Guest guest Posted February 13, 2011 Report Share Posted February 13, 2011 Hi, I currently work as a HV in Cambridgeshire we are undergoing a period of service transformation. Part of the changes are that from April 1st so called straightforward New Births will be done by Band 5's not HV's. I feel very strongly that the NBV is fundamental to our practise and key to making positive relationships with our clients. There is much apathy within teams but I am trying to rally others to respond.Is anyone aware of other PCT's that are doing the same. I have asked about the evidence behind such a decision but have not yet had a response.I would welcome any ideas . Regards Louise Cremonesini Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2011 Report Share Posted February 14, 2011 Dear Louise, Would you be able to share this competency framework with Louise please? Bw, Jane. Hi,I currently work as a HV in Cambridgeshire we are undergoing a period of service transformation. Part of the changes are that from April 1st so called straightforward New Births will be done by Band 5's not HV's. I feel very strongly that the NBV is fundamental to our practise and key to making positive relationships with our clients. There is much apathy within teams but I am trying to rally others to respond.Is anyone aware of other PCT's that are doing the same. I have asked about the evidence behind such a decision but have not yet had a response.I would welcome any ideas .RegardsLouise Cremonesini Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2011 Report Share Posted February 14, 2011 Many Thanks for all the support we are now planning a written response via the CPHVA, a copy of the competency framework would be fantastic. I will keep you all posted I can see a dissertation coming out of this !! From: jane appleton <jvappleton@...> Sent: Mon, 14 February, 2011 11:31:41Subject: Re: New Births Dear Louise, Would you be able to share this competency framework with Louise please? Bw, Jane. Hi,I currently work as a HV in Cambridgeshire we are undergoing a period of service transformation. Part of the changes are that from April 1st so called straightforward New Births will be done by Band 5's not HV's. I feel very strongly that the NBV is fundamental to our practise and key to making positive relationships with our clients. There is much apathy within teams but I am trying to rally others to respond.Is anyone aware of other PCT's that are doing the same. I have asked about the evidence behind such a decision but have not yet had a response.I would welcome any ideas .RegardsLouise Cremonesini Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2011 Report Share Posted February 15, 2011 Thanks – you make some really interesting and different points which is great and helpful. I will use them in a report I am about to write. Re Implementation Plan – it may only be plan but it is in the operating framework and the technical guidance that accompanies it - so it will happen there is no doubt. Margaret From: Coles Sent: Tuesday, February 15, 2011 1:00 PM Subject: RE: New Births Dear and SENATE So good to see SENATE firing on all guns re the success with the publication of the HV Implementation Plan and fighting talk on maintaining high standards of practice with the NBV. Are there any other health /education/social professions where initial contacts are delegated away from those with ultimate responsibility for professional outcomes of service intervention? None come to mind. This also makes one realize that the HV Implementation Plan is a plan and SENATE will be busy watching for developments. A co ncern about the NBV and any assessment for ‘straightforwardness’ is the opportunity to assess the parenting role and needs of fathers. This opportunity may not be there in antenatal contact but more likely at the NBV. Recalling that child protection needs rely on knowing father or current partner input to baby care as a baseline from birth I would be anxious to know that anyone undertaking the NBV had the skills to observe and work from this perspective. From: [mailto: ] On Behalf Of CowleySent: 13 February 2011 19:27 Subject: Re: New Births [1 Attachment] Hard to know where to start with this one, Lou, which typifies so much that has gone wrong in health visiting and, incidentally, which needs to change if the DHs 'new service vision' accompanying the HV Implementation Plan is to be taken seriously. You could start by drawing your managers' attention to that document, which ought to form the basis for any service review. Sadly, a lot of other Trusts are doing this, particularly where health visitors have been able to carry out an ante-natal assessment. I am not sure what the basis is , for believing that nothing changes in a family after a baby is born. I would be hard pressed to find 'evidence' either way: it is a bit like stating the b----ing obvious that things WILL change! CPHVA have produced a leaflet about the different skills of staff nurses and of HVs, pointing out that one key difference is that health visitors are skilled to assess across an undifferentiated caseload, whereas staff nurses are not. Regardless of any referring information to which you have access, you don't know what you will find until you get there. Carrying out such assessments are also above the pay grade of Band 5 staff. One of my earliest academic papers, from my PhD, was called 'In health visiting, a routine visit is one that has passed.' If delegation happe ns through a protocol, that cuts across lines of accountability. If a health visitor has assessed, then appropriately delegated future contacts, she is accountable if this go wrong (or to be congratulated if they go right!). Who takes responsibility for delegation via a Trust protocol? It needs to be the manager who insisted on the protocol; it cannot be the health visitor who knows nothing about it. But if it is to provide support to someone on the health visitor's caseload, the health visitor is fully accountable, and it is her registration on the line - very confusing and scary. In June, we sent a document to NMC (attached, see pages 30-36) pointing out how inadequate our so-called 'registration' is, in dealing with these issues. By stating that health visitor education is 'predicated on nursing,' the NMC suggest to managers that a staff nu rse is a junior health visitor, who can be used in the same way as a health visitor. I believe that is untrue and unsafe. Dickon Weir-, NMC Chief Exec, was very charming and polite, but disagreed, and told me he does not worry about how health visitors are regulated, because he never receives any letters about it. Perhaps you should write and ask him what your accountability position is, if your manager/Trust delegates work on your caseload and prevents you from using your professional authority in deciding how to respond to health needs? best wishes On 13 Feb 2011, at 17:42, Lou w rote: Hi,I currently work as a HV in Cambridgeshire we are undergoing a period of service transformation. Part of the changes are that from April 1st so called straightforward New Births will be done by Band 5's not HV's. I feel very strongly that the NBV is fundamental to our practise and key to making positive relationships with our clients. There is much apathy within teams but I am trying to rally others to respond.Is anyone aware of other PCT's that are doing the same. I have asked about the evidence behind such a decision but have not yet had a response.I would welcome any ideas .RegardsLouise Cremonesini Cowley sarahcowley183@... http://myprofile.cos.com/S124021COn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2011 Report Share Posted February 15, 2011 Oldies like me may remember an argument raging about 20 years ago when CMHTeams were being implemented: Consultant psychiatrists who were used to having their registrars clerk in new inpatients (in-profession delegation) often worried about CPNs becoming the first point of contact, and in effect triage nurses, for many community patients - some even cried wolf in the RCPsych that in the new community-focused service the Team Leader might not even be a doctor but rather a nurse or social worker! In the places where I worked, it gradually became clear that few home visits were being made by consultants (unless a really worried GP wanted a Section right away) and Community Mental Health Nurses were pretty good at an initial assessment for many patients (unlike most GPs)... but please please don't quote me on that heretical view of history.... From: [mailto: ] On Behalf Of ColesSent: 15 February 2011 13:00 Subject: RE: New Births Dear and SENATE So good to see SENATE firing on all guns re the success with the publication of the HV Implementation Plan and fighting talk on maintaining high standards of practice with the NBV. Are there any other health /education/social professions where initial contacts are delegated away from those with ultimate responsibility for professional outcomes of service intervention? None come to mind. This also makes one realize that the HV Implementation Plan is a plan and SENATE will be busy watching for developments. A concern about the NBV and any assessment for ‘straightforwardness’ is the opportunity to assess the parenting role and needs of fathers. This opportunity may not be there in antenatal contact but more likely at the NBV. Recalling that child protection needs rely on knowing father or current partner input to baby care as a baseline from birth I would be anxious to know that anyone undertaking the NBV had the skills to observe and work from this perspective. From: [mailto: ] On Behalf Of CowleySent: 13 February 2011 19:27 Subject: Re: New Births [1 Attachment] Hard to know where to start with this one, Lou, which typifies so much that has gone wrong in health visiting and, incidentally, which needs to change if the DHs 'new service vision' accompanying the HV Implementation Plan is to be taken seriously. You could start by drawing your managers' attention to that document, which ought to form the basis for any service review. Sadly, a lot of other Trusts are doing this, particularly where health visitors have been able to carry out an ante-natal assessment. I am not sure what the basis is, for believing that nothing changes in a family after a baby is born. I would be hard pressed to find 'evidence' either way: it is a bit like stating the b----ing obvious that things WILL change! CPHVA have produced a leaflet about the different skills of staff nurses and of HVs, pointing out that one key difference is that health visitors are skilled to assess across an undifferentiated caseload, whereas staff nurses are not. Regardless of any referring information to which you have access, you don't know what you will find until you get there. Carrying out such assessments are also above the pay grade of Band 5 staff. One of my earliest academic papers, from my PhD, was called 'In health visiting, a routine visit is one that has passed.' If delegation happens through a protocol, that cuts across lines of accountability. If a health visitor has assessed, then appropriately delegated future contacts, she is accountable if this go wrong (or to be congratulated if they go right!). Who takes responsibility for delegation via a Trust protocol? It needs to be the manager who insisted on the protocol; it cannot be the health visitor who knows nothing about it. But if it is to provide support to someone on the health visitor's caseload, the health visitor is fully accountable, and it is her registration on the line - very confusing and scary. In June, we sent a document to NMC (attached, see pages 30-36) pointing out how inadequate our so-called 'registration' is, in dealing with these issues. By stating that health visitor education is 'predicated on nursing,' the NMC suggest to managers that a staff nurse is a junior health visitor, who can be used in the same way as a health visitor. I believe that is untrue and unsafe. Dickon Weir-, NMC Chief Exec, was very charming and polite, but disagreed, and told me he does not worry about how health visitors are regulated, because he never receives any letters about it. Perhaps you should write and ask him what your accountability position is, if your manager/Trust delegates work on your caseload and prevents you from using your professional authority in deciding how to respond to health needs? best wishes On 13 Feb 2011, at 17:42, Lou wrote: Hi,I currently work as a HV in Cambridgeshire we are undergoing a period of service transformation. Part of the changes are that from April 1st so called straightforward New Births will be done by Band 5's not HV's. I feel very strongly that the NBV is fundamental to our practise and key to making positive relationships with our clients. There is much apathy within teams but I am trying to rally others to respond.Is anyone aware of other PCT's that are doing the same. I have asked about the evidence behind such a decision but have not yet had a response.I would welcome any ideas .RegardsLouise Cremonesini Cowley sarahcowley183@... http://myprofile.cos.com/S124021COn Email has been scanned for viruses by Altman Technologies' email management service~EMERGING EXCELLENCE: In the Research Assessment Exercise (RAE) 2008, more than 30% of our submissions were ratedas 'Internationally Excellent' or 'World-leading'.Among the academic disciplines now rated 'World-leading' are Allied Health Professions Studies; Art Design; English Language Literature; Geography Environmental Studies;History; Music; Psychology; and Social Work Social Policy Administration.Visit www.anglia.ac.uk/rae for more information.This e-mail and any attachments are intended for the above named recipient(s) only and may be privileged. If they have come to you in error you must take no action based on them, nor must you copy or show them to anyone: please reply to this e-mail to highlight the error and then immediately delete the e-mail from your system.Any opinions expressed are solely those of the author and do not necessarily represent the views or opinions of Anglia Ruskin University.Although measures have been taken to ensure that this e-mail and attachments are free from any virus we advise that, in keeping with good computing practice, the recipient should ensure they are actually virus free. Please note that this message has been sent over public networks which may not be a 100% secure communicationsEmail has beenscanned for viruses by Altman Technologies' email management service Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2011 Report Share Posted February 15, 2011 Dear Louise, Good luck with your campaign!I was involved with the last transformation of the HV service two years ago in Cambridge , as a result of that several excellent health visitors left the service .I was fortunate to be offered a job in CAMH and can use my HV skills still working with children and their families however I feel very sad to have left a career that I was passionate about but I was worn down by constantly fighting the cause particularly when the quality of the service delivered was not the priority!.The apathy from my old colleagues I suggest is that they are worn down from constant change and from many battles with service leaders who again constantly change So I applaude your new campaign in the service ,being part of CAMH I work with families where attachment disorders are so significant and the skills of the HV in regard to Infant mental health and early intervention should be such a significant part of your work alongside risk assessments which are carried out with every family who come into CAMH. Good luck! Nina From: loui_r@...Date: Mon, 14 Feb 2011 11:52:11 +0000Subject: Re: New Births Many Thanks for all the support we are now planning a written response via the CPHVA, a copy of the competency framework would be fantastic. I will keep you all posted I can see a dissertation coming out of this !! From: jane appleton <jvappleton@...> Sent: Mon, 14 February, 2011 11:31:41Subject: Re: New Births Dear Louise, Would you be able to share this competency framework with Louise please? Bw, Jane. Hi,I currently work as a HV in Cambridgeshire we are undergoing a period of service transformation. Part of the changes are that from April 1st so called straightforward New Births will be done by Band 5's not HV's. I feel very strongly that the NBV is fundamental to our practise and key to making positive relationships with our clients. There is much apathy within teams but I am trying to rally others to respond.Is anyone aware of other PCT's that are doing the same. I have asked about the evidence behind such a decision but have not yet had a response.I would welcome any ideas .RegardsLouise Cremonesini Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 I'd certainly endorse 's points. Men living with women and young children are very important, even if they're not biological fathers and we need to find out about their parenting experiences and needs. H > > > > Thanks - you make some really interesting and different points > which is great and helpful. I will use them in a report I am about to > write. > > Re Implementation Plan - it may only be plan but it is in the > operating framework and the technical guidance that accompanies it - > so it will happen there is no doubt. > > Margaret > > From: Coles > Sent: Tuesday, February 15, 2011 1:00 PM > > Subject: RE: New Births > > > > > > Dear and SENATE > So good to see SENATE firing on all guns re the success with the > publication of the HV Implementation Plan and fighting talk on > maintaining high standards of practice with the NBV. Are there any > other health /education/social professions where initial contacts are > delegated away from those with ultimate responsibility for > professional outcomes of service intervention? None come to mind. This > also makes one realize that the HV Implementation Plan is a plan and > SENATE will be busy watching for developments. A co ncern about the > NBV and any assessment for `straightforwardness´ is the > opportunity to assess the parenting role and needs of fathers. This > opportunity may not be there in antenatal contact but more likely at > the NBV. Recalling that child protection needs rely on knowing father > or current partner input to baby care as a baseline from birth I would > be anxious to know that anyone undertaking the NBV had the skills to > observe and work from this perspective. From: > [mailto:SENATE- HVSN ] On > Behalf Of Cowley Sent: 13 February 2011 19:27 To: > Subject: Re: New Births [1 > Attachment] > > > Hard to know where to start with this one, Lou, which typifies so much > that has gone wrong in health visiting and, incidentally, which needs > to change if the DHs 'new service vision' accompanying the HV > Implementation Plan is to be taken seriously. You could start by > drawing your managers' attention to that document, which ought to form > the basis for any service review. > > Sadly, a lot of other Trusts are doing this, particularly where > health visitors have been able to carry out an ante-natal > assessment. I am not sure what the basis is , for believing that > nothing changes in a family after a baby is born. I would be hard > pressed to find 'evidence' either way: it is a bit like stating the > b----ing obvious that things WILL change! > > CPHVA have produced a leaflet about the different skills of staff > nurses and of HVs, pointing out that one key difference is that health > visitors are skilled to assess across an undifferentiated caseload, > whereas staff nurses are not. Regardless of any referring information > to which you have access, you don't know what you will find until you > get there. Carrying out such assessments are also above the pay grade > of Band 5 staff. One of my earliest academic papers, from my PhD, was > called 'In health visiting, a routine visit is one that has passed.' > > > If delegation happe ns through a protocol, that cuts across lines of > accountability. If a health visitor has assessed, then appropriately > delegated future contacts, she is accountable if this go wrong (or to > be congratulated if they go right!). Who takes responsibility for > delegation via a Trust protocol? It needs to be the manager who > insisted on the protocol; it cannot be the health visitor who knows > nothing about it. But if it is to provide support to someone on the > health visitor's caseload, the health visitor is fully accountable, > and it is her registration on the line - very confusing and scary. > > > In June, we sent a document to NMC (attached, see pages 30-36) > pointing out how inadequate our so-called 'registration' is, in > dealing with these issues. By stating that health visitor education is > 'predicated on nursing,' the NMC suggest to managers that a staff nu > rse is a junior health visitor, who can be used in the same way as a > health visitor. I believe that is untrue and unsafe. > > > Dickon Weir-, NMC Chief Exec, was very charming and polite, but > disagreed, and told me he does not worry about how health visitors are > regulated, because he never receives any letters about it. Perhaps you > should write and ask him what your accountability position is, if your > manager/Trust delegates work on your caseload and prevents you from > using your professional authority in deciding how to respond to health > needs? > > > best wishes > > > > On 13 Feb 2011, at 17:42, Lou w rote: > > > > Hi, > I currently work as a HV in Cambridgeshire we are undergoing a period > of service transformation. Part of the changes are that from April 1st > so called straightforward New Births will be done by Band 5's not > HV's. I feel very strongly that the NBV is fundamental to our practise > and key to making positive relationships with our clients. There is > much apathy within teams but I am trying to rally others to respond.Is > anyone aware of other PCT's that are doing the same. I have asked > about the evidence behind such a decision but have not yet had a > response.I would welcome any ideas . Regards Louise Cremonesini > > > > > Cowley > > sarahcowley183@... > > http://myprofile.cos.com/S124021COn > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2011 Report Share Posted February 18, 2011 I will, thank you, !! Ann Girling CPCC, ACCThe Fulfilment Coach Tel: 01244 300391Mobile: 07787 568699Web: www.onthethreshold.co.uk From: [mailto: ] On Behalf Of CowleySent: 17 February 2011 19:27 Subject: Re: New Births Congratulations Ann, enjoy it. On 17 Feb 2011, at 12:21, Ann Girling wrote: Hi Nina, How are you? What are you up to these days. Do e mail me on ann@.... Would love to hear from you! My biggest news is that I am going to be a grandmother in April .. getting more and more excited! Ann Ann Girling CPCC, ACCThe Fulfilment Coach Tel: 01244 300391Mobile: 07787 568699Web: www.onthethreshold.co.uk <image001.png> <image002.jpg> <image003.jpg> <image004.jpg> From: [mailto: ] On Behalf Of nina heapsSent: 16 February 2011 02:35senate groupsSubject: RE: New Births Dear Louise,Good luck with your campaign!I was involved with the last transformation of the HV service two years ago in Cambridge , as a result of that several excellent health visitors left the service .I was fortunate to be offered a job in CAMH and can use my HV skills still working with children and their families however I feel very sad to have left a career that I was passionate about but I was worn down by constantly fighting the cause particularly when the quality of the service delivered was not the priority!.The apathy from my old colleagues I suggest is that they are worn down from constant change and from many battles with service leaders who again constantly change So I applaude your new campaign in the service ,being part of CAMH I work with families where attachment disorders are so significant and the skills of the HV in regard to Infant mental health and early intervention should be such a significant part of your work alongside risk assessments which are carried out with every family who come into CAMH.Good luck!Nina From: loui_r@...Date: Mon, 14 Feb 2011 11:52:11 +0000Subject: Re: New Births Many Thanks for all the support we are now planning a written response via the CPHVA, a copy of the competency framework would be fantastic. I will keep you all posted I can see a dissertation coming out of this !! From: jane appleton <jvappleton@...> Sent: Mon, 14 February, 2011 11:31:41Subject: Re: New Births Dear Louise,Would you be able to share this competency framework with Louise please?Bw,Jane. Hi,I currently work as a HV in Cambridgeshire we are undergoing a period of service transformation. Part of the changes are that from April 1st so called straightforward New Births will be done by Band 5's not HV's. I feel very strongly that the NBV is fundamental to our practise and key to making positive relationships with our clients. There is much apathy within teams but I am trying to rally others to respond.Is anyone aware of other PCT's that are doing the same. I have asked about the evidence behind such a decision but have not yet had a response.I would welcome any ideas .RegardsLouise Cremonesini No virus found in this message.Checked by AVG - www.avg.comVersion: 10.0.1204 / Virus Database: 1435/3448 - Release Date: 02/16/11 Cowleysarahcowley183@...http://myprofile.cos.com/S124021COn No virus found in this message.Checked by AVG - www.avg.comVersion: 10.0.1204 / Virus Database: 1435/3450 - Release Date: 02/17/11 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2011 Report Share Posted February 18, 2011  Thanks Margaret RE: New Births Dear and SENATE So good to see SENATE firing on all guns re the success with the publication of the HV Implementation Plan and fighting talk on maintaining high standards of practice with the NBV. Are there any other health /education/social professions where initial contacts are delegated away from those with ultimate responsibility for professional outcomes of service intervention? None come to mind. This also makes one realize that the HV Implementation Plan is a plan and SENATE will be busy watching for developments. A co ncern about the NBV and any assessment for ‘straightforwardness’ is the opportunity to assess the parenting role and needs of fathers. This opportunity may not be there in antenatal contact but more likely at the NBV. Recalling that child protection needs rely on knowing father or current partner input to baby care as a baseline from birth I would be anxious to know that anyone undertaking the NBV had the skills to observe and work from this perspective. From: [mailto: ] On Behalf Of CowleySent: 13 February 2011 19:27 Subject: Re: New Births [1 Attachment] Hard to know where to start with this one, Lou, which typifies so much that has gone wrong in health visiting and, incidentally, which needs to change if the DHs 'new service vision' accompanying the HV Implementation Plan is to be taken seriously. You could start by drawing your managers' attention to that document, which ought to form the basis for any service review. Sadly, a lot of other Trusts are doing this, particularly where health visitors have been able to carry out an ante-natal assessment. I am not sure what the basis is , for believing that nothing changes in a family after a baby is born. I would be hard pressed to find 'evidence' either way: it is a bit like stating the b----ing obvious that things WILL change! CPHVA have produced a leaflet about the different skills of staff nurses and of HVs, pointing out that one key difference is that health visitors are skilled to assess across an undifferentiated caseload, whereas staff nurses are not. Regardless of any referring information to which you have access, you don't know what you will find until you get there. Carrying out such assessments are also above the pay grade of Band 5 staff. One of my earliest academic papers, from my PhD, was called 'In health visiting, a routine visit is one that has passed.' If delegation happe ns through a protocol, that cuts across lines of accountability. If a health visitor has assessed, then appropriately delegated future contacts, she is accountable if this go wrong (or to be congratulated if they go right!). Who takes responsibility for delegation via a Trust protocol? It needs to be the manager who insisted on the protocol; it cannot be the health visitor who knows nothing about it. But if it is to provide support to someone on the health visitor's caseload, the health visitor is fully accountable, and it is her registration on the line - very confusing and scary. In June, we sent a document to NMC (attached, see pages 30-36) pointing out how inadequate our so-called 'registration' is, in dealing with these issues. By stating that health visitor education is 'predicated on nursing,' the NMC suggest to managers that a staff nu rse is a junior health visitor, who can be used in the same way as a health visitor. I believe that is untrue and unsafe. Dickon Weir-, NMC Chief Exec, was very charming and polite, but disagreed, and told me he does not worry about how health visitors are regulated, because he never receives any letters about it. Perhaps you should write and ask him what your accountability position is, if your manager/Trust delegates work on your caseload and prevents you from using your professional authority in deciding how to respond to health needs? best wishes On 13 Feb 2011, at 17:42, Lou w rote: Hi,I currently work as a HV in Cambridgeshire we are undergoing a period of service transformation. Part of the changes are that from April 1st so called straightforward New Births will be done by Band 5's not HV's. I feel very strongly that the NBV is fundamental to our practise and key to making positive relationships with our clients. There is much apathy within teams but I am trying to rally others to respond.Is anyone aware of other PCT's that are doing the same. I have asked about the evidence behind such a decision but have not yet had a response.I would welcome any ideas .RegardsLouise Cremonesini Cowley sarahcowley183@... http://myprofile.cos.com/S124021COn Quote Link to comment Share on other sites More sharing options...
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