RE: skill mix

[Guest guest]

Margaret,

I agree in part but think that there needs to be a recognised training for a

skill mix team that does not depend on the HV being teacher, team leader, needs

assessor as well as clinician. Experience in this area has shown that skill mix

staff are very mobile and HV team leaders were constantly having to re-train

staff whilst maintaining the service short-handed. This training role of

community staff is becoming much bigger with the huge numbers of pre-RGN staff

that are being pushed through the system. This leads me to be less keen to take

on skill-mix.

Ruth

Margaret Buttigieg wrote:

> You are right skill mix is the way we are going much of that initially

> triggered by staff shortages and difficulties in recruitment.

>

> However there are I believe are other reasons which show the development of

> health visiting as a profession.

>

> The policy agenda directs Hvs to lead teams and to undertake wider community

> and family centred public health work. There are not enought health

> visitors to do this and the past routine work and also some of that has

> become so tedious that bring newly qualified HVs are bored stiff by it

> especially when they have been taught to look at the public health agenda

> and not sit in a medical model. We need to encouraging them to look widely,

> to see the value again of making relationships and of recognizing it is them

> directing the team and the work of the health visiting team. It maybe that

> a newly qulaifed HV needs to be seen as part of the skill mix and not

> initally as the team leader. I am sure there are issues here about why so

> many move on to other things so quickly. also we need to educat others not

> least GPs

>

> Yes the unpredictability reamins but it also about the openess and honesty

> of team members, the building of the relationship in teams and the sharing

> and the understanding about the level of skill and knowledge of nursery

> nurses and many staff nurses. When delegation is handled effectively and

> the development in place - other staff in the team are clear about

> boundaries and what they can and cannot do and what they need to share.

>

> For me often what is missing is the qualified HV ability to lead the team,

> to see the value of a weekly meeting and regular contact and to take up

> their position as a team leader. If you set competency based JDs and are

> clear about levesl this becomes easier. The problems of even what seems a

> normal family today are so complex that we need to enable qualifed HVs to

> use their skills in the right are.

>

> For me this is not about giving up things or allowing others to do them - it

> is part of the recognition of the importance of a multiprofessional/multi

> agency agenda and of the ability of many nurses who come into health

> visiting. It also I believe links into the " do you need to be a nurse to be

> a health vistor agenda " and the way we need to be enabling non nurses to

> undertake a health visitng role.

>

> What do others think

>

> Margaret

> Re: skill mix

>

> > Ten years ago, the mention of the term 'skillmix' struck horror to the

> heart

> > of many health visitors. I am encouraged that it now seems to be an

> > everyday expectation in many parts of the country. However, ne thing that

> > was a major concern, about which we could only speculate when it foirst

> > began, was how you would solve the problem of 'predictability' when

> > delegating responsibilities. So much of health visiting practice seems

> > difficult to predict, but if anything is to be delegated, the person doing

> > the delegating (who remains accountable) needs to know BOTH the skills of

> > the person being asked to undertake an activity and enough about the

> > situation to be able to give clear instructions about 'what to do if. .

> .

> > . ,' including clear instructions about reporting back.

> >

> > I would be very interested in hearing in hearing how successful

> > 'skillmixers' have solved this conundrum. Best wishes

> >

> >

> >

> >

> >

> >

[Guest guest]

Agreed, but there does not seem to be the budget to achieve essential staff

updates let alone developments.

Ruth

Margaret Buttigieg wrote:

> Ruth

>

> Those are good points and I am saying to Trusts you need to be thinking

> wider than the individual coming into post and the staff in the team

> training them. You need to set up trainign across that is part of the

> induction and expectation and also provide on-going development

> opportunities for people.

>

> It is clear form the Senate that some Trust are and it should not be left to

> individual practitoenrs to do as we need some sort of uniformity.

>

> Margaret

>

> Re: skill mix

> > >

> > > > Ten years ago, the mention of the term 'skillmix' struck horror to the

> > > heart

> > > > of many health visitors. I am encouraged that it now seems to be an

> > > > everyday expectation in many parts of the country. However, ne thing

> that

> > > > was a major concern, about which we could only speculate when it

> foirst

> > > > began, was how you would solve the problem of 'predictability' when

> > > > delegating responsibilities. So much of health visiting practice

> seems

> > > > difficult to predict, but if anything is to be delegated, the person

> doing

> > > > the delegating (who remains accountable) needs to know BOTH the skills

> of

> > > > the person being asked to undertake an activity and enough about the

> > > > situation to be able to give clear instructions about 'what to do if.

> .

> > > .

> > > > . ,' including clear instructions about reporting back.

> > > >

> > > > I would be very interested in hearing in hearing how successful

> > > > 'skillmixers' have solved this conundrum. Best wishes

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

[Guest guest]

,

Another factor that has to be added to the equation is that an HV would

definitely work

at a different level to a skill mix team member and that that added depth may,

in the

long run, be more effective and therefore cost effective. My previous life was

management accountancy and I am aware that all these aspects can be costed and

therefore calculated. There is an NHS dept that does these things I think it is

in

York as I used a report on Parenting for one of my modules.

Ruth

Cowley wrote:

> Interesting points Ruth. I wonder if anyone has actually done the arithmetic

for

> the training time needed? I think that should be about training the health

visitor

> (how to know what delegate, when and how: safeguards etc) as well as for the

team

> member. I am still unclear about how you determine what is predictable enough

to

> count as 'routine' in a situation that has not been assessed by the health

visitor,

> whether that is a home visit or developmental check or anything else, for

someone

> that has not been seen for several months/years.

>

> One thing that I am clear about, though, is that if you 'add in' some skillmix

> hours, that has to be discounted in some way. Supposing, for example, a

20-hour a

> week nursery nurse joins a full-time HV: that means that 57.5 hours are being

> worked between them both. But if it takes 1 hour a day for both to meet

together

> to engage in team-building, teaching, delegating, handing over and reporting

back

> (on work that was previously just carried out by the HV without any additional

> training/discussion etc), that equates to 32.5 hours HV time and 15 hours NN

time

> available for doing the same work.

>

> I think that means that there is, therefore, a net gain of 10 hours 'practice

time'

> for the additional 20 hours nursery nurse input, but I failed my maths O

level, so

> perhaps someone else has added it up differently. I would be very interested

to

> know if anyone has actually factored in these kinds of issues in a more

scientific

> way when considering the costs for the necessary communication/trainingetc of

the

> 'teams' health visitors are being exhorted to lead. Best wishes

>

>

>

> ruthngrant wrote:

>

> > Margaret,

> > I agree in part but think that there needs to be a recognised training for a

> > skill mix team that does not depend on the HV being teacher, team leader,

needs

> > assessor as well as clinician. Experience in this area has shown that skill

mix

> > staff are very mobile and HV team leaders were constantly having to re-train

> > staff whilst maintaining the service short-handed. This training role of

> > community staff is becoming much bigger with the huge numbers of pre-RGN

staff

> > that are being pushed through the system. This leads me to be less keen to

take

> > on skill-mix.

> > Ruth

> >

> > Margaret Buttigieg wrote:

> >

> > > You are right skill mix is the way we are going much of that

initially

> > > triggered by staff shortages and difficulties in recruitment.

> > >

> > > However there are I believe are other reasons which show the development

of

> > > health visiting as a profession.

> > >

> > > The policy agenda directs Hvs to lead teams and to undertake wider

community

> > > and family centred public health work. There are not enought health

> > > visitors to do this and the past routine work and also some of that has

> > > become so tedious that bring newly qualified HVs are bored stiff by it

> > > especially when they have been taught to look at the public health agenda

> > > and not sit in a medical model. We need to encouraging them to look

widely,

> > > to see the value again of making relationships and of recognizing it is

them

> > > directing the team and the work of the health visiting team. It maybe

that

> > > a newly qulaifed HV needs to be seen as part of the skill mix and not

> > > initally as the team leader. I am sure there are issues here about why so

> > > many move on to other things so quickly. also we need to educat others

not

> > > least GPs

> > >

> > > Yes the unpredictability reamins but it also about the openess and honesty

> > > of team members, the building of the relationship in teams and the

sharing

> > > and the understanding about the level of skill and knowledge of nursery

> > > nurses and many staff nurses. When delegation is handled effectively and

> > > the development in place - other staff in the team are clear about

> > > boundaries and what they can and cannot do and what they need to share.

> > >

> > > For me often what is missing is the qualified HV ability to lead the team,

> > > to see the value of a weekly meeting and regular contact and to take up

> > > their position as a team leader. If you set competency based JDs and are

> > > clear about levesl this becomes easier. The problems of even what seems a

> > > normal family today are so complex that we need to enable qualifed HVs to

> > > use their skills in the right are.

> > >

> > > For me this is not about giving up things or allowing others to do them -

it

> > > is part of the recognition of the importance of a multiprofessional/multi

> > > agency agenda and of the ability of many nurses who come into health

> > > visiting. It also I believe links into the " do you need to be a nurse to

be

> > > a health vistor agenda " and the way we need to be enabling non nurses to

> > > undertake a health visitng role.

> > >

> > > What do others think

> > >

> > > Margaret

> > > Re: skill mix

> > >

> > > > Ten years ago, the mention of the term 'skillmix' struck horror to the

> > > heart

> > > > of many health visitors. I am encouraged that it now seems to be an

> > > > everyday expectation in many parts of the country. However, ne thing

that

> > > > was a major concern, about which we could only speculate when it foirst

> > > > began, was how you would solve the problem of 'predictability' when

> > > > delegating responsibilities. So much of health visiting practice seems

> > > > difficult to predict, but if anything is to be delegated, the person

doing

> > > > the delegating (who remains accountable) needs to know BOTH the skills

of

> > > > the person being asked to undertake an activity and enough about the

> > > > situation to be able to give clear instructions about 'what to do if. .

> > > .

> > > > . ,' including clear instructions about reporting back.

> > > >

> > > > I would be very interested in hearing in hearing how successful

> > > > 'skillmixers' have solved this conundrum. Best wishes

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

[Guest guest]

How interesting - it would be fun to collaborate.

Ruth

" M.Rigler " wrote:

>

> For over ten years I have been having informal conversations with

> a Senior Lecturer in Economics , who was a patient at my GP practice , at

> Aston University in Birmingham about this kind of issue. As an economist he

> is very interested to research such matters to look at the cost/benefit

> analysis etc etc. but needs the funding to do so .

> This would seem to me to be something that the Modernization

> Agency for the NHS ought to be considering i.e. the involvement of

> professionals with a background in economics interested in developing Health

> Economics Research linked to Health Visiting Practice and COmmunity

> Development.

>

> There is no such thing as a free lunch !!

> Malcolm

> Re: skill mix

> > > >

> > > > > Ten years ago, the mention of the term 'skillmix' struck horror to

> the

> > > > heart

> > > > > of many health visitors. I am encouraged that it now seems to be

> an

> > > > > everyday expectation in many parts of the country. However, ne

> thing that

> > > > > was a major concern, about which we could only speculate when it

> foirst

> > > > > began, was how you would solve the problem of 'predictability' when

> > > > > delegating responsibilities. So much of health visiting practice

> seems

> > > > > difficult to predict, but if anything is to be delegated, the person

> doing

> > > > > the delegating (who remains accountable) needs to know BOTH the

> skills of

> > > > > the person being asked to undertake an activity and enough about the

> > > > > situation to be able to give clear instructions about 'what to do

> if. .

> > > > .

> > > > > . ,' including clear instructions about reporting back.

> > > > >

> > > > > I would be very interested in hearing in hearing how successful

> > > > > 'skillmixers' have solved this conundrum. Best wishes

> > > > >

> > > > >

> > > > >

> > > > >

> > > > >

> > > > >

[Guest guest]

Agreed especially as quite a number of HVs, like myself, have also got

counselling qualifications and loads of practice.

Ruth

Manning wrote:

> Dear All

>

> I completely endorse this. It is simply ludicrous that we are shifting the

> deckcairs again and the same people in them

> and expect to make any serious impact on issues of E and T, supervision and

> support, recruitment and retention.

>

> MY message to everyone is that Workforce capacity and capability comes first

> and must underpin the entire Trust's work.

> We have prevaricated on this for years and now we have the bodies,

> potentially, who could implement it properly.

> Praise those who are doing it and lobby those who are not. It is actually

> also about Implementing Standard One of the

> NSF for MH, with the NHS, " leading by Example " . The front liners are the

> heroes and management should be underneath supporting

> them or leading from behind, not reigning down cabbages on them day after

> day!

>

> At the MH Taskforce meeting the other days, several of us iterated the

> crucial need, in terms of delivering on the

> Performance Indicators and Suicide Strategy that HVs, DNs, Practice Nurses

> and all practice staff are in the room.

> I was able to argue the case far better after reading some of the SENATE

> comments!

>

> Manning

> www.primhe.org

>

> Re: skill mix

>

> Ruth

>

> Those are good points and I am saying to Trusts you need to be thinking

> wider than the individual coming into post and the staff in the team

> training them. You need to set up trainign across that is part of the

> induction and expectation and also provide on-going development

> opportunities for people.

>

> It is clear form the Senate that some Trust are and it should not be left to

> individual practitoenrs to do as we need some sort of uniformity.

>

> Margaret

>

> Re: skill mix

> > >

> > > > Ten years ago, the mention of the term 'skillmix' struck horror to the

> > > heart

> > > > of many health visitors. I am encouraged that it now seems to be an

> > > > everyday expectation in many parts of the country. However, ne thing

> that

> > > > was a major concern, about which we could only speculate when it

> foirst

> > > > began, was how you would solve the problem of 'predictability' when

> > > > delegating responsibilities. So much of health visiting practice

> seems

> > > > difficult to predict, but if anything is to be delegated, the person

> doing

> > > > the delegating (who remains accountable) needs to know BOTH the skills

> of

> > > > the person being asked to undertake an activity and enough about the

> > > > situation to be able to give clear instructions about 'what to do if.

> .

> > > .

> > > > . ,' including clear instructions about reporting back.

> > > >

> > > > I would be very interested in hearing in hearing how successful

> > > > 'skillmixers' have solved this conundrum. Best wishes

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

[Guest guest]

Please could someone let me know who I contact at Hounslow and Spelthorne NHS Trust re: this skill mix training pack. Here at Worthing Priority Care NHS Trust we are moving toward this model owing to the lack of HV's. Judy

Re: Skillmix

Hi

I have been trying to do soem work in this area - I will share some of it

with you when we talk.

Margaret

Skillmix

> Can anyone share any similar work undertaken to look at skillmix

> (that is already in place) within health visiting teams?

> A group within my trust is looking at the role of NNEB's and RN's

> within the HV teams across the trust. This was an area of practice

> that was identified from practitioners as needing clarification prior

> to moving to PCT status in April. NNEB's and RN's within the teams

> had no career development opportunities, training was done ad hoc and

> recruitment into teams varied so much (this variation did not reflect

> local population need). We do not have any written competencies for

> members of the teams. This may sound dreadful, but to be fair to the

> trust and my colleagues there has been a rapid rise particularly of

> NNEB's within teams due to a shortage of HV's and now we are faced

> with the above situation needing urgently addressing.

> We have worked with the training pack kindly produced by Hounslow and

> Spelthorne NHS Trust - which has been invaluable. Does anyone have

> any further suggestions please? Especially around the role of

> community RN's within HV teams. The RN's were initally recruited in

> developmental posts with the idea that HV training would follow.

> These RN's no longer wish to do their HV training - which is fine.

>

>

>

>

>

>

>

[Guest guest]

NIna

I have undertaken some workj on Nursery Nurses working wirth HVs and have competency based JD for them. Presently I am working on doing the same for staff nruses - when they are available and in a suitable state - I will forward them

Margaret

skill mix

Dear

Thank you for introducing me to SENATE its been invaluable in helping me over the last year and so useful developing networks both locally and nationally.

I am currently looking at competancies too within the HV team in particular the staff nurse role.I would be extremely grateful if anyone out there has any job descriptions,competancies etc that they could share.Many thanks

Nina Heaps

Send and receive Hotmail on your mobile device: Click Here

[Guest guest]

NIna

This is the work we have done in City and Hackney on competency based JDs for nursery nurses. It has been very bottom up and we are now doing the same for staff nurses and then HVs

Margaret

skill mix

Dear

Thank you for introducing me to SENATE its been invaluable in helping me over the last year and so useful developing networks both locally and nationally.

I am currently looking at competancies too within the HV team in particular the staff nurse role.I would be extremely grateful if anyone out there has any job descriptions,competancies etc that they could share.Many thanks

Nina Heaps

Send and receive Hotmail on your mobile device: Click Here

[Guest guest]

In Worthing we are also looking at this as a possibility. I would also be grateful for any information. We are also hoping to implement the 9 day fortnight as from April 1st as a pilot scheme in one area and hope this, if it takes off, will aid recruitment.

[D'Albertson Judy (RHJ) WPC]

----Original Message-----From: nina heaps [mailto:heapsfamily@...]Sent: 09 March 2002 17:00 Subject: skill mix

Dear

Thank you for introducing me to SENATE its been invaluable in helping me over the last year and so useful developing networks both locally and nationally.

I am currently looking at competancies too within the HV team in particular the staff nurse role.I would be extremely grateful if anyone out there has any job descriptions,competancies etc that they could share.Many thanks

Nina Heaps

Send and receive Hotmail on your mobile device: Click Here

[Guest guest]

Margaret,

Thank you so much for forwarding the competancy JD for nursery nurses,it will help our planning enormously.I look forward to reading the rest!

Nina Heaps

>From: "Margaret Buttigieg"

>Reply- >

>Subject: Re: skill mix >Date: Sun, 10 Mar 2002 13:24:48 -0000 > >NIna > >This is the work we have done in City and Hackney on competency based JDs for nursery nurses. It has been very bottom up and we are now doing the same for staff nurses and then HVs > >Margaret > skill mix > > > Dear > Thank you for introducing me to SENATE its been invaluable in helping me over the last year and so useful developing networks both locally and nationally. > I am currently looking at competancies too within the HV team in particular the staff nurse role.I would be extremely grateful if anyone out there has any job descriptions,competancies etc that they could share.Many thanks > Nina Heaps > > >------------------------------------------------------------------------------ > Send and receive Hotmail on your mobile device: Click Here > >

[Guest guest]

Margaret

I seem to be doing an hour of thank you emails (technology is great just

think of all these thank-yous that wouldn't be getting done if I was writing

or phoning!) Anyway really appreciate you posting that JD for Nursery

Nurses, very topical, very interesting and really gave me food for thought.

Cheers for that

>From: " Margaret Buttigieg " <margaret@...>

>Reply-

>< >

>Subject: Re: skill mix

>Date: Sun, 10 Mar 2002 13:24:48 -0000

>

>NIna

>

>This is the work we have done in City and Hackney on competency based JDs

>for nursery nurses. It has been very bottom up and we are now doing the

>same for staff nurses and then HVs

>

>Margaret

> skill mix

>

>

> Dear

> Thank you for introducing me to SENATE its been invaluable in helping me

>over the last year and so useful developing networks both locally and

>nationally.

> I am currently looking at competancies too within the HV team in

>particular the staff nurse role.I would be extremely grateful if anyone out

>there has any job descriptions,competancies etc that they could share.Many

>thanks

> Nina Heaps

>

>

>------------------------------------------------------------------------------

> Send and receive Hotmail on your mobile device: Click Here

>

>

[Guest guest]

Hi Val,

I have a job description that we recently put together for a pilot

scheme for skill mix in a local trust. this is based on a staff

nurse, D/E grade, I will send you a copy if you forward me your

address.

tel 01633 436109

Email joomunls@....

Lorraine Joomun

On 12 Mar 2002 at 20:45, Val Sibson wrote:

For those of you out there who are working with community staff nurses in HV

teams - does anyone have a job description for these members? If so - I would

really appreciate you sharing this as we are currently examining this way

forward as a possibility.

Thank you

Val Sibson

[Guest guest]

Please could you also send me a copy because we are just going down this route.

Mrs J d'Albertson HV, Lancing Health Centre, Penstone Park, Lancing, West Sussex. BN15 9AG.

Thank you very much. Judy

Re: skill mix

Hi Val,

I have a job description that we recently put together for a pilot

scheme for skill mix in a local trust. this is based on a staff

nurse, D/E grade, I will send you a copy if you forward me your

address.

tel 01633 436109

Email joomunls@....

Lorraine Joomun

On 12 Mar 2002 at 20:45, Val Sibson wrote:

For those of you out there who are working with community staff nurses in HV teams - does anyone have a job description for these members? If so - I would really appreciate you sharing this as we are currently examining this way forward as a possibility.

Thank you

Val Sibson

[Guest guest]

As i posted earlier Val - I am working on one similar format to the nursery nurse one I posted.

Will put it on SENNATE when it is a biit more together

Margaret

skill mix

For those of you out there who are working with community staff nurses in HV teams - does anyone have a job description for these members? If so - I would really appreciate you sharing this as we are currently examining this way forward as a possibility.

Thank you

Val Sibson

[Guest guest]

Lorraine - could I have a copy to please.

My address is - 14 Lincoln Close, Ash Vale, Aldershot Gu 12 5 SU

Margaret

Re: skill mix

> Hi Val,

> I have a job description that we recently put together for a pilot

> scheme for skill mix in a local trust. this is based on a staff

> nurse, D/E grade, I will send you a copy if you forward me your

> address.

>

> tel 01633 436109

> Email joomunls@....

>

> Lorraine Joomun

>

> On 12 Mar 2002 at 20:45, Val Sibson wrote:

>

> For those of you out there who are working with community staff nurses in

HV teams - does anyone have a job description for these members? If so - I

would really appreciate you sharing this as we are currently examining this

way forward as a possibility.

> Thank you

> Val Sibson

>

>

>

>

[Guest guest]

Margaret

I have mailed a copy to you, will be interested in any comments.

Lorraine

On 14 Mar 2002 at 20:49, Margaret Buttigieg wrote:

Lorraine - could I have a copy to please.

My address is - 14 Lincoln Close, Ash Vale, Aldershot Gu 12 5 SU

Margaret

Re: skill mix

> Hi Val,

> I have a job description that we recently put together for a pilot

> scheme for skill mix in a local trust. this is based on a staff

> nurse, D/E grade, I will send you a copy if you forward me your

> address.

>

> tel 01633 436109

> Email joomunls@....

>

> Lorraine Joomun

>

> On 12 Mar 2002 at 20:45, Val Sibson wrote:

>

> For those of you out there who are working with community staff nurses in

HV teams - does anyone have a job description for these members? If so - I

would really appreciate you sharing this as we are currently examining this

way forward as a possibility.

> Thank you

> Val Sibson

>

>

>

>

[Guest guest]

Thank you Lorraine, I received my copy of your D/E job specification. I will be looking at this with my colleagues who are exploring this necessity.

Re: skill mix

Margaret

I have mailed a copy to you, will be interested in any comments.

Lorraine

On 14 Mar 2002 at 20:49, Margaret Buttigieg wrote:

Lorraine - could I have a copy to please.

My address is - 14 Lincoln Close, Ash Vale, Aldershot Gu 12 5 SU

Margaret

Re: skill mix

> Hi Val,

> I have a job description that we recently put together for a pilot

> scheme for skill mix in a local trust. this is based on a staff

> nurse, D/E grade, I will send you a copy if you forward me your

> address.

>

> tel 01633 436109

> Email joomunls@....

>

> Lorraine Joomun

>

> On 12 Mar 2002 at 20:45, Val Sibson wrote:

>

> For those of you out there who are working with community staff nurses in

HV teams - does anyone have a job description for these members? If so - I

would really appreciate you sharing this as we are currently examining this

way forward as a possibility.

> Thank you

> Val Sibson

>

>

>

>

[Guest guest]

Lorraine,

I would be really interested in looking at your job description for a staff nurse D/E grade ,would you be able to mail me one too ? Thanks Nina Heaps

Home Address;

50, Lynn Road,

Ely ,

Cambs cb6 1de

>From: "Lorraine JOOMUN"

>Reply- >"Margaret Buttigieg" , >Subject: Re: skill mix >Date: Fri, 15 Mar 2002 09:15:40 GMT0BST > >Margaret >I have mailed a copy to you, will be interested in any comments. >Lorraine > >On 14 Mar 2002 at 20:49, Margaret Buttigieg wrote: > >Lorraine - could I have a copy to please. > >My address is - 14 Lincoln Close, Ash Vale, Aldershot Gu 12 5 SU > >Margaret > Re: skill mix > > > > Hi Val, > > I have a job description that we recently put together for a pilot > > scheme for skill mix in a local trust. this is based on a staff > > nurse, D/E grade, I will send you a copy if you forward me your > > address. > > > > tel 01633 436109 > > Email joomunls@.... > > > > Lorraine Joomun > > > > On 12 Mar 2002 at 20:45, Val Sibson wrote: > > > > For those of you out there who are working with community staff nurses in >HV teams - does anyone have a job description for these members? If so - I >would really appreciate you sharing this as we are currently examining this >way forward as a possibility. > > Thank you > > Val Sibson > > > > > > > >

[Guest guest]

Has anyone got a job specification for using RSCN's in post. I have received the one from Gwent re: RN's which is very useful. Is anyone using RSCN's in the field? Judy

-----Original Message-----From: Margaret Buttigieg [mailto:margaret@...]Sent: 10 March 2002 13:25 Subject: Re: skill mix

NIna

This is the work we have done in City and Hackney on competency based JDs for nursery nurses. It has been very bottom up and we are now doing the same for staff nurses and then HVs

Margaret

skill mix

Dear

Thank you for introducing me to SENATE its been invaluable in helping me over the last year and so useful developing networks both locally and nationally.

I am currently looking at competancies too within the HV team in particular the staff nurse role.I would be extremely grateful if anyone out there has any job descriptions,competancies etc that they could share.Many thanks

Nina Heaps

Send and receive Hotmail on your mobile device: Click Here

[Guest guest]

Nina

I will post a copy to you today, will be grateful for any comments

Lorraine.

On 16 Mar 2002 at 13:09, nina heaps wrote:

Lorraine,

I would be really interested in looking at your job description for a

staff nurse D/E grade,would you be able to mail me one too ? Thanks

Nina Heaps

Home Address;

50, Lynn Road,

Ely ,

Cambs cb6 1de

>From: " Lorraine JOOMUN "

>Reply-

> " Margaret Buttigieg " ,

>Subject: Re: skill mix

>Date: Fri, 15 Mar 2002 09:15:40 GMT0BST

>

>Margaret

>I have mailed a copy to you, will be interested in any comments.

>Lorraine

>

>On 14 Mar 2002 at 20:49, Margaret Buttigieg wrote:

>

>Lorraine - could I have a copy to please.

>

>My address is - 14 Lincoln Close, Ash Vale, Aldershot Gu 12 5 SU

>

>Margaret

> Re: skill mix

>

>

> > Hi Val,

> > I have a job description that we recently put together for a

pilot

> > scheme for skill mix in a local trust. this is based on a staff

> > nurse, D/E grade, I will send you a copy if you forward me your

> > address.

> >

> > tel 01633 436109

> > Email joomunls@....

> >

> > Lorraine Joomun

> >

> > On 12 Mar 2002 at 20:45, Val Sibson wrote:

> >

> > For those of you out there who are working with community staff

nurses in

>HV teams - does anyone have a job description for these members? If

so - I

>would really appreciate you sharing this as we are currently

examining this

>way forward as a possibility.

> > Thank you

> > Val Sibson

> >

> >

> >

> >

[Guest guest]

Ten years ago, the mention of the term 'skillmix' struck horror to the heart

of many health visitors. I am encouraged that it now seems to be an

everyday expectation in many parts of the country. However, ne thing that

was a major concern, about which we could only speculate when it foirst

began, was how you would solve the problem of 'predictability' when

delegating responsibilities. So much of health visiting practice seems

difficult to predict, but if anything is to be delegated, the person doing

the delegating (who remains accountable) needs to know BOTH the skills of

the person being asked to undertake an activity and enough about the

situation to be able to give clear instructions about 'what to do if. . .

.. ,' including clear instructions about reporting back.

I would be very interested in hearing in hearing how successful

'skillmixers' have solved this conundrum. Best wishes

[Guest guest]

You are right skill mix is the way we are going much of that initially

triggered by staff shortages and difficulties in recruitment.

However there are I believe are other reasons which show the development of

health visiting as a profession.

The policy agenda directs Hvs to lead teams and to undertake wider community

and family centred public health work. There are not enought health

visitors to do this and the past routine work and also some of that has

become so tedious that bring newly qualified HVs are bored stiff by it

especially when they have been taught to look at the public health agenda

and not sit in a medical model. We need to encouraging them to look widely,

to see the value again of making relationships and of recognizing it is them

directing the team and the work of the health visiting team. It maybe that

a newly qulaifed HV needs to be seen as part of the skill mix and not

initally as the team leader. I am sure there are issues here about why so

many move on to other things so quickly. also we need to educat others not

least GPs

Yes the unpredictability reamins but it also about the openess and honesty

of team members, the building of the relationship in teams and the sharing

and the understanding about the level of skill and knowledge of nursery

nurses and many staff nurses. When delegation is handled effectively and

the development in place - other staff in the team are clear about

boundaries and what they can and cannot do and what they need to share.

For me often what is missing is the qualified HV ability to lead the team,

to see the value of a weekly meeting and regular contact and to take up

their position as a team leader. If you set competency based JDs and are

clear about levesl this becomes easier. The problems of even what seems a

normal family today are so complex that we need to enable qualifed HVs to

use their skills in the right are.

For me this is not about giving up things or allowing others to do them - it

is part of the recognition of the importance of a multiprofessional/multi

agency agenda and of the ability of many nurses who come into health

visiting. It also I believe links into the " do you need to be a nurse to be

a health vistor agenda " and the way we need to be enabling non nurses to

undertake a health visitng role.

What do others think

Margaret

Re: skill mix

> Ten years ago, the mention of the term 'skillmix' struck horror to the

heart

> of many health visitors. I am encouraged that it now seems to be an

> everyday expectation in many parts of the country. However, ne thing that

> was a major concern, about which we could only speculate when it foirst

> began, was how you would solve the problem of 'predictability' when

> delegating responsibilities. So much of health visiting practice seems

> difficult to predict, but if anything is to be delegated, the person doing

> the delegating (who remains accountable) needs to know BOTH the skills of

> the person being asked to undertake an activity and enough about the

> situation to be able to give clear instructions about 'what to do if. .

..

> . ,' including clear instructions about reporting back.

>

> I would be very interested in hearing in hearing how successful

> 'skillmixers' have solved this conundrum. Best wishes

>

>

>

>

>

>

[Guest guest]

Ruth

Those are good points and I am saying to Trusts you need to be thinking

wider than the individual coming into post and the staff in the team

training them. You need to set up trainign across that is part of the

induction and expectation and also provide on-going development

opportunities for people.

It is clear form the Senate that some Trust are and it should not be left to

individual practitoenrs to do as we need some sort of uniformity.

Margaret

Re: skill mix

> >

> > > Ten years ago, the mention of the term 'skillmix' struck horror to the

> > heart

> > > of many health visitors. I am encouraged that it now seems to be an

> > > everyday expectation in many parts of the country. However, ne thing

that

> > > was a major concern, about which we could only speculate when it

foirst

> > > began, was how you would solve the problem of 'predictability' when

> > > delegating responsibilities. So much of health visiting practice

seems

> > > difficult to predict, but if anything is to be delegated, the person

doing

> > > the delegating (who remains accountable) needs to know BOTH the skills

of

> > > the person being asked to undertake an activity and enough about the

> > > situation to be able to give clear instructions about 'what to do if.

..

> > .

> > > . ,' including clear instructions about reporting back.

> > >

> > > I would be very interested in hearing in hearing how successful

> > > 'skillmixers' have solved this conundrum. Best wishes

> > >

> > >

> > >

> > >

> > >

> > >

[Guest guest]

Interesting points Ruth. I wonder if anyone has actually done the arithmetic

for

the training time needed? I think that should be about training the health

visitor

(how to know what delegate, when and how: safeguards etc) as well as for the

team

member. I am still unclear about how you determine what is predictable enough

to

count as 'routine' in a situation that has not been assessed by the health

visitor,

whether that is a home visit or developmental check or anything else, for

someone

that has not been seen for several months/years.

One thing that I am clear about, though, is that if you 'add in' some skillmix

hours, that has to be discounted in some way. Supposing, for example, a 20-hour

a

week nursery nurse joins a full-time HV: that means that 57.5 hours are being

worked between them both. But if it takes 1 hour a day for both to meet

together

to engage in team-building, teaching, delegating, handing over and reporting

back

(on work that was previously just carried out by the HV without any additional

training/discussion etc), that equates to 32.5 hours HV time and 15 hours NN

time

available for doing the same work.

I think that means that there is, therefore, a net gain of 10 hours 'practice

time'

for the additional 20 hours nursery nurse input, but I failed my maths O level,

so

perhaps someone else has added it up differently. I would be very interested to

know if anyone has actually factored in these kinds of issues in a more

scientific

way when considering the costs for the necessary communication/trainingetc of

the

'teams' health visitors are being exhorted to lead. Best wishes

ruthngrant wrote:

> Margaret,

> I agree in part but think that there needs to be a recognised training for a

> skill mix team that does not depend on the HV being teacher, team leader,

needs

> assessor as well as clinician. Experience in this area has shown that skill

mix

> staff are very mobile and HV team leaders were constantly having to re-train

> staff whilst maintaining the service short-handed. This training role of

> community staff is becoming much bigger with the huge numbers of pre-RGN staff

> that are being pushed through the system. This leads me to be less keen to

take

> on skill-mix.

> Ruth

>

> Margaret Buttigieg wrote:

>

> > You are right skill mix is the way we are going much of that initially

> > triggered by staff shortages and difficulties in recruitment.

> >

> > However there are I believe are other reasons which show the development of

> > health visiting as a profession.

> >

> > The policy agenda directs Hvs to lead teams and to undertake wider community

> > and family centred public health work. There are not enought health

> > visitors to do this and the past routine work and also some of that has

> > become so tedious that bring newly qualified HVs are bored stiff by it

> > especially when they have been taught to look at the public health agenda

> > and not sit in a medical model. We need to encouraging them to look widely,

> > to see the value again of making relationships and of recognizing it is them

> > directing the team and the work of the health visiting team. It maybe that

> > a newly qulaifed HV needs to be seen as part of the skill mix and not

> > initally as the team leader. I am sure there are issues here about why so

> > many move on to other things so quickly. also we need to educat others not

> > least GPs

> >

> > Yes the unpredictability reamins but it also about the openess and honesty

> > of team members, the building of the relationship in teams and the sharing

> > and the understanding about the level of skill and knowledge of nursery

> > nurses and many staff nurses. When delegation is handled effectively and

> > the development in place - other staff in the team are clear about

> > boundaries and what they can and cannot do and what they need to share.

> >

> > For me often what is missing is the qualified HV ability to lead the team,

> > to see the value of a weekly meeting and regular contact and to take up

> > their position as a team leader. If you set competency based JDs and are

> > clear about levesl this becomes easier. The problems of even what seems a

> > normal family today are so complex that we need to enable qualifed HVs to

> > use their skills in the right are.

> >

> > For me this is not about giving up things or allowing others to do them - it

> > is part of the recognition of the importance of a multiprofessional/multi

> > agency agenda and of the ability of many nurses who come into health

> > visiting. It also I believe links into the " do you need to be a nurse to be

> > a health vistor agenda " and the way we need to be enabling non nurses to

> > undertake a health visitng role.

> >

> > What do others think

> >

> > Margaret

> > Re: skill mix

> >

> > > Ten years ago, the mention of the term 'skillmix' struck horror to the

> > heart

> > > of many health visitors. I am encouraged that it now seems to be an

> > > everyday expectation in many parts of the country. However, ne thing that

> > > was a major concern, about which we could only speculate when it foirst

> > > began, was how you would solve the problem of 'predictability' when

> > > delegating responsibilities. So much of health visiting practice seems

> > > difficult to predict, but if anything is to be delegated, the person doing

> > > the delegating (who remains accountable) needs to know BOTH the skills of

> > > the person being asked to undertake an activity and enough about the

> > > situation to be able to give clear instructions about 'what to do if. .

> > .

> > > . ,' including clear instructions about reporting back.

> > >

> > > I would be very interested in hearing in hearing how successful

> > > 'skillmixers' have solved this conundrum. Best wishes

> > >

> > >

> > >

> > >

> > >

> > >

[Guest guest]

Dear All

I completely endorse this. It is simply ludicrous that we are shifting the

deckcairs again and the same people in them

and expect to make any serious impact on issues of E and T, supervision and

support, recruitment and retention.

MY message to everyone is that Workforce capacity and capability comes first

and must underpin the entire Trust's work.

We have prevaricated on this for years and now we have the bodies,

potentially, who could implement it properly.

Praise those who are doing it and lobby those who are not. It is actually

also about Implementing Standard One of the

NSF for MH, with the NHS, " leading by Example " . The front liners are the

heroes and management should be underneath supporting

them or leading from behind, not reigning down cabbages on them day after

day!

At the MH Taskforce meeting the other days, several of us iterated the

crucial need, in terms of delivering on the

Performance Indicators and Suicide Strategy that HVs, DNs, Practice Nurses

and all practice staff are in the room.

I was able to argue the case far better after reading some of the SENATE

comments!

Manning

www.primhe.org

Re: skill mix

Ruth

Those are good points and I am saying to Trusts you need to be thinking

wider than the individual coming into post and the staff in the team

training them. You need to set up trainign across that is part of the

induction and expectation and also provide on-going development

opportunities for people.

It is clear form the Senate that some Trust are and it should not be left to

individual practitoenrs to do as we need some sort of uniformity.

Margaret

Re: skill mix

> >

> > > Ten years ago, the mention of the term 'skillmix' struck horror to the

> > heart

> > > of many health visitors. I am encouraged that it now seems to be an

> > > everyday expectation in many parts of the country. However, ne thing

that

> > > was a major concern, about which we could only speculate when it

foirst

> > > began, was how you would solve the problem of 'predictability' when

> > > delegating responsibilities. So much of health visiting practice

seems

> > > difficult to predict, but if anything is to be delegated, the person

doing

> > > the delegating (who remains accountable) needs to know BOTH the skills

of

> > > the person being asked to undertake an activity and enough about the

> > > situation to be able to give clear instructions about 'what to do if.

..

> > .

> > > . ,' including clear instructions about reporting back.

> > >

> > > I would be very interested in hearing in hearing how successful

> > > 'skillmixers' have solved this conundrum. Best wishes

> > >

> > >

> > >

> > >

> > >

> > >