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Amicustheunion

CPHVA Annual Conference 'On Target for Health' - Harrogate International Centre, 16- 18th October 2003

Presentations and Abstracts

Concurrent Session A

Concurrent Session B
Concurrent Session C
Concurrent Session D
 

Thursday 16th October 2003

2.30 – 3.30 Concurrent Session A

A 1

New Sure Start Unit

Caroline Healy, Health Advisor, Sure Start Unit
 

On target for equality

Lutfur Ali, Head of Equalities and Diversity

 
A 2

Working with fathers in maternity services

Duncan Fisher, Director, Fathers' Direct, Sue Pollock, Lecturer in Social Work, University of Bristol, Alison Hadley, Teenage Pregnancy Unit, Department for Education and Skills
Duncan Fisher will talk about the importance of supporting fathers as carers of mother and baby and in their own transition to parenthood. He will make the case for increased government investment in health visiting and midwifery as a front line in strategies tackling poverty and social exclusion. He will present the new magazine, Dad.
longitudinal study of the transition to fatherhood in young men. The study documented the experiences and feelings during pregnancy, birth and the early parenting process of young fathers, especially young men at risk of not accepting the parenting role. It sought to identify predictors of continuing involvement with the mother and child towards the end of the first year after the birth of the baby, and also those processes involved in the successful transition to fatherhood. The study also included interviews with a sample of health visitors to explore their involvement with the partners of the young women on their caseloads.

Alison Hadley will explain how enhancing the participation of fathers fits into the Government's Teenage Pregnancy Strategy. Some effective examples of the health professional's role in working with young fathers will be presented, drawing on results from some schemes piloted under the Government's Sure Start Plus initiative.

 
A 3

'Cool to be healthy’: an outreach project promoting health to young people

Jill Lee, Clinical Manager School Nursing , Jane Perkins, Cool to be Healthy Project Manager, East Hampshire PCT

In 2000 the School Nursing Team were given the opportunity to bid for Single Regeneration
Funding to enable the establishment of drop-ins for young people in community settings.
Since the project started in April 2001 it has developed into a service that goes well
beyond that which was initially envisaged. In the workshop we will share our experiences of the last 3 years.

The aim of the project is to provide a confidential and non-judgemental service that
enables young people to make informed decisions about their health and lifestyle.
This is made available in a variety of settings in which young people feel comfortable,
are easily accessible and at times that are convenient for young people.
These settings can include schools, youth centres, children’s homes, the young person’s home, the street and primary care.

As the project has developed the nurses have used their specific nursing as well
as music and art skills to engage with and target their work on particularly vulnerable
and socially excluded young people including: those who do not attend school,
looked after children, young people in special education and young offenders.

The project has become known and trusted by young people and their families.
Additionally other agencies that work with young people refer to and are enthusiastic to work alongside the project nurses.

 

Meeting the health needs of teenagers

Julie Carter, RGN RM BSc (Hon’s), Clinical Leader School Health, Cheshire West PCT, Sheila Lister, RCN BSc (Hons),Family Planning Nurse Specialist,Cheshire West PCT

In 1998 The Office of National Statistics showed England to have the highest teenage pregnancy rates in Western Europe and in 1999 The Social Exclusion report called for a reduction in teenage conceptions by 50% by 2010.

In response to this Chester set up a local teenage pregnancy group and made a successful bid for teenage pregnancy strategy monies to set up a multi agency project.

The project goal was to provide a pilot contraception, sexual awareness and general health service for teenagers using a multi agency approach in a non-medical setting. A school health advisor,family planning nurse and youth worker run a weekly health drop-in from a youth centre in a deprived area of Chester.The drop-in is particularly successful in attracting teenage boys; especially those who are vulnerable or excluded from school whom the teenage pregnancy unit identify as a hard to reach group.

We aim to provide an insight into how the project has developed, why young people access the service and what we feel has made this drop-in successful in attracting young people particularly with boys.
 
A 4

Sure Start and the impact on homelessness: the example of Hilldene & Gooshays Programme in the London Borough of Havering

Sue Walters, Health Improvement Strategy Manager, Chesterfield PCT,Office of the Deputy Prime Minister & CPHVA homelessness project., Anna Houston, Research & Equality Development Officer, Sure Start, Essex

Sure Start is a £1.4bn central government funded complex communityinitiative specifically designed to tackle social deprivation through the provisionof extra resources to children (aged 0-4) and families in some of the most deprived areas of the UK.

When stressful life events overshadow protective factors such as help, support and advice even the most resilient individual can surrender to the difficulties of life in a crisis situation.

One local Sure Start programme highlighted a gap in service provision that impacted on the needs of vulnerable families experiencing the crisis of homelessness. The Sure Start programme supported the women and enabled them to give voice to their perspective. This presentation will raise questions and share some Sure Start solutions. How can practitioners:

  • influence the policy/practice gap for the benefit of families?
  • support clients through the challenge of homelessness?
  • help families to manage the trauma of the transition from temporary accommodation back into the mainstream?
If practitioners believe that networks in the community have the power to positively impact on the lives of families how do we go about creating and supporting connectedness, reciprocity and trust.
 
A 5

Child accident prevention scheme (CAPS): A major collaborative public health initiative

Anne Lewis B.Nurs. RGN. RHV. DNCert, Health Visitor, Preston Primary Care Trust. Susan Smith, Health Visitor,Preston PCT, Susan Smith, Health Visitor, Preston PCT

The Child Accident Prevention and Safety Scheme (CAPS) fulfils both local and national targets to reducedeath and injury from preventable accidents. The focus is on improving life chances for children & reducing health inequalities amongst the more disadvantaged by tackling the wider determinants of health.

The scheme involves an innovative health promotion and family centered public health approach.
Supported by government policy drivers, the scheme has developed new ways of partnership working in collaboration with users and others outside of the Primary Healthcare Team.

A core group of Community nurses lead and drive the initiative. A multi-agency forum plan the development of the scheme and facilitate a collaborative approach to accident prevention. The partners are working towards empowering community ownership and choice. This will enable communities to identify and develop their own health plans around child accident prevention.

Initially the scheme had several linking strands including health promotion material, education resources,media messages and participation at community events.

Recent funding from Lancashire Children’s Fund has created further exciting opportunities for development. This has allowed appointment of a project leader and expansion of the programme to include development of an internet site and school teaching packs.

 
Irene Miller, RGN, Dip HE, RHV, BA, co-ordinator, NHS, Fife

[email protected] is a programme of physical activities for children from birth to five. Its aim is to strengthen family bonds, starting children on a life of health, exercise and sport, and most importantly – having fun.

It is organised into three books from birth to 1 year, 1 – 3 and 3 – 5 years,and the programme grows with the child. It recognises that parents are their child’s first teacher and that moving and learning are crucial to good health.

The programme suggests activities which parents can do in their own home, at little cost, to stimulate their child’s development. The activities include physical activities,songs and action rhymes and massage.

The Baby Book is issued to over 90% of Fife babies within three months of birth, the Toddler Book to over 90% of children within four months of their first birthday. The Pre-school Book is issued through nurseries and over 90% of children in Fife are offered a nursery placement.

In evaluation 93% of parents found the Baby Book useful / very useful and 82% found the Toddler Book useful / very useful.

[email protected] has now been adopted in Ayrshire, Orkney, Shetland, Glasgow, Highland,
Paisley, Dumfries and Galloway. Borders and Forth Valley are currently planning to introduce the programme.

 
A 6

Public health education – An inter-professional approach to developing the public health practitioner

Palo Almond RGN RM RHV(Dip) RNT BSc(Hons) PgD AHCP PgD (Ed) MSc., Lecturer, Programme Director, Public Health Practice, University of Southampton, School of Nursing and Midwifery , Liz Porter, MPhil, BA, PGCEA, RN, RM, RHV, CPT Lecturer, University of Southampton

Aims: To present the challenges of developing inter-professional education amidst conflicting cultures.
The objectives of the work are to enable the audience to critically evaluate:
  • the complex process of meeting different agendas in public health education
  • the development of a curriculum based on inter-professional teaching and learning
  • the management of conflicting cultures

This work is central to the conference themes in that it will describe the complex process of
meeting national public health agendas, local NHS and non-NHS agendas and
University education agendas . It presents the challenges of developing
inter-professional education in partnership with service providers and users/carers as part of preparing a public health workforce to promote and tackle the social determinants of poor health.

This requires the public health workforce of the future to be skilled,
staffed and resourced to deal with the major task of delivering on health strategy.
Whilst medically qualified public health staff have played a key part in the development
of public health in recent years, there will be a need to include in the new public health
workforce people from a wide range of professional backgrounds.

It is anticipated that this will not only better meet the range of public health skills needed to deliverin the future, but will also improve career opportunities for public health practitioners, who do not have a medical background.
 

Practice teacher preparation, development and support – an example of collaborative working

Claire Chambers, MSc, Pg Dip (Prof Ed), HV Dip, CPT, RGN, Principal Lecturer,School of Health and Social Care, Oxford Brookes University, Jane Goodman-Brown,Senior Lecturer, Oxford Brookes University

Over the last few years there has been increasing interest and debate around the role of the community practice teacher.Publication of Placements in Focus (ENB 2001) and Preparation of Mentors and Teacher (ENB 2001) led many practice teachers to feel undervalued and some HEIs(Higher Education Institution)and PCTs (Primary Care Trusts) abandoned their practice teacher training programmes.The Report on the Practice Educator Project (Byers 2002)reaffirmed the value of the practice teacher role and made suggestions for development.

The aim of this presentation is to explore how one PCT and HEI have worked together to
prepare and support practice teachers and in doing this have reaffirmed the value of the practice teacher role in preparing future health visitors. This is a dynamic process which involves collaboration and partnership working.

We will begin by describing the course that prepares practice teachers for their role.This will be followed by examples of how practice teachers are actively involvedin curriculum planning and development of the health visiting course and the supportavailable to facilitate sharing of good practice and innovative ways of working. Finally we will explore how the practice teachers, HEI and PCT have worked together to problem solve as issues have arisen.

This collaborative process has fostered a climate of mutual support leading to the valuing of each other’s roles in developing health visitors for future practice.

 
A 7

On track – supporting families

Jenny Brooks, Team Leader,On Track project, Northampton East, Dorsey Precht,Project Manager, Northampton East On Track

Established in 2001 the project, along with 23 similar projects around England and Wales, aims to address risk factors for future anti-social and offending behaviour.

Targeting the client group has been aided by a screening tool,developed by the county council senior research officer, Dr John Woolham and a needs assessment, based on the work of Dr S. McGraw and incorporating elements of the core assessment.These tools have enabled the team to determine appropriate referrals and see where families strengths and difficulties lie.

 

Children and adults mental health – an emerging public health concern and a public health priority

Tanya Dennis, BSc MSc RGN RHV FETC, Health Visitor, Harrow PCT, Annette Hambi, Health Visitor, Harrow PCT

Mental health in woman’s and children is a pressing public health problem in industrialisedcountries and the most important cause of functional disability in children and adults.Mental health is likely to become increasingly important for primary care, given the increasing recognition of the mental disorders, the limited availability of specialised services and clear evidence of the effectiveness of early parenting and family support interventions in the prevention of mental health problems in families.

The purpose of this presentation is to share our experience in developing community based parenting programme aimed at parents of children with significant behavioural problems as well as children themselves. The presentation will illustrate with practical examples how local health needs are recognised, mapped, and developed into practice and how we approached the issues of building partnerships. It also focuses on the journey into changing world of health visiting as experienced by two practitioners who participated in the project.

The evaluation obtained to date from service users and the professionals has indicated that a parenting programme of this kind can enable health visitors to work more effectively with this client group. It is argued that given the increase in the mental health problems in the community early parenting interventions may be a useful approach to addressing mental health issues on a local basis.

 
A 8

Strengthening health visiting: Developing the public health role

Glenys Hook, Senior Lecturer, University of West of England, Linda Mages, Health Visitor Specialist Teacher, Bristol North Primary Care Trust

The University of the West of England in partnership with the Bristol North Primary CareTrust implemented a programme to utilise the Health Visiting Practice Development Resource Pack and therefore enhance the ‘family centred public health role’ within the health visiting teamsof the PCT. This joint initiative provided a platform to enhance and build upon existing skills,recognising both individual and the broader group/ population focused to explore different ways of working to address the public health agenda. This presentation will discuss the facilitation and implementation of this programme with examples from the action plans produced and the current, continuing work.

 

The Gütersloh Region Hall 4 pilot project

Nia Roberts, Regional Community Nursing Team Leader,SSAFA Forces Help / British Forces Germany Health Service, Chris Edwards, Health Visitor, SSAFA Forces Help/British ForcesGermany Health Service

The British Forces Germany Health Service Management Board agreed a Pilot of the public health role of Health Visitors in March 2002.The Health Visiting service was considered an important area for investigation because of UK health policy outlining a new Family-Centred public health role for this staff group and also because of the recommendations of the Fourth Edition of Health for All Children (Hall 2003).

The presentation will give an overview of the Project from its’ infancy – setting out aims and objectives, process of change, through to identifying public health priorities,whist at the same time responding to family and child health needs in a clear and structured way.

The Pilot Project has identified the need for Health Visitors to examine and adapt their clinical practice. It has required the development of new skills and expertise and has contributed to the identification of their professional development needs.

The Pilot has also emphasized the need to work in partnership with the local community and consider their views when conducting a health needs analysis as well as their involvement with the development and delivery of a Health Improvement Plan.

 
A 9

Research paper

Community development approaches within health visiting

Sarah Forester, Co-ordinator, Sure Start Roehampton
 

Lay perceptions of health and health needs

Ruth Grant, Health Visitor / PEC Nurse, Banes PCT
 

4.30 – 5.30 Concurrent Session B

B1

Overview of CHS & the implications of the children's NSF

Dr David Elliman, Consultant in Community Child Health, Great Ormond St Hospital, London
 

Hall 4 Report

Implementing Hall 4 – Four examples and discussion

Rupa Suchak, CPHVA Executive Committee

 
B 2

Severe postnatal depression and puerperal psychosis - the role of mother and baby units

Dr Margaret Oakes
 
Postnatal Depression Network
Cheryll Adams, Professional Officer, CPHVA
 

Positives of Treatment/Improvements of Care

Vicky Sumner

 

B 3

Education for choice

Lisa Hallgarten, Programme Manager, Education for Choice
 

Teaching sex education in Scotland - Are school nurses prepared for the challenge?

Jacqueline McFadyen, MPH, BSc, PgCE, RNT, Dip HV, Fpcert, RM, RGN, Dip ON, EN,Lecturer in Public Health Nursing, University of Paisley

It is assumed by many that school nurses are comfortable and educationally prepared to teach sex education to school pupils. This assumption is based upon the belief that nurses have completed a nurse education programme that has included a sexual and reproductive health component and that the intimacy of nursing confers non embarrassment and confidence commensurate to teaching sex education to school pupils. A cross sectional study of 167 school nurses in Scotland explored attitudes and views to teaching sex education, nursing qualifications and educational needs in relation to teaching this important topic.

The study revealed that in Scotland many school nursesare over the age of 45 years and have had little or no sex education or training as part of previous nurse education programmes.Many teach sex education but feel that they lack the confidence and skills in this area of practice.

 
B 4

Targeting harassment and bullying in the workplace

Chair: Gail Cartmail, National Officer for Health, Amicus, Chris Ball and Karen Raey
 
B 5

Children’s hospital at home: Change, challenges and achievements

Margaret Simmons, Sister, Children’s Hospital at Home, Rugby, North Warwickshire PCT,Donna Powell, Children’s Nursery Nurse, Rugby, North Warwickshire PCT

The children's ward in Rugby was closed in 1998 following a review of services.This was the catalyst for commissioning a new Hospital at Home service for acutely ill children, which was launched in June 2000. Since the Platt Report in 1959 many reports have been saying that children should not be admitted to hospital unless absolutely necessary. Here was our opportunity to put words into action and empower parents to care for their sick child at home.

This session will discuss the issues involved in setting up this new service, and in ensuring its on-going quality. One of our first challenges was to write evidence-based protocols to guide decisions about care, and information leaflets for parents.

Other issues to be discussed include safety, both patient and staff; the importance and value of collaborative working; and the practicalities of being a self-managed team.

Some of the team's learning needs, opportunities and achievements will be shared, along with the team's evaluation results.

The children's National Service Framework is providing the impetus to improve children's services. This session will give an opportunity to explore a model of acute care demonstrating both innovation and collaboration within primary health care.

 

Community children’s nursing – dependency scoring and caseload management

Sarah Henderson, Community Children’s Nurse, North Argyll, Annie Hair, Child Health Development Manager, Scotland

Soon after commencing the post of a community children’s nurse in a widespread rural area, it became apparent that there was no current effective method of measuring the amount of nursing input each patient was receiving. Under direction of the Child Health Development Manager and discussions with her Community Children’s Nurse colleagues in collaboration with the IT department, a reflective rather than predictive dependency scoring tool was developed that was simple and efficient to use. The finalised tool has proven to be a reliable and effective method of quantifying the amount of time spent on direct patient contact, communication and travel time.

Dependency scoring systems are a valuable method of caseload management; by using it in conjunction with palm top computers it is a time and cost effective method of analysis. It also has the potential to be used as a method of measuring required nursing input to secure funding for further service development as well as assist in ensuring efficiency and effectiveness , the latter being a key feature of the clinical governance agenda. By using a dependency scoring system high-quality care within a framework of good economic management can be delivered enabling children to be nursed at home.

 
B 6

Health promotion in schools – whose role?

Gwyneth Roper, RGN NDN, Primary Link Development Nurse, Salford & Trafford, Assumpta O’Connell, B.Ed.,Healthy School Co-ordinator, Salford & Trafford

School address the health education needs of young people in many different ways . Drug education and sex and relationship education are high on the agenda of health issues and the promotion of adequate social skills to deal with risky situations is actively encouraged.

As well as teachers, there are many professional agencies that go into school to work on the PHSE curriculum. In view of this, a multi-agency working party was set up to produce a comprehensive, easy to follow resource which can be used in many different ways by schools and each professional concerned.Professionals see exactly where they fit into the whole school PHSE programme. The presentation will explain how the resource works and how many professionals in the school setting can use it.

 

Whose Sex is it anyway? (Doh 2002)

Sharon White, Designated Nurse for Looked After Children, St Mary’s Hospital, Leeds, Janet Butterfield, Designated Nurse for Looked After Children, St Mary’s Hospital, Leeds

Research indicates that teenage pregnancy rates, sexually transmitted diseaseand male and female prostitution are all over-represented in the looked after population.

This workshop will focus on the issues for looked after children that lead them to be more vulnerable, explore what influences their choices and decision –making in respect of their sexual health and identify how we might respond to this challenge.

We will share elements of our practice including the first known conference, led by ourselves, solely aimed at the sexual health needs of looked after children/young people and those who care for them and our experience as a pilot area for the National Healthy Care Standard and discuss how these and other approaches may benefit our most vulnerable clients.

As a result of their life experiences, emotional and physical deprivation, poverty, chaos,looked after children often have low self-esteem and poor health. To improve these outcomes the focus should be on health promotion and healthy settings as stressed in Saving Lives-Our Healthier Nation (DoH 1999a), therefore there needs to be planned, co-ordinated personal, social and health development opportunities via local strategic partnerships.

The National Healthy Care Standard, (of which Leeds is one of the pilot areas), is being developed as a parallel programme to the National Healthy School Standard.

This will provide the ‘corporate parents’, health, education, social services and wider partner agencies, with an opportunity to evidence the development of their work in promoting health. It will help to create health care settings, which, in turn, create a healthy ethos which can demonstrate a measurable improvement in children’s self-esteem, health and well-being.

 
B 7

The Nurturing Programme – as whole-population emotional health model for children and parents in the community and schools

Annette Mountford, MBE BA RGN/HV, Director,Family Links, Oxford, Shirley Stephenson, Family Links Area Coordinator, Hull,

When did you last check your emotional health? *
Family Links Nurturing Programme fosters emotional health in individuals, families and schools.

Its structured approach increases emotional literacy by building self- esteem, relationship and communication skills. As interest in the implications of childhood emotional experiences on parenting, long term health and brain development gathers momentum, professionals need to develop expertise in this area.

The Nurturing Programme began in the USA in 1975 to change intergenerational abusive parenting. Its successful outcomes led to its introduction to the U.K in1992. The Family Links team anglicised the Parent Programme and by 1997 developed a Primary school model as well.

The presentation will consider:

  • why the Nurturing Programme is a top quality parenting programme
  • how the Family Links training gives professionals the skills and confidence to be successful parent group leaders.
  • Raising self-esteem in adults and children
  • How Family Links national trainings cascade the Nurturing Programme to teams of health and education professionals.
  • How ‘The Parenting Puzzle’ supports parents and professionals alike

* Participants will be given an Emotional Literacy Quiz to take away.

 

Targeting in practice: Parenting in partnership

Pam Gledstone, RGN RHV Health Ed Cert, Health Visitor Professional Lead , Teresa Newcombe, RGN RHV Post Graduate Diploma Co-ordinator, Hertsmere PCT, Nicky Wilkins, RIPH (tbc)

This session will look at ways we have successfully provided Parenting Groups and Public Health information targeted at hard to reach clients and excluded groups. We have crossed traditional roles and boundaries by our interagency work and so provided an innovative approach to the delivery of services within existing provisions.

We will share our involvement in piloting ‘Shareplus’ a parenting resource from CEDC and ParentlinePlus. This material has been particularly useful in groups for women with English as a second language (ESOL), homeless families, parents of children with special needs, parents with mental health issues and Highscope groups.

Our on going work has helped us identify need,improve care pathways and access to care. We have been able to address health inequalities in the community by incorporating health improvement strategies and disease prevention within our parenting education. We have also responded to client led need to establish new groups. There have been many unexpected benefits to our work.

 
B 8

Public health register for specialists in public health

Nicky Wilkins, RIPH (tbc)
 

Competency framework for public health practice

Lindsay Mitchell, Director, Prime Research & Development Ltd

There are an increasing number of standards and competences being developed to describe the work of individuals, teams, organisations and partnerships.This paper will specifically describe the UK-wide work led by Skills for Health (the Sector Skills Council for the Health Sector) to develop standards/competences for the practice of public health. These standards/competences are due to be completed by the end of 2003.

It will set these competences/standards in the context of other developments such as the Standards for Specialist Practice in Public Health, the competencies for the third part of the NMC’s Register - specialist community public health nursing, and the NHS Knowledge and Skills Framework (NHS KSF). The uses and applicability of the ifferentbstandards/competences will also be addressed.

 
B 9
Research paper

ADHD – intolerance of childhood playfulness or an emerging public health problem?

Tanya Dennis, Health Visitor, Harrow PCT

ADHD has become a major clinical and public health problem in an increasing number of western countries because of its perceived impact on academic and social development in children, and its broader social impact.

Aim: this presentation describes the key findings of cross-cultural research which examinesthe rise of Attention Deficit Disorder (ADHD) in children in North London and Southern California.

Methodology: This ethnographic study involves informants from different ethnic backgrounds. Data collection tools consisted of participant observation, focus groups and semi-structured interviews.This method enabled me to explore the meaning and consequence of ADHD for the sufferer,their family and the professionals. The ethnography relied on key informants as well as on a representative sample from my personal and professional network, schools and after school care, support groups and clinics.Data are systematically analysed using content analysis methodology.

Findings:
1) ADHD has come to such diagnostic prominence through cultural preference for a medical classification,
rather than for classification, provided by other social domains whose effects will be substantially less benign.

2) Desperate parents, frustrated teachers and innovative doctors are the key players in this process.
3) Far from being just a peculiar form of childhood pathology ADHD expresses many issues which are present in children’s wider social world.
4) There has been substantial spread of ideas and infrastructures of ADHD diagnoses to a range of non-western people, who are increasingly being assimilated in western educational and medical structures.
 

Factors affecting the uptake of immunisation

Helen Macdonald, Public Health Infection Control Nurse, Public Health Department of Highland NHS Board

For several years the uptake of childhood immunisations in Highland has been lower than the Scottish average, and the sharply declining uptake of MMR over the last few years has caused particular concern.Throughout 2002 a significant amount of work was undertaken to investigate the reasons for this.

The first step was to identify the accuracy of the published vaccination statistics for Highland,thus allowing us to recalculate uptake. The methodology used to do this will be briefly described.

Surveys of all health visitors, general practitioners and practice nurses were undertaken, and the presentation will highlight significant findings. It would appear that professionals’ own concerns regarding MMR may be contributing to the low uptake levels.

The last part of the work comprised a survey to assess parents’ attitudes towards immunisation and these will be described.
Finally, the recommendations that resulted from this project and the actions being taken to address the issue will be outlined.
 
B 10
Research paper

Teenage mothers and primary health care professionals

Clare Seamark, General Practitioner, Devon

Teenage pregnancy causes concern in the UK, which has the highest rate in Western Europe.However, little research has looked at the primary care perspective.This study sought to gain a deeper understanding of how teenage mothers and primary health care professionals view each other using a qualitative methodology.

The study was conducted in East Devon. Women,who had conceived their first child as a teenager, were identified. Interviews were conducted with nine women and eight primary health care professionals (GPs, midwives, health visitors and school nurses). Semi-structured interview schedules were used and the interviews transcribed verbatim. The iterative analysis used the techniques of IPA. The aim of IPA is to try to understand the participant’s experience through analysis of their interview as interpreted by the researcher.

The teenage mothers were positive about their contacts and relationships with primary health care professionals.This was sometimes contrasted with their experience of secondary care. The health professionals did not think teenage pregnancy was desirable, but saw their role as being non-judgmental and supportive. Working together in a Primary Health Care Team was important.

 

Cigarettes sales to under age youth

Emma Croghan, Research Associate, University of Birmingham

In the UK, the most commonly named point of access to tobacco for underage smokers is cross counter in shops.A recent cross sectional survey showed 94% of young people who had attempted to purchase cigarettes from a shop had been successful. However, local council Trading Standards units routinely undertake test purchases and they report much lower successful purchase attempt rates.

Six volunteer young people from a youth club were recruited and they and their parents gave informed consent. Youths entered shops and asked for a packet of ten cigarettes. If the youth was offered cigarettes, they claimed to have forgotten their money. If the youth was asked for ID, they claimed to have ‘left it in the car’. If they were asked their age, they claimed to be 17. The researcher left the shop after the youth and met them outside. Attributes of the shopkeeper, age, gender and ethnicity were discussed between researcher and youth and these were recorded.

7 of the 38 shops refused to offer cigarettes to the young people. No significant predictors of sales were found.

Standard test sale protocols used by Trading Standards Units do not reflect the ease with which young people can illegally purchase cigarettes. Shopkeepers and communities need to be supported in recognising underage youth purchasers in order to reduce this important source of tobacco to young people.

 

Friday 17th October 2003

Plenary Session

Key Note Address - The Importance of Targeting Health Development

Jeff French - Director, Strategic Planning, Health Development Agency

 

11.30 – 12.30 Concurrent Session C

C 1

Targeting vulnerable children – who’s responsibility?

Donna Kinnair, Director, Clinical Leadership Quality and Nursing, Southwark PCT

 

Children’s Trusts

Thelma Sackman, Consultant, Primary Care and Nursing

In July this year thirty-five Children’s Trust where agreed by the Department of Health in England. These Trusts have been created to develop a focus on partnership working across all agencies that work with children. There are various models of Children’s Trusts, but the key elements are to jointly plan, commission, finance and deliver services for children together.

This session will explore the concepts of Children’s Trusts and what models are being considered and what are the common features. Workforce and employment issues will be highlighted and the anticipated child outcomes will be shared.

 
C 2

Disability champions (European year of disabled people)

Dave Parr, East Ridign Collge Trade Union Studies, Hull, Amicus MSF

 

Fair Treatment - A survey of disability access policies in PCTsFair Treatment -A survey of disability access policies in PCTs

Joe Hennessy OBE, Vice Chair, emPOWER

In 2002, Leonard Cheshire’s Social Exclusion Report "Inclusive Citizenship; Social equality for Disabled People" highlighted disabled people’s exclusion from essential primary health care services. Their degree of exclusion from doctors` surgeries, dental practices, opticians and pharmacies was alarmingly great compared to that of the general population.

As a follow-up to that research, Leonard Cheshire surveyed all 302 Primary Care Trusts in England. The research, based on the replies of the 70 PCTs who responded, investigated the policy and practice of PCTs, the training provided for primary care staff within their organisations and the level and nature of consultation with disabled users of their services.

The report of the research demonstrates the enormous gap between Government expectations about challenging health inequalities and discrimination against disabled people, on the one hand, and reality on the other.

It is important that primary health care providers realise that accessibility doesn’t just mean ramps and lifts but flexible services, effective communication and attitudes that enable rather than impair access.

The session will discuss the findings of the reports and consider how equality of access to primary health care services can be provided for disabled people.

 

C 3

Can-Do school project

Pam Brandon RGN School Nurse Certificate, Diploma Level, School Nurse Milton Keynes Primary Care Trust, Elizabeth Knight, RGN, BA (Hons), Cert. Health Ed., School Nurse, Milton Keynes Primary Care Trust

Milton Keynes has one of the highest proportions of young people in the country and this is why it is so vital for school nursing to lead in new initiatives.

If we can influence the child’s experience at school and equip them with life skills, then we have made a difference. Hence the seed was sown for the ‘CAN DO ‘ Project.

This Project addresses the mental health needs of the middle school child. The overall aim is to raise self-esteem and instil coping skills to smooth the transition into secondary education.It contributes to the criteria set down to meet the local ‘Emotional Health and Well Being’ standard of the National Healthy School Award Scheme.

The Project runs over six weeks, working with final year primary students, and linking in with the Personal Social Health Education element of the national curriculum.The pilot cohort was followed up in their new secondary school, six months later and responses from teachers indicated that the Project had been effective.

The principles and research underlying the presentation will be briefly covered, along with the content and style of delivery. The evaluation of the Project is presented both from the teaching staff and students' points of view and shows that we are 'on target for health'.

 

Health Promoting Schools

David Porter, Helath Promotion Agency for Northern Ireland

 
C4

Team working with nursery nurses

Jenny Giles, BSc (Hons) ,RGN,RHV Clinical Team Leader, Christine Healey, Community Nursery Nurse, Croydon PCT

Nursery nurses arrived in Croydon about 5 years ago and since then they have challenged and changed the way the health visiting service is delivered in Croydon (South East London).

This workshop will set the context of team working in health visiting and the contribution which nursery nurses have made to the process.

In recent months work has been carried out on a competency framework to enable a greater understanding of the skills and abilities of nursery nurses. This in turn has led to a better awareness and acknowledgement of levels of accountability.

We will examine the different roles and responsibilities which nursery nurses could develop ranging from group work and clinics to a more advanced level such as the running of Webster-Stratton parenting courses.

We hope this workshop will encourage you to look positively at the way nursery nurses can enhance the services offered by health visiting teams.

 

Using skill mix effectively for ethnic minority families

Sara Smith, Health Visitor Consultant, Luton PCT, Imtiaz Malik, Infant Feeding Advisor, Luton tPCT

This workshop is about using the right people for the right job. It is designed to critically reflect on the development and effectiveness of a skill mix approach to infant nutrition in ethnic minority families.

The session is set in the context of a weaning intervention. Staff, who had previously worked as linkworkers, are now trained as infant feeding advisors to visit clients in their own homes to offer weaning advice and support.

The presentation adopts a ‘nuts and bolts’approach exploring the development of the servicefrom both the team leader’s and infant feeding advisor’s perspectives. It includes a reflection on the process of changing role from linkworker to infant feeding advisor.

Our experience strongly suggests that the effective use of skill mix requires the health visitor to respond to the challenge of a changing work pattern. Instead of personally delivering the intervention the health visitor adopts a teaching and mentoring role, facilitating the delivery of effective health care.

 
C 5

Addressing needs of pregnant and new parents – dreams vs reality

Leila Bates, BSc (Hons) RGN, Sure Start Health Visitor, North Bexley Sure Start, Liz Gale, BSc (Hons), Sure Start Midwife, North Bexley Sure Start

This presentation is based on the Sure Start ethos, a multi-disciplinary approach and a social model of health. It will demonstrate the rationale behind the setting up of an ante-natal and post-natal drop-in support group on a local high rise estate.

The group, known as ‘Bumps and Babies at Larner’, grew out of a recognised need for more places where parents could go to get out of the home and meet other parents. In addition, we hoped to encourage them to recognise their baby’s abilities and development through structured play with our play leader thereby encouraging attachment and strengthening the parent-child bond.

The parents had indicated that they would welcome informal access to health professionals within a non-clinical setting. Parents now seek advice on a range of issues; social, emotional and physical. This helps to promote a broader discussion around expectation of childbirth and parenthood. This is provided by, a specialist midwife and health visitor team working together.

 

An alternative approach to community mental health regeneration – Sure Start Hattersley

Amanda Inverarity, Director, Standing Conference for Community Development Manager, Emma McDonough, Sure Start Health Co-ordinator, Hattersley Development Trust

Within the climate of neighbourhood renewal and regeneration, there is considerable emphasis on community participation to build ‘social capital’ that is intended to contribute to reversing a long-term decline across a wide range of issues within socially and marginalized communities. However, how can we connect individuals within communities that are marginalized and excluded when because of the very processes of exclusion we are trying to reverse, many individuals are unable to participate?

Community based research and work with Sure start Hattersley gave insight into the mental health needs of that target group in relation to wider regeneration concerns but specifically looked to respond to the following:

  • What factors have inhibited a group of Hattersley Sure Start contacts identified as having experienced mental health difficulties from building up social capital in their community?
  • What are they types of interventions they identify as helping them improve their capacity to build up social capital?

This short session will aim to highlight issues and outcomes of the research as well as to illustrate key opportunities for health practitioners to support isolated and excluded individuals in reconnecting them into mainstream activities and services.

 
C 6

Bringing service users into the classroom

Mary Hayward, Senior Lecturer, Liz Porter, Course Leader , Marion Frost, Senior Lecturer, South Bank University Mary Hayward, Senior Lecturer, Liz Porter, Course Leader , Marion Frost, Senior Lecturer, South Bank University

SIGET recognises that individuals and families/carers who use health care services have an important contribution to make to the development, delivery and evaluation of educational programmes of all those who work in health and social care settings. The values that underpin this view are based on the premise that service user’s needs and preferences should be the centre of all health related services.

User and carer involvement is central to the government’s modernisation agenda for the NHS (DH 2000) and should therefore be reflected in educational programmes.

It is suggested that healthcare professionals, including educationalists, may not appreciatethe importance of including service users or of the valuable contribution that they can offer and that this may also be an area requiring further development.

The presentation will include proposals about a way forward, drawing on principles of good practice underpinned by values for user and carer involvement, including suggestions for and examples of best practice, and will demonstrate the processes of user involvement which is one of the key targets in the modernisation agenda.

Ethical issues will be considered regarding the protection of individuals (pts/users/carers) when used for learning and teaching purposes including consent or assent, confidentiality, and support. In addition the discussion will include the role of the educator when users/carers are invited into the classroom to share their experiences with students and to offer advice. How should both be prepared and supported so that the experience is equally beneficial and valuable?

Could this be an area for Educators to do some joint initiative working with Specialist PracticeMentors together with their patient/client groups and indeed other agencies thus providing wider multidisciplinary approach to learning? This would also role-model to student groups and future practitioners ways of working with client groups with the aims of developing appropriate and effective services for health improvement. These and other issues will be discussed and considered and audience participation will be invited.

 

Getting real about consumer involvement!

Karen Whittaker, RGN, RHV, BN, MSc Senior Lecturer, University of Central Lancashire , Sarah Cowley, Professor of Community Practice Development, Kings College London

Aim: To present a discussion of the real issues practitioners and researchers need to prepare for when endeavouring to maximise the involvement of local community members in service development or research studies.

Objectives:
  • consider the barriers to user/consumer involvement and review strategies for challenging the same.
  • consider one example of consumer involvement based on the experiences from an ongoing parenting research study.
The parents (local service users) involved in the illustrated research study have had a number of roles:
  • advocates for the research project
  • reviewed questionnaire drafts
  • attending research steering group
  • assist with questionnaire distribution
  • contribute to section of study newsletter.

During the presentation reference will be made to an ongoing parenting research study that has involved local parents in the steering group. Discussion will centre on the practical considerations required for achieving consumer involvement and suggested strategies for managing challenges which if left can present as overwhelming obstacles. Finally it is anticipated that a realistic appraisal of costs will be a useful guide for those seeking to develop working partnerships with people, groups and communities.

 
C 7

Practical measures to improve access to healthcare for asylum seekers

Amanda Ryan, Nurse Consultant,Cardiff Health Access Team, Cardiff, Nasreen Dar, Liaison Health Visitor , Cardiff Health Access Team

The NASS Dispersal to Cardiff commenced in April 2001 when large numbers of non- English speaking asylum seekers began arriving in the City. Access to both primary and secondary healthcare is problematic for this vulnerable group. This is compounded by the diversity of languages spoken and the asylum seeker’s lack of familiarity with UK health provision.There are few formal interpreters for the range of languages now spoken in Cardiff, and asylum seekers have a variable ability to communicate in English.

Practical measures to reduce the need for interpreters or telephone interpreting have been developed to ease access into healthcare. Both service providers and users have been consulted to identify suitable material for translating, through the use of focus groups and interviews. The material is double-backed translated to promote accuracy.

The material has been laminated for use in general practices and to enable community practitioners to photocopy and give out to clients. It consists of interpreted material that is frequently used within practices including information on immunisations, reducing the risk of cot-death, making appointments and time-keeping.

There is an on-going process of reviewing the material developed through interacting with the practices so that re-configuration or alteration of the material may take place.

 

Interactive health promotion for asylum seekers

Judith Francois, Team Leader, Croydon Homeless Health Team, Hilary Howard, RGN Bsc ( Hons) General Practice Nurse, Specialist Practitioner, Croydon PCT Homeless Health Team

The difficulties of inequitable health access for asylum seekers have been documented both locally and nationally.

Croydon houses a significant number of newly arrived asylum seekers, who are awaiting dispersal around the country. However the length of stay in temporary accommodation can be variable, which contributes to the difficulties in offering consistent health care.

Despite these challenges the Croydon Homeless Health Team have successfully engaged this marginalised group in an interactive health promotion initiative which provides participants with their own personal tailored resource, and overcomes some of the difficulties faced by written materials. The result is a photographic resource, known as ‘Pictures of Health’.

The session will outline the journey that resulted in the achievement of this resource including
  • Client perspectives
  • The difficulties and successes
  • How this has impacted on other agencies
  • The transferability of the resource
 
C 8

Debates and challenges in public health nursing: Issues for research, practice and policy

Dr Elaine Haycock-Stuart, Division of Nursing Studies, University of Edinburgh
 

The agenda for school health research

Professor Woody Caan, Professor of Public Health, Department of Public and Family Health, APU

In 1997-98, some of the vandals who did away with the School Nurse role in Cambridge claimed
in justification that there was no "evidence base" for their practice. With publication of two key documents, School Nursing within the Public Health Agenda and the School Nurse Practice Development Resource Pack, it was apparent there was some "evidence on what works" (Department of Health, 2001). It was also apparent there were some gaps in our knowledge base and no strategic approach to developing the relevance, scope or scientific capacity for school health research.

Primary Care Trusts were on the horizon, and concern grew that PCTs might show little interest in school health - let alone develop the sort of new, population-based child-centred services that were needed to reduce health inequalities and to overcome social exclusion. Movers and shakers in the NHS needed to feel that school health matters,and that it matters to get the services right. In 2001 the inter-professional. School Health Research Group was created. Its evolution, priorities for research and recommendations for action on a national level will be presented. The lessons learned will be illustrated with the case histories of specific research ideas developed during 2001-03.
 
C 9

Research paper

Triple P – How can evidence-based parenting programmes be made to work in primary health care?

Majella Murphy-Brennan, Director, Training & Dissemination, Triple P International Pty Ltd, Australia

Primary care health and welfare professionals are well positioned to provide parenting support,
yet primary care settings are under-utilised for the provision of effective mental health programs for children and families. Primary care services can undertake several important tasks to promote children’s mental health including: early detection of significant deviations from normal development;provision of advice to parents seeking information about developmental issues; provision of brief behaviouralcounselling for child behaviour problems; and referral of moderate to severe child behaviour problems to specialised services.

This paper reports on the effectiveness and dissemination of a comprehensive multilevel model of parenting and family support with a focus on primary care settings. Results from a randomised controlled trial of Primary Care Triple P conducted by child health nurses in a community health clinic will be presented in conjunction with additional service delivery data. Issues around dissemination and uptake, training, and support for service providers will be discussed.

 

Relationship satisfaction, psychological well being and the transition to first time parenthood

Roslyn Corney, Deputy Director (Research & Innovation), One plus One

Previous work has suggested that the problems that lead to couple relationship breakdown start early and that the birth of the first child is a transition which can be accompanied by some difficulty.

This study was designed to investigate the quality of the couple relationship in first time parents and to investigate whether this is related to psychological well being. Data was collected by questionnaires from couples during pregnancy (18-26 weeks) and four months post partum.

The findings suggest that both men and women’s relationship satisfaction reduces after the birth of the first child.They also suggest that there is an association between low relationship satisfaction and depression and anxiety in both women and men.

Policy makers and health professionals have a responsibility to encourage both mothers and fathers to offer children adequate parenting. Further studies are necessary not only to investigate the transition to parenthood but also how to strengthen the couple relationship and parental bonds.

 
C 10

Development and evaluation of a questionnaire to collect public health data for school entrants: Child Health Assessment at School Entry (CHASE) Project

Sarah Edmunds, BSc (Hons), Project Coordinator, Royal College of Paediatrics and Child Health

Aims: To develop a multi-professional consensus about the relative contributions of the components of children’s health, and a questionnaire to capture the agreed important components. To evaluate this questionnaire’s feasibility, data quality, reliability and validity.

Method: A Delphi consultation was run to reach a consensus on which aspects of health should be assessed by the questionnaire and appropriate measurement methods. A questionnaire was then developed and piloted, using existing school resources. Parents of 278 year one children from ten schools in two London boroughs received a questionnaire; school nurses collected further data for participating children.

Results: The Delphi consultation reached a consensus on twenty items to include in the instrument with an agreed measurement method. In the pilot, response rate was 61%. Mean data completeness of parent and school nurse questionnaires was 98% and 82% respectively. Initial tests of internal reliability were satisfactory.Tests of construct validity found some significant associations in the hypothesised direction.Inter school and inter borough comparisons of key findings demonstrated considerable differences in physical and mental health status.

Discussion: The instrument was acceptable, and feasible to implement. The data has the potential to inform interventions and service provision at school and borough level, and public health trends over time.

 

How record keeping in the Child Health Review of the NHS Child Health Promotion Programme in Wales (not accessible on request)

Marjorie Talbot, MSc, PGCEA, BA, RHV, RN, Health Visitor, University of Wales Swansea

This study inquires into completeness and efficacy in NHS Child Health data in one Health Authority in Wales using a Soft Systems Methodological (SSM) approach (Checkland and Scholes 1990). A systemic approach enables partially hidden phenomena to emerge in human activity that enables one application of electronic documentation to support standardised administration for routine Child Health Surveillance Programmes. Particular attention is given to the interpretation of how information is captured during Child Health Review consultations using standardised, structured paper forms and also to roles and norms influencing the selection of elements documented in the paper record that are subsequently deposited as encoded data in individual electronic health records.

The aims of this study are firstly to better understand, from multiple perspectives, some of the complexity inherent in clinical information processing in Child Health computer systems,in order to propose methods for evaluating such systems.
Secondly this study discusses utilityin the principles underpinning SSM for undertaking evaluation research in nursing informatics.
Thirdly the study suggests recommendations, provisional to the local fieldwork settings in this study, that might be of interest to others seeking to evaluate and improve record keeping that feeds electronic documentation for health needs assessment.
 

2.30 – 3.30 Concurrent Session D

D 1

The evidence base for targeting public health

Mike Kelly, Director of Research and Information, Health Development Agency
 

Public health electronic library (PHEL)

Zoe Findaly, PHEL Project Manager, Health Development Agency
 
D 2

Health and domestic violence: Women's Aid campaign

Nicola Harwin, Director, Women's Aid Federation of England
 

Working with children affected by domestic violence

Dr Gill Hague, Joint Co-ordinator Domestic Violence Research Group, University of Bristol

The impact of domestic violence on children is an issue which has recently ‘found its time’ after many years of neglect. This presentation will discuss how domestic abuse impinges on children and will relate this to policy and practice responses, especially those of relevance to health practitioners.The inter-connectedness of domestic violence and child abuse will also be addressed with reference to recent research on this issue. While domestic violence can often effect children severely, they may also show remarkable strengths and resilience. Children’s coping strategies and the advice that they may give to other children in the same situation will be discussed, drawing on research findings.

The presentation will be based on a new book for Sage by Audrey Mullender, Gill Hague, Liz Kelly, Umme Imam, Linda Regan and Ellen Malos on Children’s Perspectives on Domestic Violence and on a paper in Community Practitioner in 2002 on children’s coping strategies and the community practitioner and health visitor response. We have failed to listen to what children say and know about domestic violence for too long.
 
D 3
Talk shop
Community Development and Parenting CPHVA Special Interest Group presentations
 
D 4

Barrie Brown, Head of Labour Relations, CPHVA and Colin Adkins, Research and Policy Officer, AMICUS

Agenda for change

 

Implementing Agenda for Change

Eileen Brennan, Chester and Chris Young, Nantwich
 
D 5

Community nurses and sexual relations education

Babs Young, Health Development Agency
 
D 6

Men’s Health – how can we get it sorted?

Peter Baker, Director, Men's Health Forum

There is now, at long last, increasing public, professional and political interest in men’s health.This is reflected in the Department of Health’s approach to suicide prevention and prostate cancer,in the Health Development Agency’s interest in developing a men’s health evidence base, the activities of the All Party Parliamentary Group on Men’s Health, and the involvement of a large number of local health organizations in the annual National Men’s Health Week.

What is still needed is a recognition at national and local levels that men’s health must become a strategic priority. It is still too often an issue left to committed but often isolated individuals rather than part of mainstream activity. It is also important that those interested in this area of work have access to training, networking opportunities, evidence of good practice and, of course, enough resources to do the job on a sustainable basis.

If men’s health inequalities are not tackled effectively, men’s health will remain unnecessarily poor and it will also be much harder to achieve the Government’s population-wide health targets.

 

Targeting men’s health in the military

Martin Brown, Health Visitor, British Forces, Germany

Men’s Health is increasingly on the Public Health Agenda as an area to be targeted. Men access health services less than women, are more resistant to change and see ill health as a weakness.This picture is broadly the same in the army.

The British Army is 95 % male, who are mainly under the age of 35 years old. As a group there is a high emphasis on risk taking. Peer pressure is strong and ill health can be seen as malingering. In the environment of the Army, how can the health choices of male soldiers be influenced positively so that they take more responsibility for their own health?

In the British Forces Germany (BFG), the SSAFA Forces Help Staff in the BFG Health service are seeking to influence the way Health Promotion is delivered through the use of Soldiers’ Health Fairs.

" Targeting Men’s Health in the Military," looks at how these were set up and run. The evaluation showed the simple messages were more useful than expected and that teaching Testicular Self Examination is a useful link to other issues of sexual health. It was also noted how much the education and literacy skills of the soldiers varied.

The challenge is how to move on from traditional health education approaches and create a model appropriate to soldiers needs within the given resources.

Negative messages of "don’t and be careful" need to be replaced with participative and informative programmes,which are acceptable to both the military chain of command and health service management.

 

District Nursing at the Cross Roads

Louise Thompson and Ann Brown, District Nurses and Pat Jackson, Professional Officer, CPHVA
 

A multi-agency approach to joint working for patients

Lisa Hollingworth, District Nursing Sister / Project Manager, Dudley South PCT,Catherine Brown, District Nursing Sister / Project Manager, Dudley South PCT

The purpose of this presentation is to share the work that has been undertaken in relation to enhancing communication, collaboration and continuity of care for patients’ within Dudley.

In 1999, the Audit Commission identified fundamental issues to be addressed concerning referrals to district nurses and information upon hospital discharge. Locally the audit was replicated and work was undertaken to address the following: -

  • There was no clear view of what district nurses did leading to inappropriate referrals.
  • District nursing admission to caseload was outdated and unspecific.
  • Resources were wasted on assessment time due to inappropriate referrals.
  • One in five referrals lacked basic information and one in ten referrals were inappropriate.
In view of the above issues the following work was undertaken:-
  • A review and update of the admission to nursing caseloads.
  • Development of a structured referral procedure.
  • To improve communication and working relationships between agencies
  • a Resource Pack was developed to aid discharge planning and was distributed at a rolling programme of workshops.

This presentation will detail the issues when instigating a structured referral system and the problems that have been addressed in relation to discharge planning and communication between primary and secondary care.

 
D 8

The reality of extra health visiting support: examining professional and client views

Jane Appleton, RGN RHV BA(Hons) MSc PGCEA PhD, Principal Lecturer in Research Education, Oxford Brookes University and Research Fellow, University of Hertfordshire

This presentation will describe some of the findings of a case study conducted to examine how health visitors identifyfamilies in need. It will focus on the nature of ‘extra health visiting support’, exploring this concept from both health visitors’ and users’ perspectives.

A classification of the ‘extra health visiting’ offered to clients in this study contributes to the knowledge base of f health visiting, by attempting to explicate some of the detail associated with this important, but often neglected area of practice.

In the study, the participating families receiving ‘extra health visiting’ had a wide range of different needs The majority of clients interviewed valued the support and interventions offered to them by their health visitor and most found practitioners facilitative in helping them to address their needs.

This presentation will argue that health policy must continue to recognise that health visitors have an important role in seeking out families with increased needs and that this is an essential prerequisite to facilitating health enhancing behaviour. A sensible and non-stigmatising strategy is to support the continued provision of a universal health visiting service and regard all families as potentially in need of extra support at some point.

 

'Black and (in)visible’ – the career journeys of black nurses in leadership position in the primary care sector

Dr Vina Mayor, Research Advisory Group Member, CPHVA

This paper focuses on the career journeys of twenty-two black nurses in leadership position in primary care. The research study examined the career trajectories to illuminate and understand the black nurses’ experiences of nursing as a career; acquire a greater understanding about the social mobility of black people through professional and academic accreditation; and redresses the paucity of available research about black nurses in nursing history and broader literature.

To date there has been a lack of focus on black people rising within structures, as mostly the research focus has been on those at the bottom.
The paper will detail the research processes adopted and examine the barriers, obstacles and constraints black nurses had to contend with and manage in order to negotiate their careers. It will explore the intersection between social structures of class, ‘race’/ethnicity and gender, and personal agency alongside the influences exerted by the respondents’ domestic considerations; nursing labour market; health policy changes; social and cultural capital; organisational changes or constraints; and/or professional constraints. The policy implications from this research will be identified for practitioners to consider and reflect on in order to develop strategies to promote inclusiveness of a diverse nursing profession.
 
D 9
The Millennium Cohort Study – local service availability
Angela Brassett-Grundy, Research Psychologist, Centre for Longitudinal Studies, University of London

The Millennium Cohort Study (MCS) has provided an exceptional research opportunity to follow a cohort of approximately 18,000 people born in the new millennium throughout their lives.This paper is based upon a project, the aim of which was to discover more about the geographical areas in which cohort members were living at the first sweep, thus enhancing the MCS data. This will allow neighbourhood information to be used alongside the information gathered directlyfrom the cohort members’ caregiver(s), and in the future from the cohort members themselves, to help answer questions pertaining to health inequalities, poverty and wealth, the quality of family life,and its support by public policy and the broader community. To achieve this, information was gathered by postal questionnaire from health visitors concerning the local services accessible by young families in the electoral wards elected for inclusion in the MCS.

 

Scoping pre-school projects for a mainstream agenda

Helen Weir, Research Associate and Sarah Cowley, Professor of Community Practice Development, King's College, London

In order to reduce health inequalities, additional funding has been directed to deprived areas,largely through dedicated initiatives like Sure Start, Health Action Zones or Connexions, which then fund local projects. Operating alongside and in partnership with the statutory and voluntary sector services, these initiatives affect mainstream services, particularly where the projects are concentrated, as in Inner London. Currently the borough in this study has approximately 120 different projects directed towards pre-school children and their families.

The challenge for service development is to know, not only which projects are in existence at any one time,but also how to ensure best practice is carried forward in mainstream services.

This project is developing a framework that enables the specification and selection of pre-school projects most suited for mainstreaming. The presentation will describe the context, data collection and progress towards the ‘mapping’ of the pre-school projects and learning from them. It will outline the components of a framework for deciding which projects could be carried forward into mainstream service provision, and will discuss:

  • What constitutes a ‘mainstream’ service?
  • Which criteria should inform mainstream service developments/reorganisation?
  • How to determine the ‘best practice’ to carry forward?
 
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