Re: HV Banding

April 6, 2005

we wait to find out what ideas the 2 days (different people attended each one) have uncovered, there in lies the cynicism!! We do have a professional development nurse who was a health Visitor and following her appointment over a year ago I thought she would lead us in developing our talents, but I fear she has been swallowed up with other management issues and us mear mortals on the ground don't see her very often, another lost opportunity.

April 7, 2005

A possible third reason Margaret. Sadly, in our area, the 'banding' of HVs has been deferred. I understand that this is because too many of them are undertaking extended role duties and seeking a Band 7! Our Trust remains in financial difficulties and is reluctant to reward our hard work with the appropriate level of pay.

Ruth

RE: HV Banding

I would also find it interesting to see the differences in J.Ds between those of us who have been banded 6 & those who have been awarded 7. Do we actually do different work/have different responsibilities (that are not accounted for by the differences in caseload sizes which is usually reflected by recuitment/retention influences rather then the content of the JD) or is it all in how the JD is worded?? What have been the key differences between 6 & 7, skill-mix teams, corporate caseloads?? Surely as says it would have been better for AfC to have had a unified approach to the JD. In Trusts where HVs have been awarded 6, what have the practice teachers & other specialist roles been awarded?

How are we going to standardise this process? We are going to ask for a review, what are others on a 6 going to do???

Dalton <.Dalton@...> wrote:

Interesting re: disparities between 6 and 7 and differing PCT’s. Can anyone share the differences? Are band 7 HV’s specialist posts? Band 6 generalists? Is there a stronger managerial responsibility e.g. budget holder etc?

I remember Mark (CPHVA conference 2003) saying that there was no ‘average’ health visitor when it came to describing the HV role and I took that to mean that one job description did not fit all. I appreciated Mark’s comment at that time and tended to agree. On reflection a lot of man hours have been spent writing job descriptions by individual PCT’s and AFC generally. A unified approach may have been more effective. Job descriptions could then have been modified for individual PCT’s if required.

Kathy, the issue around mentorship is an interesting one too. Practice teachers seem to fall into band H/7. Mentors are being used as practice teachers but in some trusts are not paid H but G. Kathy, I feel you are either a G or H not a split grade! Regardless of whether your student is part time or not you are still having to mentor a student (although you are probably really enjoying the role) but your skills are transferable too and the trust are reaping the benefits of your expertise to peers and the organization as well.

I wonder if any mentors have been banded 7?

We are lucky that we don’t have a staffing problem in my trust, but I know that my health visiting colleagues would be very demoralized if they were not awarded the same banding for doing the same job as another trust.

It would be useful to see job descriptions for both HV and SN’s for band 6 and band 7.

Does any one else find banding such hard work? Maybe not the HV’s who are band 7 … and that’s a really positive move.

Dalton

-----Original Message-----From: kms160360@... [mailto:kms160360@...] Sent: 01 April 2005 11:14 Subject: Re: HV Banding

Hi here in Enfield we have been assimilated to band 6 also. As I work as a mentor for an HV student, I get paid half band 6 and half an 'H' as that part has not been assimilated yet. Myself and colleagues wait with something that I would not call optimism to see where we are, (My student is part-time thats why I get half and half). I too would be interested how the lucky hvs who got awarded a 7 managed it. Does anyone have copies of job descriptions, job outlines etc to send me to compare? Kathy Soderquist

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April 8, 2005

Hi Ruth

Need an understanding and active Union here who can really challenge on the professional issues - sadly it feels like that is no longer there.

But it is so interesting and the cynical me is not surprised to hear this.

I wander if there is any mileage in taking something like this elsewhere like to the Chief Nurse or Minister as health visitors and school nurses are being asked to do lots of different things and extend their roles as I know you have done - by the way really enjoyed your article in the Journal - but as you say are not rewarded.

It will be interesting to see what happens in district nursing in terms of the community matron role as I am already hearing about the cost of paying for them and also of training them.

Margaret

RE: HV Banding

I would also find it interesting to see the differences in J.Ds between those of us who have been banded 6 & those who have been awarded 7. Do we actually do different work/have different responsibilities (that are not accounted for by the differences in caseload sizes which is usually reflected by recuitment/retention influences rather then the content of the JD) or is it all in how the JD is worded?? What have been the key differences between 6 & 7, skill-mix teams, corporate caseloads?? Surely as says it would have been better for AfC to have had a unified approach to the JD. In Trusts where HVs have been awarded 6, what have the practice teachers & other specialist roles been awarded?

How are we going to standardise this process? We are going to ask for a review, what are others on a 6 going to do???

Dalton <.Dalton@...> wrote:

Interesting re: disparities between 6 and 7 and differing PCT’s. Can anyone share the differences? Are band 7 HV’s specialist posts? Band 6 generalists? Is there a stronger managerial responsibility e.g. budget holder etc?

I remember Mark (CPHVA conference 2003) saying that there was no ‘average’ health visitor when it came to describing the HV role and I took that to mean that one job description did not fit all. I appreciated Mark’s comment at that time and tended to agree. On reflection a lot of man hours have been spent writing job descriptions by individual PCT’s and AFC generally. A unified approach may have been more effective. Job descriptions could then have been modified for individual PCT’s if required.

Kathy, the issue around mentorship is an interesting one too. Practice teachers seem to fall into band H/7. Mentors are being used as practice teachers but in some trusts are not paid H but G. Kathy, I feel you are either a G or H not a split grade! Regardless of whether your student is part time or not you are still having to mentor a student (although you are probably really enjoying the role) but your skills are transferable too and the trust are reaping the benefits of your expertise to peers and the organization as well.

I wonder if any mentors have been banded 7?

We are lucky that we don’t have a staffing problem in my trust, but I know that my health visiting colleagues would be very demoralized if they were not awarded the same banding for doing the same job as another trust.

It would be useful to see job descriptions for both HV and SN’s for band 6 and band 7.

Does any one else find banding such hard work? Maybe not the HV’s who are band 7 … and that’s a really positive move.

Dalton

-----Original Message-----From: kms160360@... [mailto:kms160360@...] Sent: 01 April 2005 11:14 Subject: Re: HV Banding

Hi here in Enfield we have been assimilated to band 6 also. As I work as a mentor for an HV student, I get paid half band 6 and half an 'H' as that part has not been assimilated yet. Myself and colleagues wait with something that I would not call optimism to see where we are, (My student is part-time thats why I get half and half). I too would be interested how the lucky hvs who got awarded a 7 managed it. Does anyone have copies of job descriptions, job outlines etc to send me to compare? Kathy Soderquist

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April 9, 2005

I am sure you are right, Margaret and Ruth. There are certain things that

do get recognised and things that do not. I was reading (can't remember

where, might have the nursing press) somewhere about how wonderful it is

that AfC recognises the emotionals tress element of health service posts:

where nursing is held to use a lot of energy. I was hearing this week of

the huge emotional stress experienced by one health visiting colleague, when

life had gone badly wrong for two families on her caseload, to the point

of suicide in one case. Her manager's response was 'not your job, not your

responsibility,' which did nothing to relieve her awful distress.

I hear of health visitors taking 'more relaxing' jobs in areas like palliative

care, intensive care etc., where it is possible to hand over the keys at

the end of a shift. The stress levels are high, but are manageable in a

way that they are not in health visiting, because of the potential to distance

oneself from the 'patient' (a distancing term), and because the expectations

are more clearly circumscribed, in a way that is not feasible in a generic

caseload, in a general community. Support and clinical supervision are not

as widely available in health visiting as in e.g. mental health, either.

Yet the general view appears to be that the job is not particularly emotionally

stressful; certainly the first overall trawl through AfC that I saw rated

this element as quite low. Is this something that needs challenging when

pursuing banding levels?

Margaret Buttigieg wrote:

Hi Ruth

Need an understanding and active Union

here who can really challenge on the professional issues - sadly it feels

like that is no longer there.

But it is so interesting and the cynical

me is not surprised to hear this.

I wander if there is any mileage in taking

something like this elsewhere like to the Chief Nurse or Minister as health

visitors and school nurses are being asked to do lots of different things

and extend their roles as I know you have done - by the way really enjoyed

your article in the Journal - but as you say are not rewarded.

It will be interesting to see what happens

in district nursing in terms of the community matron role as I am already

hearing about the cost of paying for them and also of training them.

Margaret

-----

Original Message -----

From:

Ruth Grant

To:

Sent:

Thursday, April 07, 2005 7:49 PM

Subject:

Re: HV Banding

A possible third reason Margaret.

Sadly, in our area, the 'banding' of HVs has been deferred. I understand

that this is because too many of them are undertaking extended role duties

and seeking a Band 7! Our Trust remains in financial difficulties and

is reluctant to reward our hard work with the appropriate level of pay.

Ruth

-----

Original Message -----

From:

Margaret Buttigieg

To:

Sent:

Wednesday, April 06, 2005 9:22 AM

Subject:

Re: HV Banding

This is an interesting discussion

and from my perspective - I feel several things are going on here.

In the positive where health visiting

is understood by senior managers and is strongly led - there will be

an understanding of the role and functions, its need and what it can

achieve to meet targets and I guess a more developed role as policy

would advocate which would fit the banding for 7 - where there is the

reverse the development - although it may be in pockets - is less likely

and with little understanding at senior levels of the role automatically

there will be an inclination to band at 6 as suggested.

From a more cynical stance - in London

it is difficult to get HVs and it maybe that senior managers have worked

hard to raise the level to 7 to try and ensure they recruit - of course

in London what will happen is that Hvs will move to areas which are

banded at 7 form those at 6 so we may see a rise in banding by default.

However, those HVs banded at 7 I guess will be required to take a real

responsibility for their team and do much more in terms of community

work and so on than they perhaps have previously.

My third thought is that the differences

in bandings may be used to move people on, ensure staff develop and

really as needs to happen develop qualified HV and SN roles - my sense

is that if roles really developed as they could across communities and

across the wider partnership and health and social care agenda - it

would be automatic to place team leaders on 7. Perhaps we will see

HVs on different levels according to their levels of experience and

the responsibilities they are prepared to take and exercise.

Lots to think about

Margaret

-----

Original Message -----

From:

EDWINA BLAKEMORE

To:

Sent:

Monday, April 04, 2005 11:03 PM

Subject:

RE: HV Banding

I would also find it interesting to see the differences in J.Ds

between those of us who have been banded 6 & those who have been

awarded 7. Do we actually do different work/have different responsibilities (that are not accounted for by the differences in caseload sizes which is usually reflected by recuitment/retention influences rather then the content of the JD) or is it all in how the JD

is worded?? What have been the key differences between 6 & 7, skill-mix

teams, corporate caseloads?? Surely as says it would have been

better for AfC to have had a unified approach to the JD. In Trusts

where HVs have been awarded 6, what have the practice teachers &

other specialist roles been awarded?

How are we going to standardise this process? We are going to

ask for a review, what are others on a 6 going to do???

Dalton <.Dalton@...> wrote:

Interesting re:

disparities between 6 and 7 and differing PCT’s. Can anyone share

the differences? Are band 7 HV’s specialist posts?

Band 6 generalists? Is there a stronger managerial responsibility

e.g. budget holder etc?

I remember Mark

(CPHVA conference 2003) saying that there was no ‘average’

health visitor when it came to describing the HV role and I took

that to mean that one job description did not fit all. I appreciated

Mark’s comment at that time and tended to agree. On reflection a

lot of man hours have been spent writing job descriptions by individual

PCT’s and AFC generally. A unified approach may have been more effective.

Job descriptions could then have been modified for individual PCT’s

if required.

Kathy, the issue around mentorship is an interesting one too. Practice teachers

seem to fall into band H/7. Mentors are being used as practice teachers

but in some trusts are not paid H but G. Kathy,

I feel you are either a G or H not a split grade! Regardless of

whether your student is part time or not you are still having to

mentor a student (although you are probably really enjoying the

role) but your skills are transferable too and the trust are reaping

the benefits of your expertise to peers and the organization as

well.

I wonder if any

mentors have been banded 7?

We are lucky that we don’t have a staffing problem in my trust, but I know that

my health visiting colleagues would be very demoralized if they

were not awarded the same banding for doing the same job as another

trust.

It would be useful to see job descriptions for both HV and SN’s for band 6 and band 7.

Does any one else find banding such hard work? Maybe not the HV’s who are band 7 … and

that’s a really positive move.

Dalton

Re:

HV Banding

Hi here in Enfield we have been

assimilated to band 6 also. As I work as a mentor for an HV student,

I get paid half band 6 and half an 'H' as that part has not been

assimilated yet. Myself and colleagues wait with something that

I would not call optimism to see where we are, (My student is part-time

thats why I get half and half). I too would be interested how the

lucky hvs who got awarded a 7 managed it. Does anyone have copies

of job descriptions, job outlines etc to send me to compare? Kathy

Soderquist

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Checked by AVG Anti-Virus.

Version: 7.0.308 / Virus Database: 266.9.3 - Release Date: 05/04/2005

April 10, 2005

One of the themes in my reserach was about "emotional labour" of health visiting work in terms of the way they work in the context of the relationship with clients, many of whom arguably have attachemnt difficulties. Added to that is the issues of nurses and why they come into the profession ie to meet other people's needs rather than their own. It's an emotional minefield. And reflecting back on some of the interviews i did, the complete lack of self-awareness that some of the participants appeared to have, I find it scary.

As a result of that one of the recommendations i made was that HV's need to have far more in depth supervision than they currently receive and if they don't receive anything at all personally I think it's dangerous for the HV and for the client.

One of the things we have to do is try to combat the resistance to supervision. I have been asked to write an article for the HSJ about this because I feel there are organisational & cultural issues about this as well as individual resistance.

Ann

RE: HV Banding

I would also find it interesting to see the differences in J.Ds between those of us who have been banded 6 & those who have been awarded 7. Do we actually do different work/have different responsibilities (that are not accounted for by the differences in caseload sizes which is usually reflected by recuitment/retention influences rather then the content of the JD) or is it all in how the JD is worded?? What have been the key differences between 6 & 7, skill-mix teams, corporate caseloads?? Surely as says it would have been better for AfC to have had a unified approach to the JD. In Trusts where HVs have been awarded 6, what have the practice teachers & other specialist roles been awarded?

How are we going to standardise this process? We are going to ask for a review, what are others on a 6 going to do???

Dalton <.Dalton@...> wrote:

Interesting re: disparities between 6 and 7 and differing PCT’s. Can anyone share the differences? Are band 7 HV’s specialist posts? Band 6 generalists? Is there a stronger managerial responsibility e.g. budget holder etc?

I remember Mark (CPHVA conference 2003) saying that there was no ‘average’ health visitor when it came to describing the HV role and I took that to mean that one job description did not fit all. I appreciated Mark’s comment at that time and tended to agree. On reflection a lot of man hours have been spent writing job descriptions by individual PCT’s and AFC generally. A unified approach may have been more effective. Job descriptions could then have been modified for individual PCT’s if required.

Kathy, the issue around mentorship is an interesting one too. Practice teachers seem to fall into band H/7. Mentors are being used as practice teachers but in some trusts are not paid H but G. Kathy, I feel you are either a G or H not a split grade! Regardless of whether your student is part time or not you are still having to mentor a student (although you are probably really enjoying the role) but your skills are transferable too and the trust are reaping the benefits of your expertise to peers and the organization as well.

I wonder if any mentors have been banded 7?

We are lucky that we don’t have a staffing problem in my trust, but I know that my health visiting colleagues would be very demoralized if they were not awarded the same banding for doing the same job as another trust.

It would be useful to see job descriptions for both HV and SN’s for band 6 and band 7.

Does any one else find banding such hard work? Maybe not the HV’s who are band 7 … and that’s a really positive move.

Dalton

-----Original Message-----From: kms160360@... [mailto:kms160360@...] Sent: 01 April 2005 11:14 Subject: Re: HV Banding

Hi here in Enfield we have been assimilated to band 6 also. As I work as a mentor for an HV student, I get paid half band 6 and half an 'H' as that part has not been assimilated yet. Myself and colleagues wait with something that I would not call optimism to see where we are, (My student is part-time thats why I get half and half). I too would be interested how the lucky hvs who got awarded a 7 managed it. Does anyone have copies of job descriptions, job outlines etc to send me to compare? Kathy Soderquist

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April 10, 2005

From Lund-Lack

I thoroughly agree with you about stress levels. There is always a feeling that there might be something you haven't detected when undertaking health needs assessments or that clients have not been able to access the health visiting service early enough. I'm not saying that we have to be all things to all people but there is an expectation amongst ourselves and our professional colleagues that we know our clients. When things go wrong I have had a sense that of guilt sometimes that I hadn't realised needs and others can convey the feeling that we could have known. Our particular health promotion and health prevention role with individual clients places much more onus on us to be successful in getting the message across. The presence we hold in people's homes and personal lives puts our own emotions on the line. To be empathetic you need to be sensitive and have the sort of personality thast really cares about what happens to people. We sometimes have to make difficult decisions about involving social services and other professionals that can bring about abuse and accusations of betrayal. It can be very hard to shouted at by a client because you have had to steps to protect their child or have had to be firm about not letting the parents deny their child has special needs. So much of what we do is closely interconnected with mental health and social issues that it is impossible to be cold and detached or be superficial. Anyone who does not accept that health visitors carry this weight of responsibility with being independent and autonomous is either ignorant of our role, blind or not wanting to acknowledge it.

RE: HV Banding

I would also find it interesting to see the differences in J.Ds between those of us who have been banded 6 & those who have been awarded 7. Do we actually do different work/have different responsibilities (that are not accounted for by the differences in caseload sizes which is usually reflected by recuitment/retention influences rather then the content of the JD) or is it all in how the JD is worded?? What have been the key differences between 6 & 7, skill-mix teams, corporate caseloads?? Surely as says it would have been better for AfC to have had a unified approach to the JD. In Trusts where HVs have been awarded 6, what have the practice teachers & other specialist roles been awarded?

How are we going to standardise this process? We are going to ask for a review, what are others on a 6 going to do???

Dalton <.Dalton@...> wrote:

Interesting re: disparities between 6 and 7 and differing PCT’s. Can anyone share the differences? Are band 7 HV’s specialist posts? Band 6 generalists? Is there a stronger managerial responsibility e.g. budget holder etc?

I remember Mark (CPHVA conference 2003) saying that there was no ‘average’ health visitor when it came to describing the HV role and I took that to mean that one job description did not fit all. I appreciated Mark’s comment at that time and tended to agree. On reflection a lot of man hours have been spent writing job descriptions by individual PCT’s and AFC generally. A unified approach may have been more effective. Job descriptions could then have been modified for individual PCT’s if required.

Kathy, the issue around mentorship is an interesting one too. Practice teachers seem to fall into band H/7. Mentors are being used as practice teachers but in some trusts are not paid H but G. Kathy, I feel you are either a G or H not a split grade! Regardless of whether your student is part time or not you are still having to mentor a student (although you are probably really enjoying the role) but your skills are transferable too and the trust are reaping the benefits of your expertise to peers and the organization as well.

I wonder if any mentors have been banded 7?

We are lucky that we don’t have a staffing problem in my trust, but I know that my health visiting colleagues would be very demoralized if they were not awarded the same banding for doing the same job as another trust.

It would be useful to see job descriptions for both HV and SN’s for band 6 and band 7.

Does any one else find banding such hard work? Maybe not the HV’s who are band 7 … and that’s a really positive move.

Dalton

-----Original Message-----From: kms160360@... [mailto:kms160360@...] Sent: 01 April 2005 11:14 Subject: Re: HV Banding

Hi here in Enfield we have been assimilated to band 6 also. As I work as a mentor for an HV student, I get paid half band 6 and half an 'H' as that part has not been assimilated yet. Myself and colleagues wait with something that I would not call optimism to see where we are, (My student is part-time thats why I get half and half). I too would be interested how the lucky hvs who got awarded a 7 managed it. Does anyone have copies of job descriptions, job outlines etc to send me to compare? Kathy Soderquist

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April 11, 2005

Yes, Ann:

Our old study of our former Cambridge colleagues (Wood,M., Watkins,J. &

Caan,W. Parameters of clinical supervision. Br. J. Nursing 1995; 4: 1226)

found just your unspoken " resistance " .

For Senate members unfamiliar with Pam 's work on Emotional Labour in

nursing (Pam is now a Professor at Surrey but began her work at South Bank)

this was a helpful starting point for me in getting to grips with this new

area of practice development. The psychotherapist Susie Orbach's charity

" Antidote " also has some very useful general material on emotional literacy

within the caring professions - something that our recent NHS culture of

targets and inspection mitigates against.

Good luck with the HSJ, Ann,

Woody.

Re: HV Banding

Hi here in Enfield we have been assimilated to band 6 also. As I

work as a mentor for an HV student, I get paid half band 6 and half an 'H'

as that part has not been assimilated yet. Myself and colleagues wait with

something that I would not call optimism to see where we are, (My student is

part-time thats why I get half and half). I too would be interested how the

lucky hvs who got awarded a 7 managed it. Does anyone have copies of job

descriptions, job outlines etc to send me to compare? Kathy Soderquist

----------------------------------------------------------------------

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05/04/2005

----------------------------------------------------------------------------

--

April 11, 2005

That's obviously the opposite of Unemotional New Labour?