Re: Re:regulation: response to Tories

[Guest guest]

Thanks for keeping us up to date.  On 30 Aug 2008, at 13:36, Rowe wrote:Dear AllI wrote to Ann Keen my MP some time ago and have never received a reply tomy concerns. Since then I have had a reminder letter from the NMC toRe-register. I rang the NMC and said that I could not fulfil the nursingrequirement and therefore had decided that I could not re-register. The manwho answered the phone was very patient and I read out the paragraph on theinformation they had originally sent to me to say that SCPHNs must retaintheir registration as a nurse/midwife. I explained that I could not do thisand he said - oh it is Ok you can re-register. I said that I did notunderstand this. He said that they had new guidance and he would send it outto me - I am still awaiting this 10 days later.My colleague also has a problem so made enquiries at Bucks New Universityfor return to practice courses. She received information on 2 courses. Theone for Specialist Community Public Health Nurses was £800 - which she saidshe would have difficulty in finding the money and the another was for £520for Adult, Child Mental health Nurses, Learning Disabilities and HealthVisitors!! She then rang the NMC who could not explain the difference andsaid that they thought it was a mistake for adding Health visitors forinclusion on the cheaper course.So the confusion reigns and I am so disenchanted with the whole regulationprocess to wonder whether why I would pay £76.00 for such a poor servicethat is meant to protect the public. I think the public should be reallyconcerned. sarahcowley183@...http://myprofile.cos.com/S124021COn

[Guest guest]

Ann Keen ought to know better. But I'm also troubled by the

longstanding lack of response to correspondence. There are civil

service policies on this sort of thing. Even if letters are written

in green ink (or worse), as long as they ask coherent questions and

there's a return address, they have to have a response. This is no

way to run a ministerial office.

Might be worth complaining to your MP about the lack of reply and

asking him to take it up with Ann Keen's office. You ought at least

to have a holding reply with an indication of when a pukka response

will be sent.

As for the NMC, that's the maddest answer I've heard yet. The poor

souls at the end of the re-registration helpline are having to make

it up as they go along because there's no proper policy or guidance

for them. And come to think about it, how could there be...?

How can it help public protection to have office and helpline staff

making ad hoc decisions to register professional practitioners like

this? We can all read the nonsense on the form. This is

unsustainable.

I too have a bit of work to follow up. I spoke to Gail from Unison

and she was going to check the small print and get back to me. Seems

to be taking her some time, so I shall pop a reminder in her maibox.

H

< >

From: Rowe <jean@...>

Date sent: Sat, 30 Aug 2008 13:36:00 +0100

Subject: Re:regulation: response to Tories

Send reply to:

[ Double-click this line for list subscription options ]

Dear All

I wrote to Ann Keen my MP some time ago and have never received a

reply to

my concerns. Since then I have had a reminder letter from the NMC to

Re-register. I rang the NMC and said that I could not fulfil the

nursing

requirement and therefore had decided that I could not re-register.

The man

who answered the phone was very patient and I read out the paragraph

on the

information they had originally sent to me to say that SCPHNs must

retain

their registration as a nurse/midwife. I explained that I could not

do this

and he said - oh it is Ok you can re-register. I said that I did not

understand this. He said that they had new guidance and he would send

it out

to me - I am still awaiting this 10 days later.

My colleague also has a problem so made enquiries at Bucks New

University

for return to practice courses. She received information on 2

courses. The

one for Specialist Community Public Health Nurses was £800 - which

she said

she would have difficulty in finding the money and the another was

for £520

for Adult, Child Mental health Nurses, Learning Disabilities and

Health

Visitors!! She then rang the NMC who could not explain the difference

and

said that they thought it was a mistake for adding Health visitors

for

inclusion on the cheaper course.

So the confusion reigns and I am so disenchanted with the whole

regulation

process to wonder whether why I would pay £76.00 for such a poor

service

that is meant to protect the public. I think the public should be

really

concerned.

------------------------------------

[Guest guest]

, you are right, although I suspect that it relates to the points that made; ministers are too busy worrying about whether to change their leader, or what will happen if they lose their seats at the next election to be concerned with an issue that their advisers tell them has been sorted.  But I also think (jumping in here ahead of Jean) that Ann Keen IS Jean's local MP.  So there is no other local MP that she can turn to.  On 30 Aug 2008, at 21:38, hwood@... wrote:Ann Keen ought to know better. But I'm also troubled by the longstanding lack of response to correspondence. There are civil service policies on this sort of thing. Even if letters are written in green ink (or worse), as long as they ask coherent questions and there's a return address, they have to have a response. This is no way to run a ministerial office.Might be worth complaining to your MP about the lack of reply and asking him to take it up with Ann Keen's office. You ought at least to have a holding reply with an indication of when a pukka response will be sent.As for the NMC, that's the maddest answer I've heard yet. The poor souls at the end of the re-registration helpline are having to make it up as they go along because there's no proper policy or guidance for them. And come to think about it, how could there be...?How can it help public protection to have office and helpline staff making ad hoc decisions to register professional practitioners like this? We can all read the nonsense on the form. This is unsustainable.I too have a bit of work to follow up. I spoke to Gail from Unison and she was going to check the small print and get back to me. Seems to be taking her some time, so I shall pop a reminder in her maibox.H< >From: Rowe <jean@....co.uk>Date sent: Sat, 30 Aug 2008 13:36:00 +0100Subject: Re:regulation: response to ToriesSend reply to: [ Double-click this line for list subscription options ] Dear AllI wrote to Ann Keen my MP some time ago and have never received a reply tomy concerns. Since then I have had a reminder letter from the NMC toRe-register. I rang the NMC and said that I could not fulfil the nursingrequirement and therefore had decided that I could not re-register. The manwho answered the phone was very patient and I read out the paragraph on theinformation they had originally sent to me to say that SCPHNs must retaintheir registration as a nurse/midwife. I explained that I could not do thisand he said - oh it is Ok you can re-register. I said that I did notunderstand this. He said that they had new guidance and he would send it outto me - I am still awaiting this 10 days later.My colleague also has a problem so made enquiries at Bucks New Universityfor return to practice courses. She received information on 2 courses. Theone for Specialist Community Public Health Nurses was £800 - which she saidshe would have difficulty in finding the money and the another was for £520for Adult, Child Mental health Nurses, Learning Disabilities and HealthVisitors!! She then rang the NMC who could not explain the difference andsaid that they thought it was a mistake for adding Health visitors forinclusion on the cheaper course.So the confusion reigns and I am so disenchanted with the whole regulationprocess to wonder whether why I would pay £76.00 for such a poor servicethat is meant to protect the public. I think the public should be reallyconcerned.------------------------------------

[Guest guest]

Dear allYesterday I attended a discussion forum with respect to a neonatal review that is going on in Essex. I was relieved that health visitors were mentioned as key people in delivering the Early Support Programme to these families but slightly worried about the talk of the need for neonatal outreach workers and the need for more neonatal O.T's who could go in to NNU's to meet the families before they then gave them intensive support n the community. I do believe that families need the best possible support from the right people with the right skills and expertise to help them but i did get the sense ( again) that other people are being invented to do a job that I thought health visitors always used to do i.e. provide additional and more intensive support to the people who need it most when it is needed. Unfortunately the mothers who were at the discussion also said that they hardly had any contact or support from their health visitor and one, who had just moved, had not seen a health visitor since she moved. I am wondering what happens elsewhere with this very vulnerable groups of children and families. LowenhoffOn 31 Aug 2008, at 09:26, Cowley wrote:, you are right, although I suspect that it relates to the points that made; ministers are too busy worrying about whether to change their leader, or what will happen if they lose their seats at the next election to be concerned with an issue that their advisers tell them has been sorted. But I also think (jumping in here ahead of Jean) that Ann Keen IS Jean's local MP. So there is no other local MP that she can turn to. On 30 Aug 2008, at 21:38, hwood@....co.uk wrote:Ann Keen ought to know better. But I'm also troubled by the longstanding lack of response to correspondence. There are civil service policies on this sort of thing. Even if letters are written in green ink (or worse), as long as they ask coherent questions and there's a return address, they have to have a response. This is no way to run a ministerial office.Might be worth complaining to your MP about the lack of reply and asking him to take it up with Ann Keen's office. You ought at least to have a holding reply with an indication of when a pukka response will be sent.As for the NMC, that's the maddest answer I've heard yet. The poor souls at the end of the re-registration helpline are having to make it up as they go along because there's no proper policy or guidance for them. And come to think about it, how could there be...?How can it help public protection to have office and helpline staff making ad hoc decisions to register professional practitioners like this? We can all read the nonsense on the form. This is unsustainable.I too have a bit of work to follow up. I spoke to Gail from Unison and she was going to check the small print and get back to me. Seems to be taking her some time, so I shall pop a reminder in her maibox.H< >From: Rowe <jean@....co.uk>Date sent: Sat, 30 Aug 2008 13:36:00 +0100Subject: Re:regulation: response to ToriesSend reply to: [ Double-click this line for list subscription options ] Dear AllI wrote to Ann Keen my MP some time ago and have never received a reply tomy concerns. Since then I have had a reminder letter from the NMC toRe-register. I rang the NMC and said that I could not fulfil the nursingrequirement and therefore had decided that I could not re-register. The manwho answered the phone was very patient and I read out the paragraph on theinformation they had originally sent to me to say that SCPHNs must retaintheir registration as a nurse/midwife. I explained that I could not do thisand he said - oh it is Ok you can re-register. I said that I did notunderstand this. He said that they had new guidance and he would send it outto me - I am still awaiting this 10 days later.My colleague also has a problem so made enquiries at Bucks New Universityfor return to practice courses. She received information on 2 courses. Theone for Specialist Community Public Health Nurses was £800 - which she saidshe would have difficulty in finding the money and the another was for £520for Adult, Child Mental health Nurses, Learning Disabilities and HealthVisitors!! She then rang the NMC who could not explain the difference andsaid that they thought it was a mistake for adding Health visitors forinclusion on the cheaper course.So the confusion reigns and I am so disenchanted with the whole regulationprocess to wonder whether why I would pay £76.00 for such a poor servicethat is meant to protect the public. I think the public should be reallyconcerned.------------------------------------

[Guest guest]

Hi ,

I'm wondering whether this isn't linked a bit of gap in the research

here. We all know the Olds work in the USA, but there's this UK

systematic review of home visiting which draws heavily on US based

research. I think that there's dearth of any UK based research

involving normal health visiting services which could have been

included.

The review is: Barlow J, Simkiss, D, -Brown S (2006)

'Interventions to prevent or ameliorate child physical abuse and

neglect: findings from a systematic review of reviews' Journal of

Children's Services, Volume 1 Issue 3 November 2006. I don't want to

infringe copyright, but could show you my .pdf copy if you couldn't

find it. You'd never know from reading it that there ever had been

any health visiting service in the UK and it makes it sound like the

best thing a governnment could do for children would be to emulate

this US research pronto. Maybe that's what's happening?

Reviews of reviews are considered very pukka, though they're often

quite narrowly focused and must exclude much which we'd find

informative as readers. This sort of thing can be influential for

policy makers, but the narrow focus the method requires may actually

give an odd impression. The same department at Warwick also did a

study of an Olds-type HV run service compared with a 'standard

services' group of families*. Sadly, it didn't say what 'standard

services' actually were and the groups of families couldn't easily be

matched in a smallish study. But it showed that their specially

trained HVs (or maybe just motivated HVs with reduced workloads??)

got some improved outcomes in relation to risk factors.

I just find the apparent 'editing out' of a whole service really

weird, but it could just be a touch of paranoia. And if I'm just

talking nonsense again, I can be confident that our excellent

academic colleagues will correct me!

* Barlow, J., , H., McIntosh, E., Jarrett, P., Mockford, C. &

-Brown, S. (2007) Role of home visiting in improving parenting

and health in families at risk of abuse and neglect: Results of a

multicentre randomised controlled trial and economic evaluation.

Archives of Disease in Childhood, 92(3), 229-233.

From: Lowenhoff

<project@...> Date sent: Sun, 31 Aug 2008 14:01:09

+0100 Subject: Re: Re:regulation: response to Tories

Send reply to:

Dear all Yesterday I attended a discussion forum with respect to a

neonatal review that is going on in Essex. I was relieved that

healthvisitorswere mentioned as key people in delivering the Early

SupportProgrammeto these families but slightly worried about the

talk of the need for neonatal outreach workers and the need for more

neonatal O.T's who could go in to NNU's to meet the families before

they then gave them intensive support n the community. I

dobelievethatfamiliesneed the best possible support from the

right people with the right skills and expertise to help them but i

did get the sense ( again) that other people are being invented to do

a job that I thought healthvisitorsalways used to do i.e. provide

additional and more intensive support to the people who need it most

when it is needed. Unfortunately the mothers who were at the

discussion also said that they hardly had any contact or support from

their health visitor and one, who had just moved, had not seen a

health visitor since she moved. I am wondering what happens elsewhere

with this very vulnerable groups of childrenandfamilies.

Lowenhoff

On 31 Aug 2008, at 09:26, Cowley wrote:

[Guest guest]

Hello and I must admit I ddn't even know there was such a thing as neonatal OT, although I am not surprised.   It is interesting how many specialist areas are developing, each with full multi-disciplinary teams. Shouldn't health visitors be part of these teams?I agree , that this used to be part of the routine HV work, when it was still considered proper to speak of health visiting services, with the aim of meeting needs as they arose.  Then we had the phase of 'if you are so busy, what can you give up that other people are doing?'  then as each service cut was accommodated, the pressure was on for health visitors to give up more and more.  Now, we are told via the health visiting review (which I am still resisting) that THE one and only 'role' for health visitors is to lead a team delivering the child health promotion programme.  The new CHPP is a great improvement on the last, and puts mental health promotion firmly on the map, but it is very short on details about physical health, or special or complex needs of any kind.   And you are right, , about systematic reviews. there is an excellent paper by Jane , which is not very easy to get hold of, which details the 'social construction of health visiting by research.'  ( J 1998  The social construction through research of health visitor domiciliary visiting.  Social Sciences in Health  4:  2, 90-103).  Basically, what she points out, is that only interventions validated by  randomised controlled trials and systematic reviews are acceptable, but that the organisation f services and construction of a profession requires so much more than that.  She draws on Berger's classic sociology of a country GP in 1950s as 'a fortunate man' and a traditional/archetypal  professional, which is no longer acceptable, because of the current constructions of 'evidence.'   Where does it leave health visiting?  The great problem now, is that we are so short of staff, and have disappeared off the radar in so many places, that it is very hard to maintain a presence in all these different multi-disciplinary teams.  I do think we need to keep trying, though, because outreach from hospital services is all very well (and probably a  good idea in the short term) but there is still a need for long term, informed support for families.  Apart from anything else, parents who have been through the trauma of having a child  in NNUs need both information about the particular, special needs that took the infant there, and what woudl be expected under 'normal' circumstances, so they can get back to that 'normal' position if at all feasible.   Bring back the idea of 'health visiting services,' I say, with a time allowance that enables practitioners to engage as and when needed.  On 31 Aug 2008, at 17:41, hwood@... wrote:Hi ,I'm wondering whether this isn't linked a bit of gap in the research here. We all know the Olds work in the USA, but there's this UK systematic review of home visiting which draws heavily on US based research. I think that there's dearth of any UK based research involving normal health visiting services which could have been included. The review is: Barlow J, Simkiss, D, -Brown S (2006) 'Interventions to prevent or ameliorate child physical abuse and neglect: findings from a systematic review of reviews' Journal of Children's Services, Volume 1 Issue 3 November 2006. I don't want to infringe copyright, but could show you my .pdf copy if you couldn't find it. You'd never know from reading it that there ever had been any health visiting service in the UK and it makes it sound like the best thing a governnment could do for children would be to emulate this US research pronto. Maybe that's what's happening?Reviews of reviews are considered very pukka, though they're often quite narrowly focused and must exclude much which we'd find informative as readers. This sort of thing can be influential for policy makers, but the narrow focus the method requires may actually give an odd impression. The same department at Warwick also did a study of an Olds-type HV run service compared with a 'standard services' group of families*. Sadly, it didn't say what 'standard services' actually were and the groups of families couldn't easily be matched in a smallish study. But it showed that their specially trained HVs (or maybe just motivated HVs with reduced workloads??) got some improved outcomes in relation to risk factors. I just find the apparent 'editing out' of a whole service really weird, but it could just be a touch of paranoia. And if I'm just talking nonsense again, I can be confident that our excellent academic colleagues will correct me!* Barlow, J., , H., McIntosh, E., Jarrett, P., Mockford, C. & -Brown, S. (2007) Role of home visiting in improving parenting and health in families at risk of abuse and neglect: Results of a multicentre randomised controlled trial and economic evaluation. Archives of Disease in Childhood, 92(3), 229-233. From: Lowenhoff <projectlowenhoff (DOT) demon.co.uk> Date sent: Sun, 31 Aug 2008 14:01:09 +0100 Subject: Re: Re:regulation: response to Tories Send reply to: Dear all Yesterday I attended a discussion forum with respect to a neonatal review that is going on in Essex. I was relieved that healthvisitorswere mentioned as key people in delivering the Early SupportProgrammeto these families but slightly worried about the talk of the need for neonatal outreach workers and the need for more neonatal O.T's who could go in to NNU's to meet the families before they then gave them intensive support n the community. I dobelievethatfamiliesneed the best possible support from the right people with the right skills and expertise to help them but i did get the sense ( again) that other people are being invented to do a job that I thought healthvisitorsalways used to do i.e. provide additional and more intensive support to the people who need it most when it is needed. Unfortunately the mothers who were at the discussion also said that they hardly had any contact or support from their health visitor and one, who had just moved, had not seen a health visitor since she moved. I am wondering what happens elsewhere with this very vulnerable groups of childrenandfamilies. Lowenhoff On 31 Aug 2008, at 09:26, Cowley wrote: sarahcowley183@...http://myprofile.cos.com/S124021COn

[Guest guest]

Dear

I fear it may be a bit of a post code lottery depending on where you live and the HV resource they have. Where I work this type of family would receive good HV support if the communication systems and liaison services work well. I have always tried to make contact with the family if I didn't already know them before the baby left NICU/SCBU and usually try to visit the parent/parents on the unit before discharge. As the hospital is within a 20 minute drive this is a possibility. Often however the baby may out of area or the hospital a long distance away. Trying to make contact with parents who have other children and a lot of travelling to and from hospital can present quite a challenge. They are often busy and stressed and it is another thing for them to fit into an already overcrowded life. I think this contact is important if the baby is in for a long time. The parents really value the effort you make.

How ever the truth is now HV services in so many areas are so stretched this is impossible. I am neonatal intensive care trained (a long time ago now) but know how important support for these parents. from a personal point of view I also had a son in SCBU which was a scary experience as a mother. I feel very sad by the example you give, however the reality is that community staff nurses are doing the transfer in visits in many areas and some areas have weighing clinics run by the nursery nurse, so it is possible they may not clap eyes on a HV ever. In some areas it is being proposed that NBV to non-vulnerable families can be done by a community staff nurse. As the CHCPP doesn't specify a NBV by a HV but mentions a health care professional many PCTs are interpreting this as NBV by CSN or nursery nurses. HV's are increasingly managing skill mix teams and delegating work to them as per their own PCTs CHCPP which relies heavily on other grades of staff doing the work HVs traditionally did.

I am all for the appropriate use of skill mix and there is certainly a role for skill mix in HV teams but not at the expense of dumbing down the HV service and trying to provide it on the cheap.

Rant over

Best wishes

Maggie

Re:regulation: response to ToriesSend reply to: [ Double-click this line for list subscription options ] Dear AllI wrote to Ann Keen my MP some time ago and have never received a reply tomy concerns. Since then I have had a reminder letter from the NMC toRe-register. I rang the NMC and said that I could not fulfil the nursingrequirement and therefore had decided that I could not re-register. The manwho answered the phone was very patient and I read out the paragraph on theinformation they had originally sent to me to say that SCPHNs must retaintheir registration as a nurse/midwife. I explained that I could not do thisand he said - oh it is Ok you can re-register. I said that I did notunderstand this. He said that they had new guidance and he would send it outto me - I am still awaiting this 10 days later.My colleague also has a problem so made enquiries at Bucks New Universityfor return to practice courses. She received information on 2 courses. Theone for Specialist Community Public Health Nurses was £800 - which she saidshe would have difficulty in finding the money and the another was for £520for Adult, Child Mental health Nurses, Learning Disabilities and HealthVisitors!! She then rang the NMC who could not explain the difference andsaid that they thought it was a mistake for adding Health visitors forinclusion on the cheaper course.So the confusion reigns and I am so disenchanted with the whole regulationprocess to wonder whether why I would pay £76.00 for such a poor servicethat is meant to protect the public. I think the public should be reallyconcerned.------------------------------------