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A funding model for health visiting (part 2): impact and implementation
- Author:
- COWLEY Sarah
- Journal article citation:
- Community Practitioner, 80(12), December 2007, pp.24-31.
- Publisher:
- Community Practitioners' and Health Visitors' Association
This is the second of two papers offering the information required to work out how to fund a health visiting service. This paper focuses on three background issues: service components, service scope and skill mix. In this way, it beings to describe the programmes embedded within a generic health visiting service. It then highlights the impact and outcomes that might be anticipated from delivering the kind of service funded by this model.
A funding model for health visiting: baseline requirements - part 1
- Author:
- COWLEY Sarah
- Journal article citation:
- Community Practitioner, 80(11), November 2007, pp.18-24.
- Publisher:
- Community Practitioners' and Health Visitors' Association
A funding model proposed in two papers will outline the health visiting resource, including team skill mix, required to deliver the recommended approach of 'progressive universalism', taking account of health inequalities, best evidence and impact on outcomes that might be anticipated. This paper concentrates on funding required for a service for families with new babies and the first year of life. Practical implications, anticipated impact, policy priorities and the wider service issues are addressed in a second paper.
Early interventions: evidence for implementing sure start
- Author:
- COWLEY Sarah
- Journal article citation:
- Community Practitioner, 72(6), June 1999, pp.162-165.
- Publisher:
- Community Practitioners' and Health Visitors' Association
As the government's Sure Start trailblazers prepare to come on line. This article looks at the research literature which demonstrates that early intervention can improve long-term health outcomes.
Reflecting on the past; preparing for the next century
- Author:
- COWLEY Sarah
- Journal article citation:
- Health Visitor, 69(8), August 1996, pp.313-316.
- Publisher:
- Health Visitors' Association
The author, senior lecturer in the department of nursing at Kings College, London, follows the progress of health visiting through the history of public health, and looks at how recurring themes and lessons from the past can help the profession to move forward.
Achieving positive outcomes: principles and process
- Author:
- COWLEY Sarah
- Journal article citation:
- Health Visitor, 69(1), January 1996, pp.17-19.
- Publisher:
- Health Visitors' Association
Argues that although 'gold standard' evidence of the effectiveness of health visiting may be lacking, this does not mean health visitors work is ineffective. The author outlines the difficulties in evaluating a service whose outcomes are, by nature, long-term, and the effects of which are mainly intangible and often unpredictable.
Controversial questions (part three): is there randomised controlled trial evidence for health visiting?
- Authors:
- COWLEY Sarah, BIDMEAD Christine
- Journal article citation:
- Community Practitioner, 82(8), August 2009, pp.24-28.
- Publisher:
- Community Practitioners' and Health Visitors' Association
Questions are often asked by managers, commissioners and policy-makers to find out what is, or should be, happening within health visiting services. This is the final paper in a series of three that draws on the experience of providing evidence to the Health Select Committee's 2008 inquiry into health inequalities. Material submitted has been adapted and expanded according to three common, often controversial questions. This paper considers the relevance and place of randomised controlled trials in relation to health visiting services. Increasingly, commissioners require that services and programmes that they fund to be supported by this form of evidence, and many ask, 'Is there a randomised controlled trial of health visiting?' The immediate answer to this question is 'no', but there is a wealth of evidence relevant to health visiting, much of it from experimental research and systematic reviews. The question itself is not appropriately framed, so three alternative questions are proposed - What needs doing? How should it be done? Who should do it? - that can help to guide a search for evidence that is relevant to health visiting
Controversial questions (part one): what is the right size for a health visiting caseload?
- Authors:
- COWLEY Sarah, BIDMEAD Christine
- Journal article citation:
- Community Practitioner, 82(6), June 2009, pp.18-22.
- Publisher:
- Community Practitioners' and Health Visitors' Association
This paper is the first in a short series of three that draw on health visitors experience of providing evidence to the Health Select Committee's 2008 inquiry into health inequalities. A formal process of seeking written evidence was followed up with specific questions in oral session, asked by committee members, trying to find out about how health visiting services relate to health inequalities. This line of questioning reflects concerns expressed elsewhere about the variability of health visiting services across the country and the lack of clear alignment to areas of deprivation, leading to calls for an increase in targeted services, instead of universal ones. This paper explores the notion of 'caseload', the distribution of services according to levels of deprivation and delivery of a universal or targeted health visiting service.
Evaluating family partnership training in health visitor practice
- Authors:
- BIDMEAD Christine, COWLEY Sarah
- Journal article citation:
- Community Practitioner, 78(7), July 2005, pp.239-245.
- Publisher:
- Community Practitioners' and Health Visitors' Association
This study examines the effects of family partnership (parent adviser) training which builds on health visitor's skills to facilitate partnership working with parents. Three health visitors, who took part of a training group of 12, took part in the qualitative research using stimulated recall methodology. The quantitative date was collected from the whole training group using the Constructions of Helping questionnaire and the course evaluation form. The findings suggest that family partnership training may be effective in enhancing partnerhship working in health visiting and that the stimulated recall methodology is an effective method of identifying the process of interaction.
A concept analysis of partnership with clients
- Authors:
- BIDMEAD Christine, COWLEY Sarah
- Journal article citation:
- Community Practitioner, 78(6), June 2005, pp.203-208.
- Publisher:
- Community Practitioners' and Health Visitors' Association
The aim of this first paper of two about partnership working with clients is to define and clarify partnership as it is practised within health visiting, by identifying the central notions of partnership working in practice. A literature search was undertaken to identify ways in which previous authors have used the concept within nursing, counselling and health visiting. Rodgers' approach to concept analysis was undertaken to seek clarity for the concept. This revealed the ways in which various authours have used the word, an analysis of its defining attributes, surrogate terms, antecedents, consequences and a concluding definition. The results showed that partnership with clients in health visiting can be defined as a respectful, negotiated way of working together that enables choice, participation and equity, within an honest, trusting realtionship that is based in empathy, support and reciprocity. It is best established within a model of health visiting that recognises partnership as a central tenet. It requires a high level of interpersonal qualities and communication skills in staff who are, themselves, supported through a system of clinical supervision that operates within the same partnership framework.
Investigating how health visitors define vulnerability
- Authors:
- NEWLAND Rita, COWLEY Sarah
- Journal article citation:
- Community Practitioner, 76(12), December 2003, pp.464-467.
- Publisher:
- Community Practitioners' and Health Visitors' Association
Outlines the findings of a research project that sought to identify the components within health visitors' definitions of vulnerability and the influence these had on subsequent health visitor interventions with families within the community. Twelve health visitors took part in semi-structured interviews using a modification of the Critical Incident Technique. Ethical approval was gained from the ethics committees of the university and both community NHS Trusts. Qualitative analysis identified the presence of specific themes, highlighting the features that informed the definition of vulnerability and the health visitors' subsequent actions. Vulnerability constituted a concept given to the identification of specific micro and macro levels of 'need' including social isolation, family size and composition and accommodation limitations. The health visitors demonstrated an ability to articulate and justify their actions and make rational clinical decisions based on personal knowledge and experience. Their actions constituted a three-stage cyclical process in which an interpretation of the situation preceded the implementation and evaluation of the interventions.