Primary care trusts (PCTs) have been challenged with placing greater emphasis on addressing public health issues and tackling health inequalities, which has implications for the way in which community practitioners deliver their service. Health visitors recognise that they need to be able to work more flexibly, so that they can more readily respond to change and also have the opportunity to work alongside other agencies to enable them to address health inequalities in a meaningful way. This has encouraged the health visitors on the Isle of Sheppey, Kent, to examine their practice and the way in which they deliver their service. They have identified where changes could be made in order to afford them the time and resources that they might contribute to the government's and the PCT's vision regarding public health. A model of clinical effectiveness underpinned this process. A number of issues relating to health visiting practice were raised and debated within this process, and these include the merits of providing a universal service or a more targeted service, home visiting or groupwork and working with a corporate case-load or single case-load. This paper describes the initial stages of a change process designed to enable a refocusing of health visiting practice in order to create opportunities for new community-based initiatives.
Community Practitioner - the journal of the Community Practitioners' and Health Visitors' Association (Unite/CPHVA) - has a readership that includes over 20,700 healthcare professionals who work in the community, caring for over 5,000,000 clients, patients and families across the UK. These comprise health visitors, school nurses, district nurses, practice nurses, community paediatric nurses, community nursery nurses and other community-based practitioners.