Nursery nurses and healthcare support workers could be recruited to health visiting teams in a bid to increase capacity and improve retention rates in the profession, HSJ’s sister title Nursing Times has learned.

The idea is among several the Department of Health is exploring to meet its commitment to increase health visitor numbers by 4,200 over the next four years.

A draft version of the DH’s Health Visitor Implementation Strategy 2011-15 seen by Nursing Times calls for a “comprehensive programme of action to increase entry and retention, scaling up current training plans and capacity, and looking rapidly at scope for more flexible training routes to achieve health visitor qualification”.

The draft says the DH is to explore the feasibility of conversion courses for related professions and the Nursing and Midwifery Council has been asked to review entry requirements for specialist community public healthnurses on its register.

Nursing unions and others have raised concerns that the drive to increase health visitor numbers would lead to a “dumbing down” of the profession and the introduction of direct entry courses - meaning students could train as health visitors without first needing to qualify as a nurse or midwife.

However, an NMC spokeswoman told Nursing Times that direct entry courses would not be considered as part of its review. Instead it will look at how higher education institutions might provide more course modules relevant to health visiting.

She said: “We are working with educators to find areas of flexibility within their programmes that will allow people to gain the knowledge and skills needed [to gain] entry to the specialist community public health nursing part of the register.”

Council of Deans of Health director of policy Matthew Hamilton said the flexibility would come through increasing “accredited prior experiential learning” (APEL), where nurses who have experience working in community settings could receive credits towards their registration.

But Obi Amadi, Unite lead professional officer for health visitors, raised a note of caution. “I have no problem with them promoting APEL more widely but absolutely no way should the requirement or standard for APEL be lowered,” she said.

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