RE: skill mix

[Guest guest]

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]

Hi Chris

I did not realize you were a Senate reader.

Good to have your thoughts

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 Margaret

I come to this by way of the excellent Malcolm Rigler!

Chris.

Re: skill mix

Hi Chris

I did not realize you were a Senate reader.

Good to have your thoughts

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]

Chis - I might have guessed!

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]

The people who have probably done most on building training costs

into skill mix costing are Ann Netten and her team at the Personal

Social Services Research Unit at Kent. They did a fair amount for

DH when I was there.

From: Cowley <sarah@...>

Date sent: Wed, 20 Mar 2002 21:42:11 +0000

Subject: Re: skill mix

Send reply to:

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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]

There is a piece of reseach undertaken in the acute setting which showed

this. I can't remeber the title but it is quoted in the skill mix

professional breifing I wrote when I was at the HVA (and probably still

relevant).

It showed that when there was richer skill mix ie grade mix the ward was

safer, more work got done and the lower grades worked above the level

expected as they were guided and supported.

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]

Here is reference to a paper reporting a study that looked at skill

mix in the delegation of nursing care in district nursing. It ties in

with some of the debates on Senate on skill mix over the past few

weeks. ( Do forgive me if you all know it already).

McIntosh J, Moriarity D, Lugton J (2000) Evolutionary change in the

use of skills within the district nursing team: a study of two Health

Boards in Scotland. journal of Advanced Nursing 32(4): 783 - 790.

Among the issues of concern in this study were:

* the concept of " skill " (what is actually meant by the term and how

it is sometimes used to mean " task " )

* the skill/task hierarchy in the team

* a discussion about whether care can be broken up into component

parts

* the issue of hidden skills (risk assessment, decision making,

judgment) within the skill mix context.

* do the expansion/contraction of roles in the team take into account

client need

* what are the implications of having the most skilled person in the

team - who they also found uses the widest range of skills in the

team - giving less hands on care (as they are in the leadership role)

* the isolated nature of the work of community nursing and its

implications in the skill mix team

There is much in this study of relevance to skill mix in health

visiting and school nursing.

Best wishes

Moira Graham

[Guest guest]

Here is reference to a paper reporting a study that looked at skill

mix in the delegation of nursing care in district nursing. It ties in

with some of the debates on Senate on skill mix over the past few

weeks. ( Do forgive me if you all know it already).

McIntosh J, Moriarity D, Lugton J (2000) Evolutionary change in the

use of skills within the district nursing team: a study of two Health

Boards in Scotland. journal of Advanced Nursing 32(4): 783 - 790.

Among the issues of concern in this study were:

* the concept of " skill " (what is actually meant by the term and how

it is sometimes used to mean " task " )

* the skill/task hierarchy in the team

* a discussion about whether care can be broken up into component

parts

* the issue of hidden skills (risk assessment, decision making,

judgment) within the skill mix context.

* do the expansion/contraction of roles in the team take into account

client need

* what are the implications of having the most skilled person in the

team - who they also found uses the widest range of skills in the

team - giving less hands on care (as they are in the leadership role)

* the isolated nature of the work of community nursing and its

implications in the skill mix team

There is much in this study of relevance to skill mix in health

visiting and school nursing.

Best wishes

Moira Graham

[Guest guest]

Thanks for that Moira - it is a very live debate in practice as you know,

thank you for bringing everyone back to the point through the article and

giving more food for thought

>From: " moiraegraham " <lezemore@...>

>Reply-

>

>Subject: Re: skill mix

>Date: Mon, 25 Mar 2002 09:50:08 -0000

>

>Here is reference to a paper reporting a study that looked at skill

>mix in the delegation of nursing care in district nursing. It ties in

>with some of the debates on Senate on skill mix over the past few

>weeks. ( Do forgive me if you all know it already).

>

>McIntosh J, Moriarity D, Lugton J (2000) Evolutionary change in the

>use of skills within the district nursing team: a study of two Health

>Boards in Scotland. journal of Advanced Nursing 32(4): 783 - 790.

>

>Among the issues of concern in this study were:

>

>* the concept of " skill " (what is actually meant by the term and how

>it is sometimes used to mean " task " )

>* the skill/task hierarchy in the team

>* a discussion about whether care can be broken up into component

>parts

>* the issue of hidden skills (risk assessment, decision making,

>judgment) within the skill mix context.

>* do the expansion/contraction of roles in the team take into account

>client need

>* what are the implications of having the most skilled person in the

>team - who they also found uses the widest range of skills in the

>team - giving less hands on care (as they are in the leadership role)

>* the isolated nature of the work of community nursing and its

>implications in the skill mix team

>

>There is much in this study of relevance to skill mix in health

>visiting and school nursing.

>

>Best wishes

>Moira Graham

>

>

>

>

>

>

_________________________________________________________________

Chat with friends online, try MSN Messenger: http://messenger.msn.com

[Guest guest]

Thanks for that Moira - it is a very live debate in practice as you know,

thank you for bringing everyone back to the point through the article and

giving more food for thought

>From: " moiraegraham " <lezemore@...>

>Reply-

>

>Subject: Re: skill mix

>Date: Mon, 25 Mar 2002 09:50:08 -0000

>

>Here is reference to a paper reporting a study that looked at skill

>mix in the delegation of nursing care in district nursing. It ties in

>with some of the debates on Senate on skill mix over the past few

>weeks. ( Do forgive me if you all know it already).

>

>McIntosh J, Moriarity D, Lugton J (2000) Evolutionary change in the

>use of skills within the district nursing team: a study of two Health

>Boards in Scotland. journal of Advanced Nursing 32(4): 783 - 790.

>

>Among the issues of concern in this study were:

>

>* the concept of " skill " (what is actually meant by the term and how

>it is sometimes used to mean " task " )

>* the skill/task hierarchy in the team

>* a discussion about whether care can be broken up into component

>parts

>* the issue of hidden skills (risk assessment, decision making,

>judgment) within the skill mix context.

>* do the expansion/contraction of roles in the team take into account

>client need

>* what are the implications of having the most skilled person in the

>team - who they also found uses the widest range of skills in the

>team - giving less hands on care (as they are in the leadership role)

>* the isolated nature of the work of community nursing and its

>implications in the skill mix team

>

>There is much in this study of relevance to skill mix in health

>visiting and school nursing.

>

>Best wishes

>Moira Graham

>

>

>

>

>

>

_________________________________________________________________

Chat with friends online, try MSN Messenger: http://messenger.msn.com

[Guest guest]

Yes Moira, very useful. Why are you and both coming up in duplicate?

I received both your messages twice!

Houston wrote:

> Thanks for that Moira - it is a very live debate in practice as you know,

> thank you for bringing everyone back to the point through the article and

> giving more food for thought

>

>

> >From: " moiraegraham " <lezemore@...>

> >Reply-

> >

> >Subject: Re: skill mix

> >Date: Mon, 25 Mar 2002 09:50:08 -0000

> >

> >Here is reference to a paper reporting a study that looked at skill

> >mix in the delegation of nursing care in district nursing. It ties in

> >with some of the debates on Senate on skill mix over the past few

> >weeks. ( Do forgive me if you all know it already).

> >

> >McIntosh J, Moriarity D, Lugton J (2000) Evolutionary change in the

> >use of skills within the district nursing team: a study of two Health

> >Boards in Scotland. journal of Advanced Nursing 32(4): 783 - 790.

> >

> >Among the issues of concern in this study were:

> >

> >* the concept of " skill " (what is actually meant by the term and how

> >it is sometimes used to mean " task " )

> >* the skill/task hierarchy in the team

> >* a discussion about whether care can be broken up into component

> >parts

> >* the issue of hidden skills (risk assessment, decision making,

> >judgment) within the skill mix context.

> >* do the expansion/contraction of roles in the team take into account

> >client need

> >* what are the implications of having the most skilled person in the

> >team - who they also found uses the widest range of skills in the

> >team - giving less hands on care (as they are in the leadership role)

> >* the isolated nature of the work of community nursing and its

> >implications in the skill mix team

> >

> >There is much in this study of relevance to skill mix in health

> >visiting and school nursing.

> >

> >Best wishes

> >Moira Graham

> >

> >

> >

> >

> >

> >

>

> _________________________________________________________________

> Chat with friends online, try MSN Messenger: http://messenger.msn.com

>

>

>

[Guest guest]

Dont know! Dont know!

>From: Cowley <sarah@...>

>Reply-

>

>Subject: Re: Re: skill mix

>Date: Tue, 26 Mar 2002 21:22:37 +0000

>

>Yes Moira, very useful. Why are you and both coming up in duplicate?

>I received both your messages twice!

>

> Houston wrote:

>

> > Thanks for that Moira - it is a very live debate in practice as you

>know,

> > thank you for bringing everyone back to the point through the article

>and

> > giving more food for thought

> >

> >

> > >From: " moiraegraham " <lezemore@...>

> > >Reply-

> > >

> > >Subject: Re: skill mix

> > >Date: Mon, 25 Mar 2002 09:50:08 -0000

> > >

> > >Here is reference to a paper reporting a study that looked at skill

> > >mix in the delegation of nursing care in district nursing. It ties in

> > >with some of the debates on Senate on skill mix over the past few

> > >weeks. ( Do forgive me if you all know it already).

> > >

> > >McIntosh J, Moriarity D, Lugton J (2000) Evolutionary change in the

> > >use of skills within the district nursing team: a study of two Health

> > >Boards in Scotland. journal of Advanced Nursing 32(4): 783 - 790.

> > >

> > >Among the issues of concern in this study were:

> > >

> > >* the concept of " skill " (what is actually meant by the term and how

> > >it is sometimes used to mean " task " )

> > >* the skill/task hierarchy in the team

> > >* a discussion about whether care can be broken up into component

> > >parts

> > >* the issue of hidden skills (risk assessment, decision making,

> > >judgment) within the skill mix context.

> > >* do the expansion/contraction of roles in the team take into account

> > >client need

> > >* what are the implications of having the most skilled person in the

> > >team - who they also found uses the widest range of skills in the

> > >team - giving less hands on care (as they are in the leadership role)

> > >* the isolated nature of the work of community nursing and its

> > >implications in the skill mix team

> > >

> > >There is much in this study of relevance to skill mix in health

> > >visiting and school nursing.

> > >

> > >Best wishes

> > >Moira Graham

> > >

> > >

> > >

> > >

> > >

> > >

> >

> > _________________________________________________________________

> > Chat with friends online, try MSN Messenger: http://messenger.msn.com

> >

> >

> >

[Guest guest]

I think it was by Roy Carr Hill and Sue -e, probably

about 1992. It was also over-extrapolated; I can remember seeing it

invoked in relation to community nursing, whereas the data were

gathered on acute wards from what I can remember. Also Alastair

Gray (a labour economist) recalculated the figures and found that

the improvement in quality score (it may have been Qualpacs) for a

given increase in cost wasn't that great. DH liked the latter finding,

since the skill mix bandwagon was just starting rolling at the time.

< >

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

Date sent: Fri, 22 Mar 2002 20:55:00 -0000

Subject: Re: skill mix

Send reply to:

[ Double-click this line for list subscription options ]

There is a piece of reseach undertaken in the acute setting which showed

this. I can't remeber the title but it is quoted in the skill mix

professional breifing I wrote when I was at the HVA (and probably still

relevant).

It showed that when there was richer skill mix ie grade mix the ward was

safer, more work got done and the lower grades worked above the level

expected as they were guided and supported.

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]

You are right Liz but I remember it being used quite effectively by some.

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]

many thanks

[Guest guest]

Yes I was thinking at least 6 months of induction and nurturing, not just for the staff nurse but also my colleagues who are very precious about letting go.

[Guest guest]

A week seems a bit short but will be a start. Thanks

[Guest guest]

Kathy-could you use Children's and Public health NSF's to put together a job

description?

Ann Ebeid

>From: kms160360@...

>Reply-

>

>Subject: Skill mix

>Date: Sun, 12 Dec 2004 04:58:51 EST

>

>Dear All, I am interested to know if anyone is working with D/E grade staff

>nurses who have gone through the child branch. If so, do you have any job

>descriptions? I am trying to get my manager some info as she is doing her

>best

>to reduce my workload. I would like to use a staff nurse to work with

>clients

>in the same way we do, to enable more group work to be done,link up with

>nurseries and schools and of course school nurses and practice nurses.

>

>Thanks Kathy Soderquist

[Guest guest]

I agree with you Margaret that it is about developing services to meet the needs of clients and families rather than around the professional boundaries.

A colleague of mine has developed a week 's course for "E" grades .. if you're interested I can you her contact details

Ann

Skill mix

Dear All, I am interested to know if anyone is working with D/E grade staff nurses who have gone through the child branch. If so, do you have any job descriptions? I am trying to get my manager some info as she is doing her best to reduce my workload. I would like to use a staff nurse to work with clients in the same way we do, to enable more group work to be done,link up with nurseries and schools and of course school nurses and practice nurses.

Thanks Kathy Soderquist

[Guest guest]

Due to staff difficulties in recruiting into HV i have recently introduced a

grade e staff nurse who has completed the shortened childrens into the team as

the first grade mix in our experiences. i have a draft job description i will

forward to you when i get back to work later on the week

Hope this will be helful

regards

Carol

Nurse Manager

[Guest guest]

my thoughts are to do a pilot. My manager has put this to my colleagues in the locality, some I know will run with it, others will wait and see

[Guest guest]

Your comments here suggests there is more to this than just developing a JD - it sounds there need to be work with all the health visiting team to get them to see the value of skill mix and a mixed team of staff.

You may need to start there or it may take you a year or eighteen month to settle in other grades

Margaret

Re: Skill mix

Yes I was thinking at least 6 months of induction and nurturing, not just for the staff nurse but also my colleagues who are very precious about letting go.

[Guest guest]

Hi Margaret

With my KSF/ AfC hat on I agree with you. Is it assumed that child branch nurses have the skills and knowledge of working in the community? My experience would certainly question this. Also, there are a lot of implications for children nurses from the CNO review on vulnerable children and I would certainly consider these when developing the job spec.

Charlene

Lecturer Public Health & Primary Care

School of Nursing and Midwifery

University of East Anglia

Weavers Centre

Hellesdon Hospital

drayton High Road

Norwich NR6 5BE

Tel: 01603 421287

-----Original Message-----From: Margaret Buttigieg [mailto:margaret@...] Sent: 12 December 2004 12:57 Subject: Re: Skill mix

I am not sure the basic job description should be any different for a staff nurse whether they are child or adult trained.or even mental health which may be very useful.

surely within agenda for change we would use a standard JD and then look for the additional skills required for the job through the knowledge and skills framework.

My understanding is that today we look at the needs of the clients, communities, services etc and the skills required and then see what we have and need to obtain. We are not developing posts for professions any longer and if you take on a SN at D/E then the PCT, as does the HV, has a responsible to be clear what they are asking this person to do and if they do not have the skills provide the development for them.

In my experience a good induction and development programme in the first 6 /12 months works wanders

Margaret

Skill mix

Dear All, I am interested to know if anyone is working with D/E grade staff nurses who have gone through the child branch. If so, do you have any job descriptions? I am trying to get my manager some info as she is doing her best to reduce my workload. I would like to use a staff nurse to work with clients in the same way we do, to enable more group work to be done,link up with nurseries and schools and of course school nurses and practice nurses.

Thanks Kathy Soderquist

[Guest guest]

Hi

If you log on to NHS net you will find some JD,s for Staff nurses and NNEB's

Pat

Pat Loizou Service Manager Early Years & Community 45 Middle Lane N88PH Tel 8341 2045 Fax 8341 5006

-----Original Message-----From: kms160360@... [mailto:kms160360@...]Sent: 12 December 2004 01:59 Subject: Skill mix

Dear All, I am interested to know if anyone is working with D/E grade staff nurses who have gone through the child branch. If so, do you have any job descriptions? I am trying to get my manager some info as she is doing her best to reduce my workload. I would like to use a staff nurse to work with clients in the same way we do, to enable more group work to be done,link up with nurseries and schools and of course school nurses and practice nurses.

Thanks Kathy Soderquist

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[Guest guest]

Kathy

We have 1 staff nurse who had undergone

the D to E competency framework.

This post has worked extremely well.

She is always interested in talking with

others working in HV teams. She would like to develop a support group with

other RN’s.

regards

Dalton

Community Matron (Public

Health)

Guildford & Waverley

PCT

Tele: 01483 783273

Mobile: 07747 012053

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-----Original

Message-----

From: kms160360@...

[mailto:kms160360@...]

Sent: 12 December 2004 09:59

Subject: Skill mix

Dear

All, I am interested to know if anyone is working with D/E grade staff nurses

who have gone through the child branch. If so, do you have any job

descriptions? I am trying to get my manager some info as she is doing her best

to reduce my workload. I would like to use a staff nurse to work with clients

in the same way we do, to enable more group work to be done,link up with

nurseries and schools and of course school nurses and practice nurses.

Thanks

Kathy Soderquist