Guest guest Posted May 17, 2008 Report Share Posted May 17, 2008 Thanks for this , and apologies for my slow/lack of response to all the postings; I am a bit overwhelmed with work at the moment.It is good to recall some of the good things that are going on, both in service commissioning and in education, where things have actually improved a lot in terms of content and consistency since the 2002 health visitor standards were produced (albeit that they were thrown out 2 years later), and the return for all to 45 week programme, instead of in just some areas. We need to hang on to the positive, because it shows that those of us who are shouting to retain and enhance the health visiting service and health visiting education and health visiting regulation, are not crying for the moon, but for something absolutely attainable and important for the families and communities we are trying to serve. There is certainly no shortage of folk who are saying that health visiting is damaged beyond repair, so we should not waste time trying to resurrect it. In the context of wanting the service to be run by nurses, not health visitors, I have even heard one very senior nurse suggest that the reduction in health visiting numbers and ageing population is a good thing, because it means there won't need to be any great effort to change it; it will just happen by default. This is the same idea as in the 'liberating the public health talents' book (remember that?) where it said: 'it is important to have a nurse, because in a nurse you get everything in one person.' And nurses say health visitors are arrogant!So, I am afraid there is a bit 'us and them,' , except it is more complex than just two groups. It is not just nurses against health visitors, which is very much the NMC experience; although even there I am deeply conscious that in writing 'the NMC' I am not specifying any individuals some of whom (like our Council members, like some former professional officers; it would churlish to name names because I would miss some) work or have worked desperately hard to try and first get, then maintain, a meaningful register. They are completely stymied by the totally inadequate legislative framework, which some welcome (why would need any other registrant group in the world, after all, if nurses can do everything?) and others despair of it. Nor is it just practitioners against more senior staff, because of course commissioners, managers and various other leaders come all sorts of guises, with all manner of constraints. For some, reducing the health visiting budget or ignoring the risks and needs among young families is a good way of overcoming constraints in other parts of their portfolio, whereas others (naturally, I think the most informed!) see a good service for mothers and babies, tailored to meet local need as you describe, as the key to reducing health inequalities as well as a good thing to do in its own right. Along the way, the vast majority find the whole situation so confusing that they simply burrow away and concentrate on their own little corner of the world, because at least they can influence that to some small extent. The problem with that, is they are quite likely to soon come up against the kind of excesses and high risk stories outline by . Thanks again for some good news, , and keeping us all encouraged that it ispossible to overcome at least some of the barriers. On 16 May 2008, at 08:51, Southon (Wolverhampton City PCT) wrote:There are areas where things are not as bleak. I am a health visitor and a commissioner. We started with a needs assessment, evidence gathering on effective interventions, local consultation and building on existing good practice. Our model will support the role of health visiting. Health visitors, midwives and children's centres are involved in developing the model we want to implement. The focus is on the evidence, tackling inequalities, infant mortality, supporting families, enabling children to be prepared for when they enter education.Remember, no one starts to work in the NHS for the money. It is far to easy to slip into an 'us and them' situation, I know I have been as guilty of this as everyone else. I regularly meet with commissioners from across the country and from a wide range of organisations health and otherwise. The majority are just trying to do the best for the people living in their areas. And yes, I do hear complaints about how difficult health visitors etc are to work with and how they don't understand the real world. Both 'sides' are saying similar things about each other & both are as guilty as each other in not really listening.I am not an apologist for commissioners, there are examples where it is being got very badly wrong and where the real value of health visiting is not understood. However, we have to recognise that the world is changing, the introduction of competition and a wider market of providers will continue whichever flavour of politics is in power. With this does come much more focus on 'efficiency' and the money. It also brings a whole new complexity which everyone is trying to learn about while also trying to do the day job. What keeps me going is the wish to try to work within the new world to make things better for the people we are accountable to. It is about recognising what we can change and when we can't, doing the best we can for the people out there.We are very good at gaining an understanding of our clients and populations, we all need to get much better at understanding each other and the 'other sides' position and constraints. sarahcowley183@...http://myprofile.cos.com/S124021COn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2008 Report Share Posted May 17, 2008 Thanks for this , and apologies for my slow/lack of response to all the postings; I am a bit overwhelmed with work at the moment.It is good to recall some of the good things that are going on, both in service commissioning and in education, where things have actually improved a lot in terms of content and consistency since the 2002 health visitor standards were produced (albeit that they were thrown out 2 years later), and the return for all to 45 week programme, instead of in just some areas. We need to hang on to the positive, because it shows that those of us who are shouting to retain and enhance the health visiting service and health visiting education and health visiting regulation, are not crying for the moon, but for something absolutely attainable and important for the families and communities we are trying to serve. There is certainly no shortage of folk who are saying that health visiting is damaged beyond repair, so we should not waste time trying to resurrect it. In the context of wanting the service to be run by nurses, not health visitors, I have even heard one very senior nurse suggest that the reduction in health visiting numbers and ageing population is a good thing, because it means there won't need to be any great effort to change it; it will just happen by default. This is the same idea as in the 'liberating the public health talents' book (remember that?) where it said: 'it is important to have a nurse, because in a nurse you get everything in one person.' And nurses say health visitors are arrogant!So, I am afraid there is a bit 'us and them,' , except it is more complex than just two groups. It is not just nurses against health visitors, which is very much the NMC experience; although even there I am deeply conscious that in writing 'the NMC' I am not specifying any individuals some of whom (like our Council members, like some former professional officers; it would churlish to name names because I would miss some) work or have worked desperately hard to try and first get, then maintain, a meaningful register. They are completely stymied by the totally inadequate legislative framework, which some welcome (why would need any other registrant group in the world, after all, if nurses can do everything?) and others despair of it. Nor is it just practitioners against more senior staff, because of course commissioners, managers and various other leaders come all sorts of guises, with all manner of constraints. For some, reducing the health visiting budget or ignoring the risks and needs among young families is a good way of overcoming constraints in other parts of their portfolio, whereas others (naturally, I think the most informed!) see a good service for mothers and babies, tailored to meet local need as you describe, as the key to reducing health inequalities as well as a good thing to do in its own right. Along the way, the vast majority find the whole situation so confusing that they simply burrow away and concentrate on their own little corner of the world, because at least they can influence that to some small extent. The problem with that, is they are quite likely to soon come up against the kind of excesses and high risk stories outline by . Thanks again for some good news, , and keeping us all encouraged that it ispossible to overcome at least some of the barriers. On 16 May 2008, at 08:51, Southon (Wolverhampton City PCT) wrote:There are areas where things are not as bleak. I am a health visitor and a commissioner. We started with a needs assessment, evidence gathering on effective interventions, local consultation and building on existing good practice. Our model will support the role of health visiting. Health visitors, midwives and children's centres are involved in developing the model we want to implement. The focus is on the evidence, tackling inequalities, infant mortality, supporting families, enabling children to be prepared for when they enter education.Remember, no one starts to work in the NHS for the money. It is far to easy to slip into an 'us and them' situation, I know I have been as guilty of this as everyone else. I regularly meet with commissioners from across the country and from a wide range of organisations health and otherwise. The majority are just trying to do the best for the people living in their areas. And yes, I do hear complaints about how difficult health visitors etc are to work with and how they don't understand the real world. Both 'sides' are saying similar things about each other & both are as guilty as each other in not really listening.I am not an apologist for commissioners, there are examples where it is being got very badly wrong and where the real value of health visiting is not understood. However, we have to recognise that the world is changing, the introduction of competition and a wider market of providers will continue whichever flavour of politics is in power. With this does come much more focus on 'efficiency' and the money. It also brings a whole new complexity which everyone is trying to learn about while also trying to do the day job. What keeps me going is the wish to try to work within the new world to make things better for the people we are accountable to. It is about recognising what we can change and when we can't, doing the best we can for the people out there.We are very good at gaining an understanding of our clients and populations, we all need to get much better at understanding each other and the 'other sides' position and constraints. sarahcowley183@...http://myprofile.cos.com/S124021COn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2008 Report Share Posted May 17, 2008 sarah and paul regulation has been set against deregulation. regulation is seen as tribalism, self interest, inflexibility expensive. deregulation is seen as flexible, cheap, easy to manage modern. Deregulaters seem to know the cost of everything and regulaters know the value of everything. Somehow we need to have modern regulation. The present situation of deregulation and anarchy is not acceptable especially to the public, front line staff are seeeing everyday the effects of deregulation. This week I spoke to a couple who endured 14 hours of nothing short of torture in an nhs setting where management decisions about staffing certainly contributed to their experience. We also saw the Healthcare Commission report this week. Again i say there is a leadership vacumn at government level with a small "g" meaning DOH, NMC and Trust Nurses but there is lots of informal leadership. Those of us who trained in a time when advocacy was an important characteristic need to think outside the box about challenging the professional status quo. The public still believe we have extensive training knowledge and skills regrettable many of our clients have more knowledge from their internet research than our skill mix colleagues. we have had subprime mortgages now we have subprime professionals with I suspect ultimately the same catastrophic effect. I firmly beleve that Commissioners should be elected every four years probably alongside local authority elections There is a major democratic deficit in our process where faceless unaccountable beaucrats decide healthcare priorities and spend billions of pounds of our money. For the best argument for elected commissioners read the Report on Brent PCT website We hold most other public to account democratically from the police to social services why not health mary Re: HV registration Thanks for this , and apologies for my slow/lack of response to all the postings; I am a bit overwhelmed with work at the moment. It is good to recall some of the good things that are going on, both in service commissioning and in education, where things have actually improved a lot in terms of content and consistency since the 2002 health visitor standards were produced (albeit that they were thrown out 2 years later), and the return for all to 45 week programme, instead of in just some areas. We need to hang on to the positive, because it shows that those of us who are shouting to retain and enhance the health visiting service and health visiting education and health visiting regulation, are not crying for the moon, but for something absolutely attainable and important for the families and communities we are trying to serve. There is certainly no shortage of folk who are saying that health visiting is damaged beyond repair, so we should not waste time trying to resurrect it. In the context of wanting the service to be run by nurses, not health visitors, I have even heard one very senior nurse suggest that the reduction in health visiting numbers and ageing population is a good thing, because it means there won't need to be any great effort to change it; it will just happen by default. This is the same idea as in the 'liberating the public health talents' book (remember that?) where it said: 'it is important to have a nurse, because in a nurse you get everything in one person.' And nurses say health visitors are arrogant! So, I am afraid there is a bit 'us and them,' , except it is more complex than just two groups. It is not just nurses against health visitors, which is very much the NMC experience; although even there I am deeply conscious that in writing 'the NMC' I am not specifying any individuals some of whom (like our Council members, like some former professional officers; it would churlish to name names because I would miss some) work or have worked desperately hard to try and first get, then maintain, a meaningful register. They are completely stymied by the totally inadequate legislative framework, which some welcome (why would need any other registrant group in the world, after all, if nurses can do everything?) and others despair of it. Nor is it just practitioners against more senior staff, because of course commissioners, managers and various other leaders come all sorts of guises, with all manner of constraints. For some, reducing the health visiting budget or ignoring the risks and needs among young families is a good way of overcoming constraints in other parts of their portfolio, whereas others (naturally, I think the most informed!) see a good service for mothers and babies, tailored to meet local need as you describe, as the key to reducing health inequalities as well as a good thing to do in its own right. Along the way, the vast majority find the whole situation so confusing that they simply burrow away and concentrate on their own little corner of the world, because at least they can influence that to some small extent. The problem with that, is they are quite likely to soon come up against the kind of excesses and high risk stories outline by . Thanks again for some good news, , and keeping us all encouraged that it ispossible to overcome at least some of the barriers. On 16 May 2008, at 08:51, Southon (Wolverhampton City PCT) wrote: There are areas where things are not as bleak. I am a health visitor and a commissioner. We started with a needs assessment, evidence gathering on effective interventions, local consultation and building on existing good practice. Our model will support the role of health visiting. Health visitors, midwives and children's centres are involved in developing the model we want to implement. The focus is on the evidence, tackling inequalities, infant mortality, supporting families, enabling children to be prepared for when they enter education.Remember, no one starts to work in the NHS for the money. It is far to easy to slip into an 'us and them' situation, I know I have been as guilty of this as everyone else. I regularly meet with commissioners from across the country and from a wide range of organisations health and otherwise. The majority are just trying to do the best for the people living in their areas. And yes, I do hear complaints about how difficult health visitors etc are to work with and how they don't understand the real world. Both 'sides' are saying similar things about each other & both are as guilty as each other in not really listening.I am not an apologist for commissioners, there are examples where it is being got very badly wrong and where the real value of health visiting is not understood. However, we have to recognise that the world is changing, the introduction of competition and a wider market of providers will continue whichever flavour of politics is in power. With this does come much more focus on 'efficiency' and the money. It also brings a whole new complexity which everyone is trying to learn about while also trying to do the day job. What keeps me going is the wish to try to work within the new world to make things better for the people we are accountable to. It is about recognising what we can change and when we can't, doing the best we can for the people out there.We are very good at gaining an understanding of our clients and populations, we all need to get much better at understanding each other and the 'other sides' position and constraints. sarahcowley183btinternet http://myprofile.cos.com/S124021COn No virus found in this incoming message.Checked by AVG. Version: 7.5.524 / Virus Database: 269.23.16/1448 - Release Date: 16/05/2008 19:42 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2008 Report Share Posted May 17, 2008 sarah and paul regulation has been set against deregulation. regulation is seen as tribalism, self interest, inflexibility expensive. deregulation is seen as flexible, cheap, easy to manage modern. Deregulaters seem to know the cost of everything and regulaters know the value of everything. Somehow we need to have modern regulation. The present situation of deregulation and anarchy is not acceptable especially to the public, front line staff are seeeing everyday the effects of deregulation. This week I spoke to a couple who endured 14 hours of nothing short of torture in an nhs setting where management decisions about staffing certainly contributed to their experience. We also saw the Healthcare Commission report this week. Again i say there is a leadership vacumn at government level with a small "g" meaning DOH, NMC and Trust Nurses but there is lots of informal leadership. Those of us who trained in a time when advocacy was an important characteristic need to think outside the box about challenging the professional status quo. The public still believe we have extensive training knowledge and skills regrettable many of our clients have more knowledge from their internet research than our skill mix colleagues. we have had subprime mortgages now we have subprime professionals with I suspect ultimately the same catastrophic effect. I firmly beleve that Commissioners should be elected every four years probably alongside local authority elections There is a major democratic deficit in our process where faceless unaccountable beaucrats decide healthcare priorities and spend billions of pounds of our money. For the best argument for elected commissioners read the Report on Brent PCT website We hold most other public to account democratically from the police to social services why not health mary Re: HV registration Thanks for this , and apologies for my slow/lack of response to all the postings; I am a bit overwhelmed with work at the moment. It is good to recall some of the good things that are going on, both in service commissioning and in education, where things have actually improved a lot in terms of content and consistency since the 2002 health visitor standards were produced (albeit that they were thrown out 2 years later), and the return for all to 45 week programme, instead of in just some areas. We need to hang on to the positive, because it shows that those of us who are shouting to retain and enhance the health visiting service and health visiting education and health visiting regulation, are not crying for the moon, but for something absolutely attainable and important for the families and communities we are trying to serve. There is certainly no shortage of folk who are saying that health visiting is damaged beyond repair, so we should not waste time trying to resurrect it. In the context of wanting the service to be run by nurses, not health visitors, I have even heard one very senior nurse suggest that the reduction in health visiting numbers and ageing population is a good thing, because it means there won't need to be any great effort to change it; it will just happen by default. This is the same idea as in the 'liberating the public health talents' book (remember that?) where it said: 'it is important to have a nurse, because in a nurse you get everything in one person.' And nurses say health visitors are arrogant! So, I am afraid there is a bit 'us and them,' , except it is more complex than just two groups. It is not just nurses against health visitors, which is very much the NMC experience; although even there I am deeply conscious that in writing 'the NMC' I am not specifying any individuals some of whom (like our Council members, like some former professional officers; it would churlish to name names because I would miss some) work or have worked desperately hard to try and first get, then maintain, a meaningful register. They are completely stymied by the totally inadequate legislative framework, which some welcome (why would need any other registrant group in the world, after all, if nurses can do everything?) and others despair of it. Nor is it just practitioners against more senior staff, because of course commissioners, managers and various other leaders come all sorts of guises, with all manner of constraints. For some, reducing the health visiting budget or ignoring the risks and needs among young families is a good way of overcoming constraints in other parts of their portfolio, whereas others (naturally, I think the most informed!) see a good service for mothers and babies, tailored to meet local need as you describe, as the key to reducing health inequalities as well as a good thing to do in its own right. Along the way, the vast majority find the whole situation so confusing that they simply burrow away and concentrate on their own little corner of the world, because at least they can influence that to some small extent. The problem with that, is they are quite likely to soon come up against the kind of excesses and high risk stories outline by . Thanks again for some good news, , and keeping us all encouraged that it ispossible to overcome at least some of the barriers. On 16 May 2008, at 08:51, Southon (Wolverhampton City PCT) wrote: There are areas where things are not as bleak. I am a health visitor and a commissioner. We started with a needs assessment, evidence gathering on effective interventions, local consultation and building on existing good practice. Our model will support the role of health visiting. Health visitors, midwives and children's centres are involved in developing the model we want to implement. The focus is on the evidence, tackling inequalities, infant mortality, supporting families, enabling children to be prepared for when they enter education.Remember, no one starts to work in the NHS for the money. It is far to easy to slip into an 'us and them' situation, I know I have been as guilty of this as everyone else. I regularly meet with commissioners from across the country and from a wide range of organisations health and otherwise. The majority are just trying to do the best for the people living in their areas. And yes, I do hear complaints about how difficult health visitors etc are to work with and how they don't understand the real world. Both 'sides' are saying similar things about each other & both are as guilty as each other in not really listening.I am not an apologist for commissioners, there are examples where it is being got very badly wrong and where the real value of health visiting is not understood. However, we have to recognise that the world is changing, the introduction of competition and a wider market of providers will continue whichever flavour of politics is in power. With this does come much more focus on 'efficiency' and the money. It also brings a whole new complexity which everyone is trying to learn about while also trying to do the day job. What keeps me going is the wish to try to work within the new world to make things better for the people we are accountable to. It is about recognising what we can change and when we can't, doing the best we can for the people out there.We are very good at gaining an understanding of our clients and populations, we all need to get much better at understanding each other and the 'other sides' position and constraints. sarahcowley183btinternet http://myprofile.cos.com/S124021COn No virus found in this incoming message.Checked by AVG. Version: 7.5.524 / Virus Database: 269.23.16/1448 - Release Date: 16/05/2008 19:42 Quote Link to comment Share on other sites More sharing options...
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