wishes

>> >

>> > v.drennan@... wrote:

>> >

>> > > Dear Charlene ,

>> > > Yes I'm interested in the reference - having developed and

>> > > researched systems of workload/caseload weightings as resource

>> > > management tools in the early nineties - I'm fascinated by the

way

>> > > different areas develop their own - so would welcome any info.

as I

>> > > cant place this reference.

>> > > I'm also interested in the way these tools get used in different

>> > > financial and policy environments .It seems to me that in times/areas

>> > > of financial growth - they are a way of arguing for more

resources or

>> > > allocatingm oney already earmarked for growth - in times of

financial

>> > > cut backs/or policy climate that is negative to health visiting

>> > > and school nursing they get used to take money out of particular

parts

>> > > of the primary care health system .

>> > >

>> > > Rarely when people write about using them do they describe the

real

>> > > world issues of making change happen - in changing practice,

changing

>> > > posts , addressing thei nequities these tools expose .

>> > >

>> > > So I'd be interested in hearing your experiences .

>> > > VariD rennan

>> > >

>> > > In @y..., "Charlene Lobo" <charlene@c...>

wrote:

>> > > > Gill Newell,

>> > > >

>> > > > Gill, on behalf of Nina Heaps and myself we must thank you

for a

>> > > wonderful

>> > > > study day on the 9th. It was inspiring, and supportive

and gave us

>> > > so much

>> > > > food for thought.

>> > > >

>> > > > There seemed some discussion around weighting of HV caseloads.

Has

>> > > anybody

>> > > > seen Nick Steele's work published in one of the public health

>> > > journals? I

>> > > > shall find the reference and pass it on if anyone is interested.

we

>> > > are

>> > > > using it in West Norfolk as a spring board for reviewing HV

>> > > services.

>> > > >

>> > > > charlene

>> > >

October 12, 2001

Yes, it would be useful to look at Nick Steele's work; I heard him present

it at UKPHA conference in March, and it looked much simpler than Mike

Shephard's work. Simplicity has both benefits and problems (can overlook

key/important issuees; but takes less time and may be equally robust in the

end).

I worry about the Bristol approach, because I have seen questions that are

entirely appropriate in researching deprivation in areas used as assessment

tools in clinical practice (not, I hasten to add, that that is advocated by

the Bristol team). That can lead to health visitors being expected to go in

on one visit asking very insensitive questions about things like domestic

violence, drug use, bereavements etc, when there has been no time to assess

the readiness of the client to discuss issues; it closes topics down instead

of opening them up, and can seriously alienate clients. Best wishes

v.drennan@... wrote:

> Dear Charlene ,

> Yes I'm interested in the reference - having developed and

> researched systems of workload/caseload weightings as resource

> management tools in the early nineties - I'm fascinated by the way

> different areas develop their own - so would welcome any info. as I

> cant place this reference.

> I'm also interested in the way these tools get used in different

> financial and policy environments .It seems to me that in times/areas

> of financial growth - they are a way of arguing for more resources or

> allocating money already earmarked for growth - in times of financial

> cut backs/or policy climate that is negative to health visiting

> and school nursing they get used to take money out of particular parts

> of the primary care health system .

>

> Rarely when people write about using them do they describe the real

> world issues of making change happen - in changing practice, changing

> posts , addressing the inequities these tools expose .

>

> So I'd be interested in hearing your experiences .

> Vari Drennan

>

> In @y..., " Charlene Lobo " <charlene@c...> wrote:

> > Gill Newell,

> >

> > Gill, on behalf of Nina Heaps and myself we must thank you for a

> wonderful

> > study day on the 9th. It was inspiring, and supportive and gave us

> so much

> > food for thought.

> >

> > There seemed some discussion around weighting of HV caseloads. Has

> anybody

> > seen Nick Steele's work published in one of the public health

> journals? I

> > shall find the reference and pass it on if anyone is interested. we

> are

> > using it in West Norfolk as a spring board for reviewing HV

> services.

> >

> > charlene

>

October 12, 2001

Does anyone know of a Trust in or around the London area that has

implemented anything different or innovative in the area of child health

surveillance.

> ----Original Message-----

> From: Cowley [sMTP:sarah@...]

> Sent: 12 October 2001 14:25

>

> Subject: Re: weighting caseloads/workloads

>

> Yes, it would be useful to look at Nick Steele's work; I heard him present

> it at UKPHA conference in March, and it looked much simpler than Mike

> Shephard's work. Simplicity has both benefits and problems (can overlook

> key/important issuees; but takes less time and may be equally robust in

> the

> end).

>

> I worry about the Bristol approach, because I have seen questions that are

> entirely appropriate in researching deprivation in areas used as

> assessment

> tools in clinical practice (not, I hasten to add, that that is advocated

> by

> the Bristol team). That can lead to health visitors being expected to go

> in

> on one visit asking very insensitive questions about things like domestic

> violence, drug use, bereavements etc, when there has been no time to

> assess

> the readiness of the client to discuss issues; it closes topics down

> instead

> of opening them up, and can seriously alienate clients. Best wishes

>

> v.drennan@... wrote:

>

> > Dear Charlene ,

> > Yes I'm interested in the reference - having developed and

> > researched systems of workload/caseload weightings as resource

> > management tools in the early nineties - I'm fascinated by the way

> > different areas develop their own - so would welcome any info. as I

> > cant place this reference.

> > I'm also interested in the way these tools get used in different

> > financial and policy environments .It seems to me that in times/areas

> > of financial growth - they are a way of arguing for more resources or

> > allocating money already earmarked for growth - in times of financial

> > cut backs/or policy climate that is negative to health visiting

> > and school nursing they get used to take money out of particular parts

> > of the primary care health system .

> >

> > Rarely when people write about using them do they describe the real

> > world issues of making change happen - in changing practice, changing

> > posts , addressing the inequities these tools expose .

> >

> > So I'd be interested in hearing your experiences .

> > Vari Drennan

> >

> > In @y..., " Charlene Lobo " <charlene@c...> wrote:

> > > Gill Newell,

> > >

> > > Gill, on behalf of Nina Heaps and myself we must thank you for a

> > wonderful

> > > study day on the 9th. It was inspiring, and supportive and gave us

> > so much

> > > food for thought.

> > >

> > > There seemed some discussion around weighting of HV caseloads. Has

> > anybody

> > > seen Nick Steele's work published in one of the public health

> > journals? I

> > > shall find the reference and pass it on if anyone is interested. we

> > are

> > > using it in West Norfolk as a spring board for reviewing HV

> > services.

> > >

> > > charlene

> >

October 15, 2001

The debate around caseload weighting and equitable distrubution of HV' is a