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Monitoring the Health Visiting Service - The CONWAY System

Public Health Development Health Visitor
East Lancashire Health Authority
31/33 Kenyon Rd Lomeshaye Estate
Nelson, Lancashire, BB9 5SZ

Tel: 01282-610285

 I'm in the process of considering the amount of administrative work that my health visitor colleagues are having to deal with on a daily basis, particularly around how we demonstrate/measure our service.  

In East Lancashire, we are using the 'CONWAY' system, which focuses on counting contacts with clients.  Many health visitors are having to complete contact forms manually, not having access to 'palm tops' to assist them. This, as I am sure many of you would agree, can take a big chunk out of the working day.

There is no doubt about the limitations of this system, introduced some years ago.  Unfortunately the system more fitted the scenario where health improvement was seen more as an issue of efficiency, with little account taken for how effective interventions were.  It also has a demoralising impact for staff, for whom it becomes no more than a laborious thankless task, that serves no one other than those that 'agree' contracts between organisations, with little account for what actually happens within practice.  It can be quite dis-empowering.  

Today's environment though, calls for an approach that identifies means to demonstrate how effective we are in what we do. And I am looking for a way to take this forward.  I do think that our outcomes need to be centered on our effectiveness;  how close do we come to improving health? 

 Ideas that do go through my head include finding ways to demonstrate changes in health status/health awareness/behaviours/value for the health visiting service.  I also think that we have to push for legitimising more qualitative approaches for demonstrating outcomes, particularly because of the ambiguities and complexities of the role.

 Has anyone got any (or know of) examples for how they have tried to tackle this in their area of work?  Or indeed, I would welcome your thoughts on the issue