Tags: SAPHNA

New tools for enabling a good learning environment in community practice settings

Enabling a good learning environment for Specialist Community Public Health Nursing students in community settings is essential to equip the workforce for the future and ensure that all learners have a positive experience. The Institute of Health Visiting (iHV) and the School and Public Health Nurses Association (SAPHNA) have collaborated to produce resources for Specialist Community Public Health Nurse (SCPHN) practice learning. Our organisations invite practice learning and employer partners to pledge their support for good learning environments by adopting the Charter.

The resources have been produced thanks to funding provided by London NHS England Workforce Training and Education Directorate (NHSE WTED), previously Health Education England. The suite of resources includes a Charter for enabling a good learning environment and a self-completion maturity matrix (available in portrait and landscape formats). They are tools for communicating a commitment to quality and appraisal of education within community settings.

Learning in practice is a critical element of education and training to qualify as a specialist community public health nurse (SCPHN), a pre-requisite for registration and employment as a health visitor or school nurse within the UK. All students completing SCPHN educational programmes must, under the guidance of practice supervisors and practice assessors, demonstrate achievement of the Nursing and Midwifery Council (NMC) (2022) Standards of Proficiency for SCPHN practice1.

The NMC also stipulates requirements for the preparation and support of those supervising and assessing – indicating that each approved educational institution, and their practice learning and employer partners, must have ‘robust processes in place to support practice supervisors, practice and academic assessors prior to and throughout programmes’2.  Organisations are encouraged to adopt the Charter to communicate their commitment to a culture for learning and embed eight principles into their processes for supporting practice supervisors and practice assessors.

The eight principles for a good learning environment are summarised as:

  • Leadership for excellence
  • Effective communication
  • Enable learning through supportive supervision and teaching
  • Assessment strategies for progress monitoring
  • Interprofessional collaboration and learning
  • Equality and anti-discriminatory practice
  • Safety and continuous improvement
  • Quality improvement and innovation informed by evidence

Development process

Each of the principles was identified following an appraisal of existing published research and a range of resources already used to support practice learning in the UK. The latter included NMC standards for student supervision and assessment3, the Queen’s Nursing Institute (QNI) standards for community practice teaching and education4, the NHS England safe learning environment charter5, and the Pan-London Practice Learning Environment Audit tool in use during 2023. The iHV and SAPHNA also engaged with a number of different stakeholder groups providing perspectives as students, practitioners and academics, to help shape and refine the final content of the Charter and maturity matrix. Some of those contributing were actively involved in supporting learners as either practice supervisors, practice assessors or academic assessors.

In developing the resources, stakeholders have commented:

I fully support all 8 features of the “good practice principles”.  They are student-focused and learning-focused. (Health Visitor Team Lead)

I think self-assessment is a good idea and will work well. (Practice Supervisor)

It is important to include protected learning time for students and assessors, this must be valued by managers. Also, the importance of progress monitoring and ability for the student to navigate constructive feedback. (School Nurse Academic)

The maturity matrix will highlight priorities for development and will therefore be supportive for practice supervisors and practice assessors developing in their roles. (SCPHN Course Lead)

The iHV and SAPHNA invite providers of practice placements to pledge their support for good learning environments by adopting the Charter. Practitioners and teams are invited to use the maturity matrix (available in portrait and landscape formats) prior to and during provision of support for students and colleagues (new starters or those in preceptorship). The maturity matrix is a tool for reviewing professional practice and aid for planning new developments that enable learning in practice.

Jenny Gilmour, Lead supporting HEE London Improving SCPHN (HV/SN) Education Infrastructure and SCPHN Student Expansion Project, writes:

As NHSE London SCPHN (HV/SN) Education Infrastructure and SCPHN Student Expansion Project Lead, I am delighted to have commissioned and collaborated on this SCPHN Practice Learning Resource resulting in a high quality, evidence-based tool to support students in their practice placement. By highlighting essential aspects for colleagues to consider for provision of high-quality practice learning, a student experience of excellence in practice and to facilitate exposure to a positive learning environment, the tools will impact on successful student completion of the SCPHN Programme. Well supported students will, in turn, influence retention for the SCPHN Workforce going forward.

Jennifer Kirman, Principal Lecturer and Course lead SCPHN – Oxford Brookes University, and Chair of the United Kingdom Standing Conference for SCPHN Education, states:  

This charter highlights the valuable aspects that make a positive learning environment. Enabling individuals and teams to self-assess against the matrix will empower a positive move to enhance the learning environment and celebrate successes to share widely with others. These resources are clear and accessible; providing an example rating will be beneficial to many in self-assessing. Thank you for this valuable charter to enhance and articulate a positive learning culture.

Helen Kimble, Senior Lecturer /Course Leader for SCPHN Programmes, University of Northampton, National Forum of School Health Educators (NFSHE) representative reviewed the resources, commenting that:

The maturity matrix will be a valuable tool alongside the Charter for guiding personal and team development and for the ongoing review of the learning environment. It provides a structured template to stimulate detailed conversations to reflect on, evidence, action plan and develop from. The maturity matrix will help teams celebrate strengths and build on any areas of weakness whilst promoting the requirements for a dynamic and evolving good professional learning environment.

Elaine Tabony, Senior Lecturer and School Nurse Field Lead, SCPHN, Brunel University London, SAPHNA Academic Advisor, notes:

The impact in signing the charter will ensure the elements of support for the student will be discussed. It clarifies expectations of both student and the assessors in practice and in university. It shows managers that there is a professional responsibility that must be adhered to.

The authors of the Charter and Maturity Matrix can be contacted at:

Please use these external links to cite these documents:

References:

  1. Available at: https://www.nmc.org.uk/standards/standards-for-post-registration/standards-of-proficiency-for-specialist-community-public-health-nurses2/ 
  2. NMC 2024 Supporting information for post registration standards. Available: https://www.nmc.org.uk/standards/standards-for-post-registration/standards-for-post-registration-programmes/
  3. NMC 2024 SSSA Supporting information hub. Available: https://www.nmc.org.uk/supporting-information-on-standards-for-student-supervision-and-assessment/
  4. QNI 2023 standards for community practice teaching and education. Available: https://qni.org.uk/nursing-in-the-community/standards/community-nursing-practice-teacher-standards/
  5. NHS England 2024 Safe learning environment charter. Available: https://www.england.nhs.uk/long-read/safe-learning-environment-charter/

iHV and SAPHNA joint response to Autumn Budget 2022

Yesterday’s budget provides some welcome investment in the NHS, social care and education. However, a quick search for the terms ‘children’, ‘babies’, ‘prevention’ or ‘early intervention’ will leave you disappointed. We know that the country faces a tight fiscal settlement – money is tight. But are we spending our money on what matters?

The autumn budget misses the mark and is focused on firefighting. The settlement is presented as sound economics in the ‘here and now’. However, our children will not thank us for failing to grasp the evidence on prevention and early intervention. We have more evidence than any other generation that the foundations for future health and wellbeing are laid in the earliest years of life. It therefore follows that ‘smart economics’ will ensure that spending on babies, children and young people is front-loaded in any fiscal settlement and seen as the smart investment that it is, rather than a cost.

Failing to invest in the public health budget at a time when inequalities are widening, preventable deaths in children are increasing, and 1 in 3 vulnerable children are not known to services, is short sighted and will end up costing much more in the long run. Public health has been at the bottom of the list for investment for too long and this is undermining the Government’s ambition to improve the nation’s health and reduce the long-term burden on the NHS and adult social care.

Health visitors and school nurses working in local government play a pivotal role in ensuring all children get the best possible start in life and can thrive throughout their school years. Their work includes both prevention and direct support for babies, children, young people and families for a range of health needs, and often during times of great distress.

Failing to invest in these services will lead to significant pressures and reductions in capacity across the country. Where services are reduced or cut, this will have a real impact on families, babies and children, and many will be left without the support they need.

The public health grant has already been cut by 24% on a real terms per person basis since 2015/16. There is nothing left to cut. Health visitor and school nurse numbers are continuing to decline without additional investment, whilst pressure grows for both professions as demand continues to soar.

Further investment is urgently needed to enable councils to develop strong and innovative health visiting and school nursing teams in their local areas. Increased funding in this area will protect and support parents, babies and children so they can achieve the best possible outcomes.

Read the Chancellor's full Autumn Budget Statement

Key headlines relevant to babies, children and families:

NHS funding – The government is providing additional funding of £3.3 billion in each of the next 2 years to support the NHS in England in response to the significant financial pressures it faces, and enabling rapid action to improve emergency, elective and primary care performance. There is no mention of public health.

NHS workforce plan – The government is publishing a comprehensive NHS workforce plan, including independently verified workforce forecasts, next year. This will include measures to make the best use of training to get doctors, nurses and allied health professionals into the workforce, increase workforce productivity and retention. At face value, this offers nothing for staff working in public health – we are awaiting confirmation.

Maternity services – The government is bolstering maternity services by meeting recommendations supported by the Ockenden Review for 2,000 more midwives. This is welcome news for maternity services but fails to tackle the national shortage of more than 5,000 health visitors who have a significant role to play in improving pregnancy outcomes and supporting safer postnatal care.

Children’s Social Care – £1.3 billion in 2023-24 and £1.9 billion in 2024-25 will be distributed to local authorities through the Social Care Grant for adult and children’s social care. This much needed investment is welcomed, but any efforts to improve outcomes for our most vulnerable children, and reduce the risks of harm, will also require a strengthened ‘upstream’ approach through preventative public health and early intervention services.

Schools – The government has committed to, “redouble its commitment to support schools, enabling school leaders to continue investing in the areas that positively impact educational attainment”. The core schools’ budget in England will receive an additional £2.3 billion of funding in 2023-24 and £2.3 billion in 2024-25.

From a school nursing perspective, whilst investment in schools is welcomed, the link between attainment and good health cannot be ignored. Without a parallel investment into school nursing to improve the worsening outcomes for so many school-aged children, this is somewhat futile.

Similarly, for health visiting, it is also disappointing to see that there is no similar commitment to the first five years of a child’s life, despite compelling evidence that the early years are vital for social mobility as this is where gaps in outcomes first begin to take hold.

 

Alison Morton                                           Sharon White
Executive Director                                    CEO
Institute of Health Visiting                      School and Public Health Nurses Association

iHV welcomes NNDHP letter on cuts to local public health budgets

iHV welcomes a letter from the National Network of Designated Healthcare Professionals for Children (NNDHP) sent to Hampshire County Council as part of their consultation, outlining its concerns regarding the proposed reductions in Hampshire’s Health Visiting and School Nurse services.

NNDHP supports the arguments that the joint letter from the iHV and the School and Public Nursing Health Association (SAPHNA) sent (25 June 2021) to Hampshire County Council made without qualification, and particularly the risk to the Council’s safeguarding responsibilities and the undermining of the healthy child programme.

NNDHP’s letter states:

“Babies whose parents find it difficult to provide all the love, attention and appropriate care that they need do not have a voice to describe when things are not going well for them. Health visitors provide that independent voice. This is a valuable in two ways because they not only provide help and support to the family in a direct fashion, but they also flag up the need for other services to help that otherwise would not get to know. If this function is reduced, or lost, then the likelihood is that the family will then present later in the child’s life in crisis or worse, and will cost the system a lot more to try and put matters right, after the damage has become embedded as adverse child events.”

Read full NNDHP letter to Hampshire County Council