There are quite a few areas I can think of.
I. The 5 mandated core contacts not being done by HVs
2. The commissioning of the service and whole tendering process and the competition this engenders.
3. The huge drop in the number of HV students being trained this year
4. The removals of the ring fencing around the PH grant and the implications this will have for the future of the health visiting service.
5. The number of visits HVs are expected to do daily. It is true service provides expect 7 a day? Most HVs say 4-5 a day with admin and inputting is the most they can manage.
6. How do we measure the quality of the HV service? It all seems to be about numbers and contacts.
7. The fall in the number of HVs again and the reduction of HVs in practice as there numbers are being cut as skill mix is on the rise again.
8. The increase in mobile working and the implications of this.
9. The cuts in the LA services and Childrens Centres and the impact this had on the HV service.
I could go on… I am sure there are many more. It would be good to hear how other areas are rising to these challenges and some innovative management and practice around these areas.
A lot of this thinking and sharing is something we will be exploring at the iHV Leadership Conference on December 5th.