Re: Education Select Committee

[Guest guest]

Hi Aisling

Thank you for the suggestions, I quite agree and it seems so fundamental I can never understand why people don't get it!!!! It feels to me as if we have just gone backwards big time in what we have been forced into offering as a HV service in some areas that is now not effective and everyone keeps coming up with new ideas on how to fix it instead of going back to the basics of what works.

In 1998 a review into health inequalities chaired by Sir Acheson concluded that there were three interventions which should be invested in to reduce health inequalities in childhood.

They were fruit in schools,

Improved access to pre-school care and home visiting by health visitors.

Whilst the government invested in the first two, health visiting has been disinvested in until now as they are trying to reverse the trend and we are very thankful for this as it was reaching a seriopus tipping point.

Yes I am nervous everyone keeps telling me it is a great honnour, it is a lot of unpaid work and is quite terrfiying!!!!!!

Best wishesMaggie

RE: Education Select Committee

Berkshire East ( Berkshire Healthcare Foundation Trust) offers a review, which is carried out by Bands 4/5 in a clinic / Children's Centre setting. (Previously sent out a questionnaire/ leaflet on development).

Clare O'Riordan

From: [mailto: ] On Behalf Of Maggie FisherSent: 30 May 2011 18:07 Subject: Re: Education Select Committee

Hi

I am sure this is an area they will be very interested in. I don't have up to date figures on coverage. However I seem to recall seeing something on this re PCTs in London last year ( I will have to see if I can track down what it was) Coverage was very patchy and on the whole poor.

Interestingly a quick straw poll of the audience at the CH Conference revealed about 50% of the participants were conducting a universal 2-2.5 year development assessment and. all were doing a targeted one. These developmental reviews were being carried out by numerous practitioners from the HV for targeted reviews to CSNs and CNNs if they were done as a face to face contact as opposed to questionnaire/birthday card in the post.

Perhaps I can ask Senate members about coverage in their areas, this would be a helpful start and who conducts this developmental review in their areas?

Best wishes

Maggie

I have been invited to give oral evidence to the House of Commons Education Select Committee on Wednesday 22 June to explore the role of Health Visitors in School Readiness I am one of a panel of witnesses, comprising representatives from health visiting and early years.

I would really like to gather published evidence, specific examples and anecdotal from across the country on this. Any help you can give with this would be gratefully received.

The timescale is quite short so a speedy response would be very much appreciated. Do feel free to point me in the direction of published evidence you know about, the documents you produced on returning HV to statute will be very useful here. So I will revist those.

Best wishesMaggie

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[Guest guest]

HI Maggie

Enjoy it - it is a great experience and I always found there was someone on a Health Select Committee who was really interested in the practical issues in the field and if you could back it with research they were hooked.

Best wishes

Margaret

RE: Education Select Committee

Berkshire East ( Berkshire Healthcare Foundation Trust) offers a review, which is carried out by Bands 4/5 in a clinic / Children's Centre setting. (Previously sent out a questionnaire/ leaflet on development).

Clare O'Riordan

From: [mailto: ] On Behalf Of Maggie FisherSent: 30 May 2011 18:07 Subject: Re: Education Select Committee

Hi

I am sure this is an area they will be very interested in. I don't have up to date figures on coverage. However I seem to recall seeing something on this re PCTs in London last year ( I will have to see if I can track down what it was) Coverage was very patchy and on the whole poor.

Interestingly a quick straw poll of the audience at the CH Conference revealed about 50% of the participants were conducting a universal 2-2.5 year development assessment and. all were doing a targeted one. These developmental reviews were being carried out by numerous practitioners from the HV for targeted reviews to CSNs and CNNs if they were done as a face to face contact as opposed to questionnaire/birthday card in the post.

Perhaps I can ask Senate members about coverage in their areas, this would be a helpful start and who conducts this developmental review in their areas?

Best wishes

Maggie

I have been invited to give oral evidence to the House of Commons Education Select Committee on Wednesday 22 June to explore the role of Health Visitors in School Readiness I am one of a panel of witnesses, comprising representatives from health visiting and early years.

I would really like to gather published evidence, specific examples and anecdotal from across the country on this. Any help you can give with this would be gratefully received.

The timescale is quite short so a speedy response would be very much appreciated. Do feel free to point me in the direction of published evidence you know about, the documents you produced on returning HV to statute will be very useful here. So I will revist those.

Best wishesMaggie

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[Guest guest]

I recall working with nurses and nursing assistants on a neurosurgery

ward. The nurses has such a poor appreciation of their own skills

that they were content to delegate post op care of cranial surgery

patients to nursing assistants. It was a popular move and the nurses

and the nursing assistants were very proud of what they'd achieved,

both saw it as as real step forward and the assistants received a pay

increment and wore a different bit of trim to their uniform to

recognise their superior status.

The staff in question had been on the ward for many years, but had

neither sought nor received special training, not even NVQ. They

were careful people though: they had been shown how to measure the

patient's vital and neuro signs and chart them on the clipboards. As

far as I could cross check, they did a reasonably accurate job. Snag

was, they'd got zero idea of what it all meant and what might be

going on for the patient. If a set of readings had gone off the

scale on the chart, they might've asked for more paper, but wouldn't

have known the significance of the data, nor what to do about it.

They also couldn't link different physiological obervations to

trigger concern about what might be going on - for example, an

intercranial bleed or an infection. They couldn't instigate further

checks to verify their suspicions that a patient was deteriorating,

because they never suspected anything was going amiss before the

patient decompensated or crashed.

The nurses had completely overlooked their own knowledge base of

neurophysiology and pathology when they taught the mechanical skills

of 'assessment' to the nursing assistants. They liked and respected

their assistant colleagues and simply failed to recognise that they'd

not all had the same foundation in college. They hadn't realised

that their delegation of such tasks was profoundly unsafe for

patients.

It taught me a truly frightening lesson about what happens when

nurses lose sight of what their job is about. It's not the

mechanical skills, it's the knowledge you use to make expert

professional judgements about what's really going on.

Seems to me that it's partly based on assuming that we are what we

do, not what we know and think. It starts with setting a low value

on your own professional knowledge and judgement, perhaps based on

what doctors or managers believe, or maybe that we're just not used

to articulating what it is we're doing. Sometimes it's about another

perspective being imposed - for example, a medical model of disease

screening being used to look at a developmental assessment. They

think we're just looking for disease or specific abnormalities. The

managers just see what we're doing and it just doesn't look that

complicated to them.

I get a bit wobbly when I think of these scenarios being applied in

health visiting with some of the complex family situations out there.

The fact that somebody's got a child's name on CPR at any given time

is irrelevant to delegation decisions because the criteria for

registration are so variable. It's hardly a measure of risk anymore.

Seems to me that the outcomes of dodgy delegations might be a bit

harder to pick up than they were in the neuro ward. I wonder what

school nurses and reception class teachers identify? Do they ever

feed back missed problems?

< > From: " Maggie Fisher "

<mfisher2241@...> Date sent: Fri, 3 Jun 2011 10:32:40

+0100 Subject: Re: Education Select Committee Send

reply to:

Hi Terry

Your point is very well made and is leading to a deskilling of HVs.

Best wishes

Maggie

Re: Education Select Committee

Hi Maggie,

I was recently interviewing a Health Visitor asking if she came

across many kids with iron deficiency anaemia. " Very rarely, " was her

reply. With a very deprived South Asian case-load I found it hard to

believe. It was when she pointed out that routinely Health Visitors

in our area would only see children up to eight months that I made

sense of her reply. Contacts after that at two and three would be by

CNNs or by letter respectively.

When I was a student nurse in coronary care there was a hierarchy of

tasks; the charge nurses took the bloods, the staff nursed did the

ECGs and Florence & May, the Auxiliaries, did the bed baths. I

thought it should have been the other way round. With skill-mix,

instead of the most qualified doing the routine contacts and

assessments then prescribing any follow-up, we seem to have sub-let

the later visits.

This isn´t to denigrate Florence & May or the Nursery Nurse members of

our teams but to question how these decisions are made.

Best wishes,

Terry McGinn

On 30/05/2011 18:07, Maggie Fisher wrote:

[Guest guest]

Maggie, Sir also told me he was a big fan of school nursing, for example in relation to teenage pregnancy and life chances.... Woody.

From: [mailto: ] On Behalf Of Maggie FisherSent: 03 June 2011 11:06 Subject: Re: Education Select Committee

Hi Aisling

Thank you for the suggestions, I quite agree and it seems so fundamental I can never understand why people don't get it!!!! It feels to me as if we have just gone backwards big time in what we have been forced into offering as a HV service in some areas that is now not effective and everyone keeps coming up with new ideas on how to fix it instead of going back to the basics of what works.

In 1998 a review into health inequalities chaired by Sir Acheson concluded that there were three interventions which should be invested in to reduce health inequalities in childhood.

They were fruit in schools,

Improved access to pre-school care and home visiting by health visitors.

Whilst the government invested in the first two, health visiting has been disinvested in until now as they are trying to reverse the trend and we are very thankful for this as it was reaching a seriopus tipping point.

Yes I am nervous everyone keeps telling me it is a great honnour, it is a lot of unpaid work and is quite terrfiying!!!!!!

Best wishesMaggie

RE: Education Select Committee

Berkshire East ( Berkshire Healthcare Foundation Trust) offers a review, which is carried out by Bands 4/5 in a clinic / Children's Centre setting. (Previously sent out a questionnaire/ leaflet on development).

Clare O'Riordan

From: [mailto: ] On Behalf Of Maggie FisherSent: 30 May 2011 18:07 Subject: Re: Education Select Committee

Hi

I am sure this is an area they will be very interested in. I don't have up to date figures on coverage. However I seem to recall seeing something on this re PCTs in London last year ( I will have to see if I can track down what it was) Coverage was very patchy and on the whole poor.

Interestingly a quick straw poll of the audience at the CH Conference revealed about 50% of the participants were conducting a universal 2-2.5 year development assessment and. all were doing a targeted one. These developmental reviews were being carried out by numerous practitioners from the HV for targeted reviews to CSNs and CNNs if they were done as a face to face contact as opposed to questionnaire/birthday card in the post.

Perhaps I can ask Senate members about coverage in their areas, this would be a helpful start and who conducts this developmental review in their areas?

Best wishes

Maggie

I have been invited to give oral evidence to the House of Commons Education Select Committee on Wednesday 22 June to explore the role of Health Visitors in School Readiness I am one of a panel of witnesses, comprising representatives from health visiting and early years.

I would really like to gather published evidence, specific examples and anecdotal from across the country on this. Any help you can give with this would be gratefully received.

The timescale is quite short so a speedy response would be very much appreciated. Do feel free to point me in the direction of published evidence you know about, the documents you produced on returning HV to statute will be very useful here. So I will revist those.

Best wishesMaggie

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[Guest guest]

Woody

thank you for being a great advocate for School Nursing and keeping the focus on

a rapidly depleting service....

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>  

> I have been

> invited to give oral evidence to the

> House of Commons

> Education Select Committee on Wednesday

>

> 22 June to

> explore the role of Health Visitors in

> School Readiness I am

> one of a panel of witnesses, comprising

> representatives from

> health visiting and early

> years.

> I

> would really like to

> gather published evidence, specific

> examples and anecdotal

> from across the country on this. Any help

> you can give with

> this would be gratefully

> received. 

>  

> The

> timescale is quite

> short so a speedy response would be very

> much appreciated. Do

> feel free to point me in the direction of

> published evidence

> you know about, the documents you

> produced on returning

> HV to statute will be very useful here.

> So I will revist

> those.

>  

> Best

> wishes

> Maggie

>

>

>

>

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[Guest guest]

Dear Rita,

Even the Conservatives recognise that Schools can do something to reduce inequalities... if only we can educate them that school nurses are a key component of that reduction.

This appeared in the Lancet earlier, re Sir . You may think there are lessons for the new Public Health England and local Health & Wellbeing Boards...

The Lancet, Volume 377, Issue 9761, Page 207, 15 January 2011

doi:10.1016/S0140-6736(11)60045-7

UK Public Accounts Committee report on health inequalities

Woody Caan a

Acheson inspired many of us then at University College London to think creatively about reducing entrenched health inequalities. I personally take responsibility for the “agonising debacle”1 following his inquiry. Do not blame civil servants or medical advisers, who never recognised the constraint holding back progress in tackling inequalities. Over years I collected evidence of a systematic failure of leadership in public health,2 but failed to persuade any statutory or professional body to take that handicap seriously. It is my fault bureaucrats are reduced to “claptrap” justifying “the worsening situation”.1

Failing at an institutional level, how about the individual level? I teach trainees about health inequalities and the evidence base for tackling them. The Evaluation of the Foundation Programme for England3 just arrived. Across 12 specialties, assessment found public health to be the least interesting to junior doctors (only 41 of 5398 involved). Quality of “educational supervision” for trainees trying public health scored lowest of any specialty. Mea culpa.

The community level? I became honorary consultant to a Pathfinder children's trust: a key interagency development. The Commissioning Support Programme, which helps children's trusts achieve their aspirational outcomes, held an illuminating meeting in May, 2009. This meeting claimed that Joint Strategic Needs Assessment (JSNA) would “reduce inequalities”, but asked “is it possible to draw a line from the JSNA to the commissioning decisions?” The answer: a resounding “no”, since inequalities in child health have widened. Sorry.

There are ways to reduce inequalities through commissioning4—but don't tell anyone I told you…

References

1 The Lancet. “Claptrap” from the UK's Department of Health. Lancet 2010; 376: 1617. Full Text | PDF(33KB) | CrossRef | PubMed

2 Caan W. “Lost boys” to clean up the leadership mess. BMJ Careers 2005. published online June 18. DOI: 10.1136/bmj.330.7505.s252-a. PubMed

3 J. Foundation for excellence: an evaluation of the foundation programme. London: Medical Education England, 2010.

4 Shircore R. Promoting health and well-being: reducing inequalities. Guide for world class commissioners. London: RSPH, 2009.

a Anglia Ruskin University, Cambridge CB1 1PT, UK

From: [mailto: ] On Behalf Of reeta chaudhrySent: 03 June 2011 18:16 Subject: RE: Education Select Committee

Woody thank you for being a great advocate for School Nursing and keeping the focus on a rapidly depleting service....> > > > > > > > > > > > > > > > > > > > > > > I have been > invited to give oral evidence to the> House of Commons > Education Select Committee on Wednesday> > 22 June to > explore the role of Health Visitors in> School Readiness I am > one of a panel of witnesses, comprising> representatives from > health visiting and early> years.> I> would really like to > gather published evidence, specific> examples and anecdotal > from across the country on this. Any help> you can give with > this would be gratefully> received. > > The> timescale is quite > short so a speedy response would be very> much appreciated. Do > feel free to point me in the direction of> published evidence > you know about, the documents you> produced on returning > HV to statute will be very useful here.> So I will revist > those.> > Best > wishes> Maggie> > > > ********************************************************************************************************************> > This > message may contain confidential> information. If you are not > the intended recipient please inform the> sender that you > have received the message in error before> deleting > it.> Please do not disclose, copy or distribute information > in this e-mail or take any action in> reliance on its > contents:> to do so is strictly prohibited and may be > unlawful.> > Thank you for your > co-operation.> > NHSmail is the secure email and directory > service available for all NHS staff in> England and > Scotland> NHSmail is approved for exchanging patient data > and other sensitive information with> NHSmail and GSi > recipients> NHSmail provides an email address for your > career in the NHS and can be accessed> anywhere> For more > information and to find out how you can> switch, visit www.connectingforhealth.nhs.uk/nhsmail> > ********************************************************************************************************************> > > > > > > ********************************************************************************************************************> > This > message may contain confidential> information. 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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

[Guest guest]

Yes Woody I agree I wasn't meaning to leave out school nurses and the important role they play often unsung!!! I was just thinking pre-school sorry.

Best wishesMaggie

RE: Education Select Committee

Berkshire East ( Berkshire Healthcare Foundation Trust) offers a review, which is carried out by Bands 4/5 in a clinic / Children's Centre setting. (Previously sent out a questionnaire/ leaflet on development).

Clare O'Riordan

From: [mailto: ] On Behalf Of Maggie FisherSent: 30 May 2011 18:07 Subject: Re: Education Select Committee

Hi

I am sure this is an area they will be very interested in. I don't have up to date figures on coverage. However I seem to recall seeing something on this re PCTs in London last year ( I will have to see if I can track down what it was) Coverage was very patchy and on the whole poor.

Interestingly a quick straw poll of the audience at the CH Conference revealed about 50% of the participants were conducting a universal 2-2.5 year development assessment and. all were doing a targeted one. These developmental reviews were being carried out by numerous practitioners from the HV for targeted reviews to CSNs and CNNs if they were done as a face to face contact as opposed to questionnaire/birthday card in the post.

Perhaps I can ask Senate members about coverage in their areas, this would be a helpful start and who conducts this developmental review in their areas?

Best wishes

Maggie

I have been invited to give oral evidence to the House of Commons Education Select Committee on Wednesday 22 June to explore the role of Health Visitors in School Readiness I am one of a panel of witnesses, comprising representatives from health visiting and early years.

I would really like to gather published evidence, specific examples and anecdotal from across the country on this. Any help you can give with this would be gratefully received.

The timescale is quite short so a speedy response would be very much appreciated. Do feel free to point me in the direction of published evidence you know about, the documents you produced on returning HV to statute will be very useful here. So I will revist those.

Best wishesMaggie

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Cowley

sarahcowley183@...

http://myprofile.cos.com/S124021COn

< /div>

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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 rated as '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 communications

Email has been scanned for viruses by Altman Technologies' email management service