RCN fears ‘dumbing down’ health visits

Department of Health plans published alongside the health white paper show the DH hopes to recruit 4,200 so called “Sure Start health visitors” by 2015 and envisages revising the training curriculum in order to do so.

HSJ has learned options being considered include “on the job” training and validating nurses with relevant hospital experience as competent to work alone as health visitors in the community.

Health visitor numbers have fallen dramatically. In 1988 there were 10,680 full time equivalents but by September 2009 this had fallen to 8,519.

But proposals to rapidly increase the workforce by changing the training requirements have led to concerns the health visitor role could be “dumbed down”.

Royal College of Nursing chief executive and general secretary Peter Carter told HSJ’s sister title Nursing Times: “We’re talking with the government and [are] wanting to ensure we don’t dumb down the standards.”

He said: “They wouldn’t use that expression. But it is a concern we have.”

At present, rules dictate that health visitors must be qualified nurses, generally with at least two years’ practice, who have completed a further degree level course of at least a year.

Skills include working independently - in contrast to hospital nursing - and leading a team.

Courses cover management and leadership, research, public health and prescribing.

But Mr Carter said discussions at the DH centred on questions such as: “Is current training over elaborate; is it really needed?”

HSJ understands the DH is also exploring how nurses working in hospitals might be given a health visiting qualification through an “accredited prior learning” model or “on the job” training.

Direct entry courses are also being considered which would mean students could train to be health visitors without obtaining a nursing degree first, similar to midwifery courses.

A spokeswoman for the DH said: “We are working with the Nursing and Midwifery Council, NHS and professional bodies looking at how the entry standards can be achieved through more flexible ways of training.”