Community Practitioners' and Health Visitors' Association

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Short in Supply’ but ‘Superb!’ - Hastings and St Leonards Health Visiting Survey


This was how respondents described Health Visitors in a recent survey of Clients’ satisfaction with the Health Visiting Service!

n Hastings and St Leonards, there have been some major changes in the Health Visiting Service over the last 18 months with a move away from the traditional ‘attachment’ of individual HVs to GP practices. Now Health Visitors work in four teams, all based in the Communities they serve – Flat 1 Kennedy Court for Upper St Leonards, The Health Hut in London Road for Lower St Leonards, Ore Clinic for East Hastings and 153 Farley Bank for West Hastings.

As well as working geographically instead of by GP attachment, another development has been to change the emphasis of their work to try to reach more people of all ages (including men!) using more group activities and a variety of approaches to look at more ‘public’ health concerns such as diet, smoking and exercise. This means Health Visitors and their teams targeting their talents and energies where the needs are in the whole community. The change to a more focussed approach has also been taken in Bexhill and the Rural areas where GP attachment continues and is virtually identical to geographical attachment – someone living in Battle, for example, is not likely to be registered with a GP in Rye!

Mothers and young babies are still considered to be priority targets in terms of their needs, so all very new babies and their parents continue to be visited at home. However, nowadays there is much more negotiation between mother and Health Visitor as to how much home visiting and how much clinic and group activity she would like and, indeed, who she would like to see – each team now has Community Nursery Nurses and / or paediatric trained staff nurses adding to the valuable resources to be drawn on.

Changes have not been made lightly, and are under continuous evaluation. This of course has included examining whether the clients – the most important people here! – are happy with the new-look service. Do they still know how to contact their Health Visitor? When have they seen her? What health topics interest them? And how satisfied are they with home, clinic, group or telephone contacts with the Health Visitors? Were they equally happy (or unhappy) in all areas? Were they as happy as we found them in previous questionnaires (1997 and 1998)?

We sent out 273 questionnaires to mothers of children in each geographical area, including mothers of babies under a year and some with a child up to 3 years old. We were delighted to get 122 (45%) of these back.

100% of mothers with babies born in the last year knew how and where to contact their Health Visitor. A few in Hastings and St Leonards with older toddlers said they did not know, but as one or two commented, they did not need her now the child was older and they added that they could easily find out if need be.

Half of the mothers could not name the team area they live in, but in the time since the questionnaire went out a leaflet has been printed which will be handed to mothers and includes the name and contact details their team.

All the mothers with young babies had seen a Health Visitor in the last year, mainly at home. A third of those with older children had not seen a Health Visitor but said that this was their own choice, as they did not feel the need to contact one.

Nearly all respondents rated their satisfaction with home visiting very highly indeed. Most ticked ‘5’ or ‘6’ on the 6-point scale. Satisfaction with clinic contacts was also consistently high, most being about ‘5’ on the scale. There were minor variations between the different team areas, but all areas were rated highly. In Hastings and St Leonards, satisfaction is now higher than it used to be in 1997 and 1998.

Group and telephone contacts were both rated favourably (around 4.5 on the 6 point scale) everywhere, consistent with previous surveys. One mother said, ‘The ABC (Arthur Blackman Clinic) Mother and baby group is great!’

Mothers with young babies were interested in topics such as growth, infant feeding, health and development while more general subjects such as family health only appear to become interesting a bit later on. We had also found this to be true in our earlier surveys, confirming that Health Visitor input is wanted most when babies are small. Several respondents made this point, e.g. ‘the Health Visitor is a key link with a first baby’ and, ‘she was especially helpful in the first few weeks’.

Reflecting the changes over the last eighteen months, one client said she hadn’t realised that there was now ‘help with diet and smoking’ and another said it was ‘nice to be able to talk about me and not just the baby’. There was interest in using Health Visitors to access education and personal development courses.

Many clients wrote general comments on their questionnaires and almost all were exceptionally positive in their tone. This was true of all the geographical team areas. Nine individual Health Visitors were specifically mentioned as being ‘superb’ or ‘kind and considerate’ or ‘gave excellent answers’ or similar … and one respondent said the service ‘has improved brilliantly in the last three years’.

We are delighted with the results from this survey and we will continue to evaluate our progress in a variety of ways; however, the satisfaction of the clients is one of the best indicators that the Health Visiting service really is improving.