Current educational challenges for specialist community public health nurses following a health-visiting pathway and the consequences of these challenges for public health

Abstract

The UK Standing Conference on Specialist Community Public Health Nurse Education represents the interests of those most intimately involved with specialist community public health nurse (health visitor) (SCPHN (HV)) education in higher education institutions across the UK. This paper summarizes issues currently affecting the education of SCPHN (HV)s and the delivery of health visiting and public health nursing services across the UK. Difficulties in recruitment, numbers of practice teachers and tensions created by the gap between expected and actual practice roles for health visitors are discussed. This discussion takes place in the context of the Programme of Action on Health Visiting, which was launched in 2009 by the Department of Health in England. Recommendations for action by HEIs are made in response to the difficulties identified in particular. Although this paper applies to all the UK SCPHN education programmes the majority of these are in England, which has resulted in a focus being placed on challenges in England.

The Economics of Health Professional Education and Careers: Insights from a Literature Review

“…Public financial stringency in England reveals issues with attempts to reshape professional roles and curricula for specialist community public health nurses (SCPHNs) (Lindley, Sayer, and Thurtle 2011). Employment of SCPHNs-formerly known as health visitors but now with a broader scope of practicedeclined by 14 percent between 1999 and 2008, and student numbers declined by 30 percent in the latter five years of that period.…”

Building the English health visitor workforce as a result of the Health Visitor Implementation Plan 2011–2015: a survey study of career progression and retention for newly qualified health visitors

“…The impact of market forces is apparent here and the size of this influence is clear from the quantitative findings that show a significant association between leaving the profession and moving to higher paid role, reiterating that dissatisfaction with low pay is a variable associated with intention to leave nursing (Collins et al, 2000;Homburg et al, 2013). Prior to the Health Visitor Implementation Plan, many students took a drop in salary to become an HV (Lindley et al, 2010), and concern by HVs about salary on qualification is a recognised issue, especially as occupations that are traditionally a springboard to health visiting such as midwifery and senior nurse specialists are often paid more than HVs (Baldwin, 2012;Whittaker et al, 2013). Line managers are key to ensuring that the rewards newly qualified nurses receive are sufficient to compensate for their perception of low pay (Homburg et al, 2013).…”

An innovative strategy to increase a professional workforce: the fast track initiative for health visitors in England

“…The rapid expansion of funded places on health visiting programmes took place while the profession was under considerable pressure with high caseloads and staff shortages. 13 As a consequence, additional strain was placed on existing resources particularly those of the practice teachers who needed to provide intense support to FT students amidst an increase in the number of students requiring supervision. This situation reflects Van Meter and Van Horn's 26 assertion that there are a number of variables which mediate the link between policy and practice, one of which is the availability of adequate resources to facilitate the policy's administration without which there is a risk that policy implementation can be diluted.…”

“…8 A falling number of recruits resulting in commissioned places not being filled. 13 Increasing attrition rates due to, for example, lower salaries compared to other clinical specialist roles and rising levels of stress within the diminishing workforce. 14 …”