The Institute of Health Visiting (iHV) and London NHS England Workforce Training and Education Directorate (NHSE WTED) launch a new report: An audit of practice education infrastructure for Specialist Community Public Health Nurses (SCPHN) in Greater London.

iHV was delighted to be awarded funding by NHSE WTED to complete an audit of practice education infrastructure for SCPHN in Greater London.

Numbers of SCPHN health visitors and school nurses have decreased by more than 40% in England and London is one of the hardest hit areas[1]. To address workforce expansion needs, the London SCPHN workforce was offered a range of training and educational programmes to support practitioner professional development and growth of a learning culture. Reversing workforce shortfalls requires action to expand and improve training opportunities. Specifically, SCPHN workforce education infrastructure was identified as an important factor which could impact on the sustainable expansion of SCPHN Student community placements across all London 0-19 provider organisations.

The iHV completed an audit of practice education infrastructure at two separate time points – when the training was introduced and 6 months later. The audits explored whether targeted investments in practitioner development had been matched with an upturn in the organisational learning culture and infrastructure to support learning. The audit questions were framed using the four levels of learning (reaction, learning, behaviour, results) from the Kirkpatrick Evaluation Model[2].

Key findings from the audit included:

  • Improvements were seen in the learning environment across the duration of the project.
  • There is evidence to suggest that the education infrastructure and learning culture within London has been strengthened with:
    • Practitioners reporting greater use of learning in practice over time
    • Examples of perceived ability to provide better care
    • Improved professional development
    • Improved job satisfaction
    • An improved learning environment.
  • Factors considered important to support learning in practice included:
    • Supervision and a supportive learning environment
    • Embedding learning for impact
    • Improved time and capacity for practitioners to participate in Continuous Professional Development (CPD).

Our findings have been presented in a report and summarised into two engaging infographics. Whilst this audit has provided information on the unique context of the SCPHN workforce in London, it is also hoped that the findings will provide transferable learning to SCPHN providers across the UK who may be experiencing similar workforce issues.

You can view the report and infographics here
(to cite this report, please use this link https://bit.ly/3Y4rw3E).

The Audit for Education project forms part of a wider commissioned piece of work with London  NHSE WTED which includes the student SCPHN recruitment pathway development review and a charter for enabling a good learning environment.

Nicky Brown, Senior Nurse for CYP OHID London, said:

“It has been such a pleasure working within the London system to develop the role of specialist public health nurses and their teams. This project has enabled London’s 0-19 Public Health Nursing workforce to explore areas of development in their own practice and the way they learn and teach others. It is hoped that this project is the beginning of an integrated approach to learning and development for all qualified health visitors and school nurses and their teams across London.”.

Caroline Ward, Clinical Workforce Transformation Manager – Maternity and Neonates, Children and Young People, Public Health and Community Nursing and Return to Practice, said:

I am so pleased that I was able to achieve funding through legacy HEE to support such a vital piece of work. A well-trained and sustainable specialist community public health nursing workforce supply is vital to improving the health and wellbeing of our children, young people and families in London. Working with our London systems and service providers is key to the project’s philosophy to enable those who recognise the huge workforce challenges to be supported to work together with us to find solutions and ultimately make a difference within London and beyond.”

Jenny Gilmour, Lead for NHSE WTE London Improving SCPHN (HV/SN) Education Infrastructure and SCPHN Student Expansion Project, said:

It has been a pleasure to work with the iHV to lead on the Audit of Education as evaluation of this important opportunity to invest in improving the SCPHN Education Infrastructure across London. The report evaluates the impact of the initiative within the current SCPHN workforce. And these results are positive, as evidence suggests that the current workforce, despite the very real pressures of achieving service delivery, has risen to the challenge. As a result, the SCPHN workforce has been prepared, and is ready and able to improve the quality of SCPHN student placements, as well as support expansion across London 0-19 Provider Organisations over the next few years as required under the NHS Long Term Workforce plans.”

Georgina Mayes – iHV Health Visiting Professional Lead (Quality and Policy) said:

“I was delighted to lead on this very important project which has the experiences of London SCPHN practitioners at its heart. SCPHN workforce shortages are of national concern and this project showcases how increasing and improving training opportunities can support professional development and growth of a learning culture which in turn can address SCPHN workforce expansion needs. I’m excited to see how our recommendations will be translated into practice.”

We would like to say a heartfelt thank you to London NHS England Workforce Training and Education Directorate (NHSE WTED) for their generous funding of this project, and to OHID London and the Chief Public Health Nursing Directorate (DHSC) for their professional advice. We would also like to thank the survey respondents, co-design workshop participants for generously sharing their experiences and insights with us, and to members of the iHV Health Visiting Advisory Forum (HVAF) who tested the audit survey.

(to cite this report, please use this link https://bit.ly/3Y4rw3E).

References

[1]NHS Digital Source: NHS Digital. NHS Hospital & Community Health Service (HCHS) monthly workforce statistics October 2023. 2024. [accessed 23 April 2024]. Available from: https://bit.ly/3JUw3h6

[2] Kirkpatrick Partners (2024) Demonstrate Training Effectiveness with The Kirkpatrick Model. 2024. [accessed 23 April 2024]. Available from: https://bit.ly/44wd5H6

The Institute of Health Visiting (iHV) publishes a pathway for a career in health visiting.

Across all UK nations, governments are looking to build a health and care workforce fit for the future. This includes responding to changes in our population’s needs and investing in prevention and public health to ensure that people can live longer, healthier and happier lives. There is also much greater awareness of the evidence for investing in the earliest years of life as a critical period to build strong foundations for future health and reduce the risks for diseases that are largely preventable – it is clear that health visitors are needed now more than ever.

But, at the same time, we have significant workforce shortages in health visiting, which is impacting on parents’ experience, service capacity and constrains our ability to transform services to improve support for families with babies and young children. Rebuilding the workforce will take time. The solution rests on building worthwhile and attractive career opportunities in health visiting at all levels – whether practitioners are just entering the field or looking to progress in the profession to more senior roles.

Our career pathway sets out health visiting career options. It draws on the NHS Long Term Workforce Plan’s priorities to “train, retain and reform” in order to build workforce capacity and capability and support practitioners to have worthwhile careers in health visiting.

Health visiting is a form of public health practice dedicated to creating good health. Health visitors embrace strengths-focused relational approaches and take account of the setting and circumstances impacting on a person’s life. These features, and the primary goal of health creation, define health visiting as a distinctive form of nursing and is an area of public health within which a whole career can be grown.

The Career Pathway for Health Visiting has been designed as a resource for workforce planning.  It includes the different job roles contributing to health visiting provision and maps these against levels of practice that reflect registration status, educational development, expertise, and responsibility.

The downward trend in total health visitor workforce numbers in England needs urgently addressing (see our news story Health visiting in the NHS Long Term Workforce Plan: In brief). The NHS Long Term Workforce Plan published in June 2023 signals a commitment to address the shortfall, which needs action not only on recruitment but also retention. The iHV recognises the use of skill mix roles and has developed the career pathway with entry and progression in mind. It sets out possibilities for movement towards a health visitor qualification and beyond, through advanced practice.

The imperative is for employers to invest in new talent and harness expertise whilst helping individuals see where their ambition can take them when health visiting is their chosen career.

More details about the Career Pathway in Health Visiting will be shared by Dr Karen Whittaker at the iHV Leadership conference on 6 December 2023 – an event that can be joined in-person or online (in-person ticket sales close Friday 24 November). See https://ihv.org.uk/events/leadership-conference-2023/ for booking details.

To cite this infographic, please use the link to the pdf here: https://bit.ly/47GEm9Q

Please also see:

 

The Secretary of State for Education has issued a notice to extend the temporary changes to the law on what provision has to be made currently for those children & young people with Education, Health and Care (EHC) plans.

The temporary changes to the law have been in force since 1 May and are now extended to 30 June. Once the notice expires, the Secretary of State can issue a further notice for a period of up to a month if it would be appropriate and proportionate to do so in the context of coronavirus.

The Department for Education (DfE) will keep this under close review.

DfE has also taken the opportunity to publish an updated version of Changes to the law on education, health and care needs assessments and plans due to coronavirus.

The Institute of Health Visiting (iHV), alongside 5 health organisations, is delighted to publish the new Recommended National Curriculum for Specialist Community Public Health Nursing – Health Visiting/School Nursing (0-19 child public health nursing services).

The Recommended National Curriculum is a consensus statement of the overarching knowledge, skills and attributes that can be expected of Specialist Community Public Health Nurses delivering health visiting and school nursing services to families, children and young people from age 0-19.  It is the product of a consensus-building partnership between the Institute of Health Visiting (iHV), Unite/Community Practitioner Health Visitor Association (CPHVA), United Kingdom Standing Conference (UKSC), National Forum of School Health Educators (NFSHE), School and Public Health Nurses Association (SAPHNA) and the Royal College of Nursing (RCN).

Recommended National Curriculum

Developed for use by curriculum developers and providers of health visitor education including higher education institutes, private providers, charities and other voluntary sector organisations, amongst many others, the Curriculum provides authoritative evidence-based guidance applicable across the whole UK in the context of rapid change in policy and practice, fragmentation of services and inconsistency in delivery.

Dr Cheryll Adams CBE, Executive Director at the Institute of Health Visiting, said:

“Parents, children and young people consistently highly rank having good access to a health visitor or school nurse as being important as a source of advice and support due to their reliable knowledge and expertise on the health issues that matter to them.  The publication of this Recommended National Curriculum provides a consensus statement of the overarching knowledge, skills and attributes for nurses to be educated and trained to deliver this specialist level of community public health nursing across the UK. The partners collaborating in the development of this curriculum commend its use to commissioners and providers of health visiting and school nursing education and services, and to the NMC as it reviews its Standards of Proficiency.”

The Recommended National Curriculum provides a firm basis for future developments in individual higher education institutions and also at a national level, when the Nursing and Midwifery Council (NMC) proceeds with its Programme of Change for Education and reviews the Standards for Specialist Community Public Health Nursing.

The curriculum also endorses health visiting and school nursing as a distinctive level and form of practice that warrants regulation, to assure the public of the professional standards that they can expect of registrants prepared for and practising as health visitors and school nurses.

Information Sharing Matters is a free education programme designed for the early years workforce and healthcare professionals about information sharing in early years.

An RCPCH/ 4Children project , it is a free educational resource that aims to empower families and professsionals to share information about children safely and effectively. This is a significant issue for anyone working with young children, and health visitors are at the very fore of this work.

Information Sharing Matters is designed to improve your knowledge, skills and understanding of the benefits of effectively sharing information in a professional context. It is made up of online and face-to-face resources supporting the training of individuals and multidisciplinary teams.

On completion of this programme you will be able to:

  • explain what information can and cannot be shared in a context of integrated working
  • describe the range of benefits to children and families related to information sharing, with a focus on improving outcomes
  • use and share good practice with your colleagues and between individuals and organisations
  • support improved information sharing, helping to build trust between professionals and improving outcomes for young children and their families

 

Two new e-publications on preconception health, education and care in Scotland.  These e-publications are intended to raise awareness about preconception health, education and care, particularly within the Scottish context. This, it is hoped, will lead to many positive actions (large and small; national, local and individual) that prospective mothers and fathers across Scotland find informative, valuable, empowering and supportive as they make their decisions about parenthood. While individual choices are crucial, it also is the case that larger societal forces, political choices and structural issues can powerfully shape what is true for individuals and couples.

The main report “Missed Periods: Scotland’s opportunities for better pregnancies, healthier parents and thriving babies the first time . . . and every time” is a 45-page evidence-based report (including links to extensive references and international resources).

A brief version of this report “Prepared for Pregnancy?: Preconception health, education and care in Scotland” is an introduction and overview of the above more detailed report.  This also includes the advance reviews by a leading public health professor in Scotland and the senior advisor on preconception health to the U.S. Centers for Disease Control and Prevention (CDC). Scotland’s Chief Medical Officer, Dr Catherine Calderwood (herself an obstetrician) also reviewed this report in advance and has been publicly supportive of it.

These two e-publications were commissioned by NHS GG&C’s Public Health Director, Dr Linda de Caestecker.

 

 

The iHV has written this position statement on their views on what the future of health visitor education should look like and in particular how it could be strengthened but also what the blocks to doing that are.