Essay Sample on Loss of Health Visitor Services: Impact of Local Commissioning Model

Introduction

In 2015, the local authorities completely received the health visiting commission from the National Health Service(NHS). This affected the quality of services delivered by health visitors and the health visitors-NHS relationship (IHV, 2018) partly due to cuts of health budgets in the public sector and the reduction in a close working relationship with NHS (IHV, 2018). The local commissioning model has witnessed close to a 20% loss in the workforce over the last three years (IHV, 2018). As such, a combined model between the NHS and the local authority governance has been proposed. The NHS 10-year plan has a specific focus on prevention and mental health, and children (IHV, 2018). The following paper will review the implication of the Institute of Health Visiting (IHV) position statement, that is, the NHS and health visiting in ten years.

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The position statement outlines recommendations to strengthen health-visiting and improve children outcomes. The primary focus of the statement is children services, improvement of mental health, prevention, and reduction of inequalities (IHV, 2018).

The NHS long term plan recognizes that medicine is advancing, health needs are changing, and society is developing, and a suitable service is needed for the future (NHS, 2019). The NHS long term plan aims at delivering world-class care, give an excellent start in life, and help people age well (NHS, 2019). The NHS long term plan is to be delivered by doing things differently, tackling health inequalities, and preventing illness. Through backing the workforce, efficient utilization of digital technology and data, and maximizing investment in NHS by taxpayer's will also ensure the plan is delivered (Luker, McHugh & Bryar, 2016).

Over the next ten years, the health visiting and the NHS propose a joint commissioning model that is based on the principle of proportionate universalism in tackling inequalities and supports health visitor's leadership role in delivering Healthy Child Program (HCP) (Luker, McHugh & Bryar, 2016). Again the model aims at providing a health visiting service that is well-staffed, supported and trained and also resource health visitors in leading infant as well as perinatal mental health (Luker, McHugh & Bryar, 2016). The proposed model also ensures health visitors lead in supporting the health needs of the vulnerable and marginalized children (Luker, McHugh & Bryar, 2016).

The Implication of the Health Visiting and the NHS

Alexis, Vydelingum, and Robbins (2006) reported a significant difference in equivalent opportunity policies in NHS in the UK as well as their implementation. The implication for the health visiting and NHS is that the long term plan could encourage managers in re-examining equal opportunity policies and reduce inequality significantly.

The health visiting and the NHS long term plan is expected to develop and unleash the maximum potential for practitioners, impact the relationship between practitioners and their team effectiveness via clinical leadership and also shape contribution by practitioners in transforming future healthcare (Manley & Greaves, 2016).

The introduction of health information technology (HIT) is often faced by tensions among local and national strategies of implementing the HIT and a poor fit between the HIT design and healthcare work system (Waterson, 2014). Since health visiting and NHS long term plan aim to efficiently use data and digital technology to maximize taxpayer's investment in NHS, the plan could be a solution to the implementation of HIT in healthcare.

The health visiting is expected to increase the trusting relationship between patients and practitioners and between practitioners themselves. Again, it is expected to strengthen the weakening prevention activities in primary care (Bryar, Cowley, Adams, Kendall & Mathers, 2017). Health visitors lack role awareness or role overlap which affect the working relationships (Machin & Pearson, 2013). The health visiting and NHS long term plan are expected to improve awareness and clarity of the roles, experiences, and outcomes for HV. The improved recognition of roles will deliver positive health outcomes and reduce inequalities (Machin & Pearson, 2013).

The other implication of the health visiting is that it will address the challenge of marrying the long-standing valued professional approaches for health practitioners to the recent technological advancements alongside evidence-based techniques (Cowley et al., 2013). The health visiting is also expected to increase opportunities for early identification and monitoring of wellbeing and health concerns (Doi, Jepson & Hardie, 2017). Further, it creates a structure for an effective partnership which will ensure children and families are supported (Doi, Jepson & Hardie, 2017).

Conclusion

Health visiting has a significant role in promoting health and preventing ill-health. As such, it is evident that health visiting is significant in searching health needs as well as stimulating their awareness. Further, it aims to influence policies that impact health and enable health-enhancing undertakings. The overall implication of the health visiting and NHS long term plan is to support self-determination and active participation by clients to improve their health. The second implication is to promote health improvement for children, families, and society. Further, the practice ensures the use of evidence-based approaches in a cost-effective manner for the marginalized groups. Lastly, these practices ensure that they are equitably delivered across populations and reduces impacts resulting from health inequalities.

References

Alexis, O., Vydelingum, V., & Robbins, I. (2006). Overseas nurses' experiences of equal opportunities in the NHS in England. Journal of Health Organization and Management, 20(2), 130-139. doi:10.1108/14777260610661529

Bryar, R. M., Cowley, D. S. A., Adams, C. M., Kendall, S., & Mathers, N. (2017). Health visiting in primary care in England: a crisis waiting to happen? British Journal of General Practice, 67(656), 102-103. doi:10.3399/bjgp17x689449

Cowley, S., Whittaker, K., Grigulis, A., Malone, M., Donetto, S., Wood, H., ... & Maben, J. (2013). Why Health Visiting? A review of the literature about key health visitor interventions, processes, and outcomes for children and families. National Nursing Research Unit, King's College London.

Doi, L., Jepson, R., & Hardie, S. (2017). Realist evaluation of an enhanced health visiting programme. PLOS ONE, 12(7), e0180569. doi:10.1371/journal.pone.0180569

IHV. (2018, September 3). iHV publishes its 10-year plan for health visiting. Retrieved from https://ihv.org.uk/news-and-views/news/ihv-publishes-its-10-year-plan-for-health-visiting/

Luker, K. A., McHugh, G. A., & Bryar, R. M. (Eds.). (2016). Health Visiting: Preparation for Practice. John Wiley & Sons.

Machin, A. I., & Pearson, P. (2013). Health visitors' interprofessional working experiences: Implications for their collaborative public health role. Journal of Health Visiting, 1(1), 31-38. doi:10.12968/johv.2013.1.1.31

Manley, K., & Greaves, J. (2016). Implementing & evaluating a community of practice for health visiting-final report.

NHS. (2019, September 10). NHS England, >> NHS Long Term Plan. Retrieved from https://www.england.nhs.uk/long-term-plan/

Waterson, P. (2014). Health information technology and sociotechnical systems: A progress report on recent developments within the UK National Health Service (NHS). Applied Ergonomics, 45(2), 150-161. doi:10.1016/j.apergo.2013.07.004