Karen Luker - Health Visiting: A Rediscovery

This edition first published 2012 2012 by Blackwell Publishing Ltd.

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Library of Congress Cataloging-in-Publication Data

Health visiting : a rediscovery / edited by Karen A. Luker, Jean Orr, Gretl A. McHugh.
3rd ed.
p. ; cm.
Includes bibliographical references and index.

ISBN-13: 978-1-4443-3581-1 (pbk. : alk. paper)
ISBN-10: 1-4443-3581-2
I. Luker, Karen A. II. Orr, Jean. III. McHugh, Gretl A.
[DNLM: 1. Community Health NursingGreat Britain. 2. Evidence-Based
NursingGreat Britain. WY 106]
LC classification not assigned
610.7343dc23

2011030348

A catalogue record for this book is available from the British Library.

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List of Contributors

Professor Rosamund Bryar FQNI, PhD, Cert Ed (FE), MPhil, BNurs, RN, SCPHN (HV), NDNCert, SCM

Professor of Community and Primary Care Nursing

School of Health Sciences

City University London

London, UK
Professor Karen I. Chalmers PhD, MSc(A), BScN, RN

Honorary Professor

School of Nursing, Midwifery and Social Work

The University of Manchester

Manchester, UK
Ms Julianne Harlow MA, BSc(Hons), PGCE, SCPHN-HV(T), RN

Senior Lecturer

Health and Social Care

Faculty of Well-Being and Social Sciences

University of Bolton

Bolton, UK
Dr Maria Horne PhD, MA, BA(Hons), Dip Community Health Studies, SCPHN (HV), SCM, RN

Health Visiting Lecturer

School of Nursing Midwifery and Social Work

The University of Manchester

Manchester, UK
Professor Karen A. Luker FMedSci, PhD, BNurs, SCPHN (HV), NDNCert.

QNI Professor of Community Nursing

School of Nursing Midwifery and Social Work

The University of Manchester

Manchester, UK
Dr Gretl A. McHugh PhD, MSc (Public Health), BNurs (Hons), RN, SCPHN (HV)

Senior Lecturer

School of Nursing Midwifery and Social Work

The University of Manchester

Manchester, UK
Professor Jean Orr CBE, MSc, BA, HV Cert

Emeritus Professor of Nursing

Queens University Belfast

Belfast, UK
Professor Kate Robinson PhD, BA, RN, SCPHN (HV)

Professor Emeritus

University of Bedfordshire

Luton, UK
Mr Martin Smith MPH, MFPH, PGCert HEd, FHEA, BA(Hons), DipHV, SCPHN-HV(T), RN

Specialty Registrar-Public Health

Mersey Deanery School of Public Health

Liverpool, UK

Introduction

Karen A. Luker and Gretl A. McHugh

The University of Manchester

Manchester, UK

Over two decades have passed since the publication in 1992 of the Second Edition of Health Visiting: Towards Community Health Nursing and there have been numerous challenges and developments within the National Health Service (NHS), social care and nurse education in the intervening years.

In brief, the role of the nurse has been strengthened both in primary and secondary care by the redrawing of the boundaries between medical and nursing work (for example, nurse prescribing). New careers for nurses have emerged such as, nurse consultants, community matrons, specialist nurses and nonmedical public health specialists. These developments have enabled the nursing profession to have an impact on shaping and developing services for the public.

Skill mix has enabled the refocusing of some roles, for example the building of teams and closer collaborative working among health professionals. Teamwork, with the goal of providing a comprehensive service has been a particular development within the community; with health visiting teams consisting of community staff nurses, nursery nurses, trainee assistant practitioners (TAPs), bilingual support workers and clerical staff.

The health visiting profession is 150 years old in 2012 and the changes and developments in the profession have been immense, and some more welcome than others. A noteworthy change for health visitors was the dissolution of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) (and the four National Boards for England, Northern Ireland, Scotland and Wales) and its replacement in 2002 by the Nursing and Midwifery Council (NMC). The removal of the health visiting profession from statute in 2001 (removing any legal status) and closure of the professional register in 2004 (ceasing NMC regulation) has been seen as detrimental to the profession and one in which the professional organisation, the Community Practitioners and Health Visitors Association (CPHVA), has been lobbying to get reinstated (Unite/CPHVA, 2010). Health visitors considered that with this loss of statute the importance of their work had been overlooked. Health visiting is included as part of the Specialist Community Public Health Nursing (SCPHN) section of the NMC register. The NMC sets standards of education, training and conduct in nursing and midwifery in the UK, including proficiency for SCPHNs to ensure the maintenance of high standards within this specialist area (NMC, 2004) and these standards are currently being reviewed.

During the last ten years the NHS has been continually changing and improving, but when there is a change of the government, there is often a new strategic vision and new challenges for health professionals working in the NHS. The latest NHS plan (DH, 2010a) sets out a number of radical changes in both the organisation and delivery of services for the NHS. The vision is for the commissioning of services to be organised by health professionals closest to the patient and work has begun on the establishment of General Practice (GP) consortia, and this will be the mechanism which supersedes Primary Care Trusts (PCTs) in England to purchase some specialist and secondary care. In addition, there will be an independent NHS Commissioning Board, which will ensure that resources are allocated and accounted for in pursuit of defined health outcomes. The NHS Commissioning Board will tackle inequalities in access to health and lead on quality improvement (DH, 2010a). Organisational changes have been made with the aim of improving the quality of service for patients and similar developments are occurring in Wales, Northern Ireland and Scotland.