Community Practitioners' and Health Visitors' Association

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7th August 2001

Performance Directorate

Room 4WO4 (CPHVA)

Department of Health t

Quarry House

Quarry Hill

Leeds LS2 7UE

Dear Sir

Re:Community Practitioners and Health Visitors Association Response to NHS Performance Indicators Consultation

The CPHVA welcomes the opportunity to respond to this important document. We have consulted widely with key individuals within the Association and the response is based on their feedback. We recognise that to produce such indicators is fraught with difficulties and challenges. Our focus is on the specific indicators as all those responding have had real concerns that the type of information which has previously been collected and that much of it in this document isnít specific enough to address broader primary preventative, public health and inequalities concerns.

The general comment is that the document has adopted a very disease focused definition of health and as such in its current form will be of much more interest to doctors than health visitors, midwives and nurses. This needs to be addressed as it should be of value to all groups working in health care. This government has recognised the benefit of holistic approaches to health care delivery and some acknowledgement of these should be built into the health indicators. In particular prevention is crucial to health gain and needs to be addressed at 3 levels, primary, secondary and tertiary. The focus also remains on acute care despite the apparent refocusing in policy to primary care.

A further comment must be that whilst health professionals may be able to ensure that certain services relevant to health are provided these services may not actually need to be provided by the health service. This should not be a reason for not including them as a clinical indicator. An example would be classes relating to health issues in schools which could have a profound effect on health and school nurses could be significant is advising on choice of content and ensuring they are built into the curriculum although they may be delivered by teachers.

The needs of the long-term ill and disabled people specifically seem to have been omitted and should be acknowledged with indicators, we view these as tertiary prevention.

For each section we include specific comments on some of the indicators and additional views on other indicators which should be provided. Due to pressure of work and the nature of the feedback we have received we have not submitted this information on the form provided but have tried to respond to the specific questions.

Please contact me if you need clarification on any points made.

Yours sincerely

Professional Officer, Research and Practice Development