Anorexia ARFID - Community Practitioner

Page created by Marcus Moran
Anorexia ARFID - Community Practitioner

                                                                                                            JULY / AUGUST 2021



    Binge eating
    Other specified
                                                                               Eating disorders among children and
                                                                               young people have rocketed during the
                                                                               pandemic. Is there enough support and
                                                                               awareness out there?

Cover_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 1                                            08/07/2021 15:24
Anorexia ARFID - Community Practitioner

                        BAUME AP+M
                        [AQUA POSAE] + [MICRORÉSYL]
                        FROM THE 1ST DAY OF LIFE

                                                                                STUDY PROVES
                                                                                   LIPIKAR AP
                                                                                     IS A COST

                                                                                  SCAN HERE
                                                                                  TO LEARN MORE

                                   Cabout E, Eymere S, Launois R, Aslanian F, Taïeb C, Seité S. Cost Effectiveness of Emollients in the
                               Prevention of Relapses in Atopic Dermatitis. Clin Cosmet Investig Dermatol. 2020 Dec 21;13:987-996.
                                                             doi: 10.2147/CCID.S279233. PMID: 33376376; PMCID: PMC7762264.

                                                                            FOR HEALTHCARE PROFESSIONAL USE ONLY

CPJULY2021.002.indd 2                                                                                                              07/07/2021 10:01
Anorexia ARFID - Community Practitioner
                                               S          July / August 2021 | Vol 94 | No 04

           COVER STORY

           1.25 million
           people affected by an eating                                                                                                  32
               disorder in the UK.
                                                                                                                                         Why SCID
                  25% are male                                                                                                            is joining
                                                                                                                                         the list of
                                                                                                                                     newborns are
                                                                                                                                      screened for
           29       The most common vision problem
                    you’ve never heard of                                                                             What you like, what you

                                                                34                                                    love, about your journal
                                                                                                                      - the results are now in
                                                                A look at
                                                                and lactation

                                                                                           waiting lists
                                                                                           are having a
                                                                                           effect on
                                                                                           public health

       NEWS                                   14 BIG STORY                            22 HERE’S WHAT                    29 CLINICAL
                                                 More than five million                  YOU TOLD US                       Cerebral visual impairment:
       7    NEWS IN NUMBERS                      people are on NHS                       Key findings from the             mixed messages between
            Your at-a-glance guide               waiting lists. Is this                  Community Practitioner            brain and eye
                                                 storing up trouble for                  2021 readership survey
       8    PUBLIC HEALTH LATEST                 our children’s health?                                                 32 SPOTTING THE DANGER
            A look at what’s new                                                      PRACTICE                             An evaluation of
                                               OPINION                                                                     blood spot screening
       10 PROFESSIONAL UPDATE                                                         24 CONFERENCE SPECIAL                for severe combined
          Your latest round-up                20 CNO REFLECTION                          Health and wellbeing for          immunodeficiency
                                                 AND THANK YOU                           all ages: experts on the
       12 GLOBAL RESEARCH                        Chief nursing officers                  key issues for CPs through     34 THE RIGHT TO FEED
          Recent findings from                   on how CPs stepped up                   a Covid lens, from                Lactation for all across
          around the world                       during the pandemic                     resilience to vaccination         the gender spectrum

                                                          COMMUNITY PRACTITIONER | JULY / AUGUST 2021

CONTENTS_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 3                                                                        09/07/2021 15:43
Anorexia ARFID - Community Practitioner
Problem                                                                                            Solved
         Passive safety pen needles protect
          you from needlestick injuries, but
         come with challenges of their own:

                           Lack of needle visibility1

                             Premature activation
                          of the safety mechanism1

                             Limited control during
                             the injection process1

                                                                                                        If you were given more control,
              71% agreed that the safety pen needle
               activates before they have finished                                                                you’d take it
                   administering the injection1
                                                                                                            For product information visit

            69% agreed that premature activation of
           the safety pen needle makes them unsure
                                                                                                                                                                              © Copyright Owen Mumford 2020

             that the full medication dose had been
                    delivered to the patient*1

        * Of the 71% of healthcare professionals who had experienced safety pen
          needles activating before they had finished administering the injection.
        1. Project Saturn A (2017) Online study commissioned with an independent
           market research agency. Data on file.

                                                            Owen Mumford Ltd, Primsdown Industrial Estate, Worcester Road, Chipping Norton, Oxfordshire OX7 5XP, United Kingdom
                                                            T : +44 (0)1608 645555 E :

CPJULY2021.004.indd 4                                                                                                                                                    05/07/2021 15:24
Anorexia ARFID - Community Practitioner
                                                                                                       Best Magazine for a Professional Association
                                                                                                   or Membership Organisation 2020 Memcom Awards

       38 COVER STORY
          What’s behind the rise in
          eating disorders? Between 2016
          and 2020, rates of referrals for
          eating disorders doubled across
                                                                              from your editor, Aviva
          England. Since March 2020,
          rates have doubled again. Is it a                                   As we edge ever closer to that elusive ‘normal’ way of life, there are plenty of
          way of expressing distress? A life                                  reminders that, even if Covid ceased to exist tomorrow, the impact would continue
          lived through social media? Or                                      to be felt. And of course Covid isn’t going to simply vanish. On page 14, our Big story
          lockdown itself?                                                    looks at the waiting times facing children and young people for all kinds of services
                                                                              – not just surgical procedures, but CAMHS and dental appointments too.
        RESEARCH                                                                 This issue’s cover feature on page 38 tackles the sharp rise in eating disorders
                                                                              among children and young people during the pandemic. An upward trend had already
       44 COMMUNITY NURSING                                                   started pre-Covid. What’s going on? Is there enough support and awareness out there
          STUDENTS’ EXPERIENCES OF                                            generally? And how you can help to spot the signs of an eating disorder early on?
          USING E-PORTFOLIOS                                                     There’s no doubt that life has been a challenge for many, and with that in mind,
          Exploring the perceptions of                                        the Unite-CPHVA one-day conference focused on health and wellbeing for all ages
          nurses when using e-portfolios to                                   (highlights on page 24). And on page 20, three chief nursing officers offer a heartfelt
          record their work. Cathy Taylor                                                                                                      thank you to all CPs as
          of Swansea University discusses                                                                                                      they reflect on the past
          the benefits and pitfalls of digital                                                                                                 18 months or so.
          recording, and its potential for                                                                                                        Other topics covered
          expansion across health visiting                                                                                                     this issue include
                                                                                                                                               equality for people with
        PROFESSIONAL PAUSE                                                                                                                     a learning disability
                                                                                                                                               (page 48)and inclusive
       48 TREAT ME WELL                                                                                                                        lactation (page 34).
          People with a learning disability                                                                                                       Finally, discover the
          suffer health inequalities from an                                                                                                   latest readership survey
          early age, and they are more likely                                                                                                  findings on page 22, and
          to die younger and more avoidably.                                                                                                   please keep letting us
          Closing these gaps must start at the                                                                                                 know what you think.
          earliest possible moment, says Paul
          Donnelly, head of campaigns at                                                                       JOIN THE CO
          learning disability charity Mencap

                                                 Non-member subscription rates                     Editorial team                              Obi Amadi Jane Beach and Dave Munday
                                                 Individual (UK)                 £135.45           Editor Aviva Attias                         Printed by Warners
                                                 Individual (rest of world)      £156.45 
                                                 Institution (UK)                £156.45           Group content sub-editor James Hundleby     © 2021 Community Practitioners’ and
                                                                                                                                               Health Visitors’ Association
                                                 Institution (rest of world)     £208.95           Head of content (health) Emma Godfrey       ISSN 1462-2815
       Unite-CPHVA                                                                                 Executive editor Gavin Fergie
                                                                                                                                               The views expressed do not necessarily
       Existing Unite-CPHVA members with         Subscription enquiries may be made to             Clinical editor Pippa Atkinson              represent those of the editor nor of
       queries relating to their membership      Community Practitioner subscriptions              Senior designer Nicholas Daley              Unite-CPHVA.
       should contact 0845 850 4242 or see       Redactive Publishing Ltd                          Picture editor Akin Falope                  Paid advertisements in the journal do for     PO Box 35                                         Advertising                                 not imply endorsement of the products
       further details.                          Robertsbridge TN32 5WN                                                                        or services advertised.
                                                                                                   020 7880 6244
       To join Unite-CPHVA, see                  01580 883844                                 Any Unite-CPHVA member wishing to                                                                                                 change their contact details must get
                                                                                                   Recruitment                                 in touch with their local Unite office.
                                                 The journal is published on behalf of             020 7880 7621
       Unite-CPHVA is based at                   Unite-CPHVA by Redactive Media Group,
       128 Theobald’s Road London WC1X 8TN                                               
                                                 78 Chamber Street, London E1 8BL
       020 3371 2006                                                                               Production                                          Recycle your magazine’s plastic
                                                 020 7880 6200
                                                                                                   Production director Jane Easterman                  wrap – check your local LDPE
                                                 Editorial advisory board                                                                              facilities to find out how.
       Community Practitioner                    Obi Amadi Barbara Evans                           Unite health sector officers
       Unite-CPHVA members receive the journal   Gavin Fergie Elaine Haycock-Stuart                National officers Jacalyn Williams and
       free. Non-members and institutions may    Michelle Moseley Christopher Sweeney              Colenzo Jarrett-Thorpe. Lead professional
       subscribe to receive it.                  Janet Taylor                                      officers Gavin Fergie Ethel Rodrigues

                                                              COMMUNITY PRACTITIONER | JULY / AUGUST 2021

EDITORIAL_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 5                                                                                                   09/07/2021 15:43
Anorexia ARFID - Community Practitioner

                                                             Based on the true story of
                                                             an extraordinary discovery
                                                             on the Labor and Delivery
                                                               wards of 19th century
                                                             Vienna  that would forever
                                                               change the practice of

                                                                 Available now at Amazon and
                                                                 other book sellers

                                           5-Star
                                                5 Star Amazon R
        “Superb storytelling,         “Great, entertaining, easily      “Relevant, timely and
        fascinating read, and a       readable story of an important    compelling”
                                      hero of medical discovery”
        cautionary tale”                                                “An extraordinarily interesting
                                      “I couldn’t put this book down”   and enjoyable read”
        “In every sense, a stunning
        book”                         “Brilliant!”                      “Read it now”

Unclean Hands FP CP 270X210.indd
CPJULY2021.006.indd  6           1                                                                        08/02/2021
                                                                                                          05/07/2021 16:06
Anorexia ARFID - Community Practitioner

            NEWS IN NUMBERS
                                                                                                                More than

                                                                                                                2 million
        watershed                                                                                 Cough
                                                                                                                    adults in England may have had
                                                                                                                    long Covid, a study of more than
                                                                                                                        500,000 adults found.
                                                                                                                 Around 37% of those who self-reported
            Adverts of foods high in fat, salt and sugar
                                                                                                                 Covid experienced at least 1 symptom
             can only be shown from 9pm to 5.30am
                                                                                                                         for 12 weeks or more.
             on TV (and UK on-demand programmes)                                                 Headache
                    from the end of next year.                                                                    Almost 15% had 3 or more symptoms
                                                                                                                          for at least 12 weeks.
                There will also be new rules for online
                  promotion (paid-for adverts), the                                                              Women were more likely to suffer, with
                      government announced.                                                                     increasing age a factor. The government
                                                                                                                    has provided £50m for research
               The new restrictions could remove up                                              Shortness
                                                                                                 of breath
             to 7.2 billion calories from children’s diets
               per year in the UK, which in time could
               reduce the number of obese children
                         by more than 20,000


                                                                                                   young people aged 18 to 25 in Scotland
                                                                                                       are set to benefit from free NHS
                                                                                                     dental care from the end of August,

                                                                                                      subject to parliamentary approval

                                    Find links to relevant reports and surveys highlighted in the news stories at

                                                                COMMUNITY PRACTITIONER | JULY / AUGUST 2021

    NEWS In numbers_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 7                                                        08/07/2021 15:27
Anorexia ARFID - Community Practitioner

      PUBLIC HEALTH LATEST                                                                                                                    KEY

                     CHILDHOOD TO DRIVE AWARENESS AND ACTION                                                                                   Video
                                                                                                  come’, the Duchess said in a video
                                                                                                  for the launch.
                                                                                                     The centre will focus on three
                                                                                                  areas of activity: promoting and
                                                                                                  commissioning research; working
                                                                                                  with people across the private,
                                                                                                  public and voluntary sectors on new
                                                                                                  solutions; and campaigning to raise
                                                                                                  awareness and inspire action.
                                                                                                     The centre’s first report, Big
                                                                                                  change starts small, is ‘a summary         Campaign
                                                                                                  of decades of science on early
                                                                                                  childhood and research on why
                                                                                                  the early years matter. By bringing
                                                                                                  this body of evidence together, we
                                                                                                  hope to demonstrate the strategic
                                                                                                  importance of this vital issue
                                                                                                  to everybody.’
                                                      ‘THE COST OF LOST                              The report also revealed The Royal
       The Duchess of Cambridge has                                                               Foundation’s work with the London
                                                      OPPORTUNITY IN                              School of Economics, which calculated
       launched The Royal Foundation
                                                      EARLY CHILDHOOD                             ‘the cost of lost opportunity in early      Website
       Centre for Early Childhood to
       drive awareness of, and action on,             IS AT LEAST £16.13bn                        childhood’ is at least £16.13bn annually
       ‘the transformative impact of the                                                          in England alone.
       early years’.
                                                      ANNUALLY IN
          The aim of the centre is to                 ENGLAND ALONE’                             
       ‘transform lives for generations to                                                                 early_years                         Health

            A poll of more than 4000           were feeling stressed                 Barnardo’s chief
            eight- to 24-year-olds             (58%), worried (54%), sad          executive Javed Khan
            across the UK suggests             (52%) and lonely (56%)             said: ‘Barnardo’s has
            the mental health and              more now than before               consistently warned that
            wellbeing of children and          the pandemic.                      the negative effects of
            young people could still be           Few young adults                the pandemic could last
            worsening a year after the         reported feeling less so (11%      a lifetime if children [and]
            pandemic started.                  or under) now than before          young people don’t have
              Between 28 April and             the pandemic.                      the right support.
            10 May, respondents were              Younger children                   ‘Our survey adds further
            asked how they were                seemed to fare better, but         weight to the argument
            feeling now compared with          almost a third of eight- to        that children must be
            before the pandemic.               15-year-olds said they were        front and centre of the
              More than half of 16- to         feeling more stressed and          government’s plans for     
            24-year-olds said they             worried now.                       the post-Covid period.’              young_wellbeing

                                                            COMMUNITY PRACTITIONER | JULY / AUGUST 2021

NEWS Public Heal_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 8                                                                 08/07/2021 15:28
Anorexia ARFID - Community Practitioner


      78%Actions to reduce the number of babies born
         before 37 weeks’ gestation and improve their
         outcomes are among the recommendations in
                                                          of child deaths occurred
                                                          in a hospital setting
                                                                   The most frequent was smoking by a parent
                                                                   or carer, followed by gaps in service delivery.
                                                                   Challenges with access to services and poor
                                                                                                                        BASIC INCOME
                                                                                                                        SCHEME COULD
         a recent report.                                          communication also feature. Others included          IMPROVE HEALTH
            The University of Bristol National Child               substance/alcohol misuse by a parent or carer,       FOR ALL, SAYS PHW
         Mortality Database’s national analysis of child           and unsafe sleeping.                                 Adopting a basic income
         deaths in England aims to learn lessons from                 Overall, there were approximately 28              scheme in Wales could be
         all child deaths.                                         child deaths for every 100,000 children in           a catalyst for better health
            In their latest report, the 3347 deaths of             England. 78% of child deaths occurred in a           and wellbeing outcomes
         under-18s between 1 April 2019 and 31 March               hospital setting.                                    for all, a report published
         2020 in England were analysed.                               The report makes a clear call to action for all   by Public Health Wales
            The majority of children who died (63%) were           professionals involved in planning or providing      has suggested.
         under one year old. Of these, where known,                services to children to play an active part            The report, A basic
         69% were born preterm. In fact, 42% of all                in reducing the number of children who die,          income to improve
         child deaths occurred before children were 28             encouraging them to use the data available.          population health and well-
         days old.                                                                                                      being in Wales?, assesses
            For the first time, factors considered                                      evidence and different
         modifiable in children’s deaths were analysed.                      young_babies                               approaches to policy design
                                                                                                                        and implementation.
                                                                                                                          Potential positive
                                                                                                                        effects on health included
                       SPIKE IN CHILDREN WITH MILD FEVER ATTENDING                                                      reductions in child poverty,
                       A&E PUTS PRESSURE ON STAFF                                                                       improved educational
                                                                                                                        attainment, a higher
                                                            The infections             In response, the RCPCH           standard of living for those
                                                        are the usually mild        has issued advice on how            more likely to be in lower
                                                         respiratory infections     parents can treat children          paid jobs, greater food
                                                         such as bronchiolitis      with mild fever and when to         security, better nutrition and
                                                         and rhinovirus. The        seek help.                          fewer hospital admissions.
                                                         easing of lockdown            Professor Martin Marshall,         Report author Adam Jones
                                                         has meant that             chair of the RCGP, said: ‘In        said: ‘Evidence suggests that
                                                          children are being        most cases of mild fever,           members of society would
                                                          exposed to these          runny nose or cough, simple         benefit from an income that
                                                          infections this           self-care measures such             supports their health and
                                                           summer as they           as taking paracetamol or            wellbeing and allows them
                                                           come back into           ibuprofen can help, but             to contribute to society
          Emergency departments                contact with other children.         in cases where parents              and flourish.
          (EDs) across the UK are                 The RCPCH say that many           are concerned, seeking                ‘How well a basic income
          seeing very high numbers             parents have not seen fever          medical assistance from a           scheme works would
                                                                                                                                                           ISTOCK / SHUTTERSTOCK

          of young children for this           in their child – particularly if     pharmacist, their GP or by          certainly depend on how it’s
          time of the year because of          born during lockdown – and           calling 111 is the appropriate      designed and delivered.’
          a rise in infections usually         are taking them straight             first port of call.’
          seen in winter, says the Royal       to A&E. However this is
          College of Paediatrics and           placing pressure on already               
                                               busy EDs.                                      A_and_E                           universal_income
          Child Health (RCPCH).

                                                            COMMUNITY PRACTITIONER | JULY / AUGUST 2021

NEWS Public Heal_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 9                                                             08/07/2021 15:28
Anorexia ARFID - Community Practitioner

                           PROFESSIONAL UPDATE
                                                                             suggested the intervention
                                                                                                                         ‘The wellbeing of
                                                                                                                          staff remains a
                                                                             had made them more likely
                                                                               to discuss other issues                    critical priority
                                                                                                                        that will influence
                                                                                                                         the way that our
                                                                                                                         health and social
                                                                                                                         services recover’

                            WORKFORCE BURNOUT                               DISCLOSING ACEs                             £8M TO SUPPORT
                            AT EMERGENCY LEVELS,                            FORGES BETTER                               WORKER WELLBEING
                            SAYS COMMITTEE                                  BONDS WITH HVs                              AFTER COVID
                                          A report by the Health                          A study commissioned by                     The Scottish Government
                                          and Social Care                                 the Welsh Government                        has increased its
                             Committee (HSCC) suggests that the             reveals that positive benefits are          wellbeing support budget this
                             future functioning of services is at           gained by all parties when health           year by £3m to help its health and
                             grave risk, and calls for an overhaul of       visitors enquire about caregivers’          social care workforce recover from
                             workforce planning.                            adverse childhood experiences               the pandemic.
                                The HSCC’s inquiry into workforce           (ACEs) at routine visits.                      The £8m package will support staff
                             burnout and resilience in the NHS and             Feedback provided by four in every       wherever they work – from acute
                             social care identified staff shortages         five caregivers agreed that their HV        hospital wards to community settings
                             as the biggest cause of burnout. And           got to know them better by asking           – supplementing the resources that
                             although Covid-19 impacted on the              about ACEs, and 85% suggested the           are in place locally.
                             workforce immensely, the committee             intervention had made them more                The priority areas for action will
                             was informed of serious staff                  likely to discuss other issues with their   include the National Wellbeing Hub,
                             shortages prior to the pandemic.               HV in the future.                           National Wellbeing Helpline, and
                                NHS workforce planning was at                  Despite concerns from HVs that           psychological interventions and
                             best opaque and at worst responsible           the offer of ACE enquiry would              therapies for staff.
                             for unacceptable pressure on staff.            receive a negative response, the               Some £2m will be targeted
                             The report concludes that available            proposal was well received, with nine       at social and primary care in
                             funding was the driver behind                  out of 10 caregivers agreeing to take       recognition of the specific needs
                             planning, rather than the level of             part in the pilot.                          of staff working in those services in
                             demand and staffing capacity                      More than 40% of caregivers with         responding to Covid-19.
                             needed to service it.                          ACEs said the study was the first time         Health secretary Humza Yousaf
                                HSCC chair Jeremy Hunt MP said:             they had told a professional or service     said: ‘The wellbeing of staff remains

                             ‘Achieving a long-term solution                about these experiences, with first         a critical priority that will influence
                             demands a complete overhaul of                 disclosure most common among male           the way that our health and social
                             workforce planning.’                           caregivers (55.1% of males with ACEs).      services recover.’


                                                                        COMMUNITY PRACTITIONER | JULY / AUGUST 2021

NEWS Professiona_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 10                                                                      08/07/2021 15:29

           HEE BOOSTS CLINICAL                                      UPDATE ON MENTAL                       PROTECT STAFF FROM
           PLACEMENTS IN                                            HEALTH ACTION PLAN                     PREJUDICE, SAYS
           2021-22 BY £15M                                          AND CARE NETWORKS                      RACE OBSERVATORY
                         Health Education England                                Health minister Robin                  Healthcare leaders and
                         (HEE) has pledged extra                                 Swann reports that                     employers must ensure
           funding to increase the number                           ‘substantial progress’ has been made   staff are protected from all forms
           of placements offered to nursing,                        in the 12 months since the Northern    of racism, discrimination, bias or
           midwifery, allied health professional                    Ireland Mental Health Action Plan      prejudice, says the NHS Race and
           (AHP) and healthcare students from                       was published.                         Health Observatory (NHSRHO).
           September 2021.                                             In his update, the minister            Along with three regulators, it says
              It is hoped that the increased                        highlighted key achievements           that healthcare employment policies
           number of placements will help HEE                       including the creation of a mental     and processes need to be fair, inclusive
           deliver sufficient numbers of skilled                    health champion, approval of the       and in line with the 2010 Equality Act.
           healthcare workers for the NHS of                        business case and securing of £4.7m       NHSRHO director Habib Naqvi said
           the future.                                              funding for the development of a       the body would identify and tackle
              The £15m boost is in addition to                      specialist perinatal mental health     structural inequalities that lead to
           the £180m spent each year by HEE                         community service model, the           differential experience and outcomes
           on placements for around 120,000                         establishment of the CAMHS and         for the workforce and patients.
           nursing, midwifery and AHP students.                     Forensic Mental Health Managed            ‘The Observatory operates by
              The funding will be allocated                         Care Networks, and the launch of a     shining a light on discriminatory
           regionally to ensure it meets local                      Mental Health Innovation Fund.         policies and practices, and by
           demand, and will be used for extra                          He said that the progress made      gathering evidence that supports
           supervision and coaching models to                       was a ‘considerable achievement’,      healthcare organisations to progress
           support growth.                                          given the pressures of Covid.          in a way that eradicates, rather than
              Some of the money will be used                           He added: ‘The progress that has    exacerbates, inequality.’
           to evaluate the quality, impact and                      been made is due in no small part         NMC chief executive Andrea
           value of this investment and consider                    to the drive and dedication of so      Sutcliffe said it is determined to play a
           capacity and funding options for                         many people working tirelessly to      ‘significant part’ in becoming a better
           the future.                                              improve services.’                     and fairer regulator.

                    funding                                                 plan                                   healthcare

                                                                      PRACTITIONER | JULY
                                                                        PRACTITIONER  | FEBRUARY
                                                                                          / AUGUST

NEWS Professiona_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 11                                                         08/07/2021 15:29

                                                                                                                           u For more
                                                                                                                           information on
                                                                                                                           these studies, visit
      GLOBAL RESEARCH                                                                                                      the links

      THE EARLY WARNING                                           UK
      Researchers have identified two distinct
                                                                  SENSE OF COMMUNITY INDICATES
      subgroups among young people who self-
                                                                  ENTHUSIASM FOR VACCINE UPTAKE
      harm, with risk factors showing as early as                 People who feel a sense of                identification, sense of duty,
      age five. It may therefore be possible to                   community belonging are more              and vaccination willingness.
      predict which individuals are most at risk of               willing to have a Covid-19 vaccine,         The authors recommended
      self-harm up to a decade ahead of time.                     according to a study in the Journal       volunteering to increase
         The study, published in the Journal                      of Community and Applied                  people’s strength of identification
      of the American Academy of Child and                        Social Psychology.                        with their community.
      Adolescent Psychiatry, found that while                        The 130 study participants were
      both groups were likely to experience sleep                 questioned on levels of community
      difficulties and low self-esteem at age 14,
      other risk factors differed.
         The first group showed a long history
      of poor mental health, as well as
      bullying. The second group were
      harder to predict, but a key sign was
      more risk-taking behaviour.
         Co-author Duncan Astle said: ‘Boosting
      younger children’s self-esteem, making
      sure that schools implement anti-bullying
      measures, and providing advice on sleep
      training could all help reduce self-harm
      levels years later.’


           AFTER BABY’S INTENSIVE CARE STAY                                                 GERMANY
           Both mothers and fathers with a baby in the neonatal                            ALCOHOL CONSUMPTION
           intensive care unit are at risk of depression, a study of                       IN EUROPE DECREASED
           more than 400 people in Pediatrics found.                                       DURING COVID – BUT NOT IN UK
              Depression symptoms were identified in 33% of                                The European Alcohol and Covid-19 Survey collected
           mothers and 17% of fathers. However. the probability of                         data from nearly 32,000 alcohol users across 21
           reporting symptoms declined significantly                                       European countries from late April to late July 2020.
           for mothers but not for fathers after the                                         Published in Addiction, the study showed significant
           baby came home.                                                                 decreases in average alcohol consumption in every country
              Author Craig Garfield said                                                   except Ireland (decreases and increases evened each other
                                                                                                                                                             SHUTTERSTOCK / FREEPIK

           the finding ‘underscores the                                                    out) and the UK – where there was an increase.
           importance of reaching out to                                                     Less binge drinking was behind most of the reduction.
           fathers, who might not even be                                                  Those who reported distress were less likely to reduce
           aware that they need help’.                                                     drinking than those reporting no distress.
           u                                                 u

                                                          COMMUNITY PRACTITIONER | JULY / AUGUST 2021

NEWS Research_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 12                                                                  08/07/2021 15:31
CPJULY2021.013.indd 13   05/07/2021 15:49

                                              HS waiting times                    analyst in the policy team at The            Concern for children with SEND,

                             N                have been hitting
                                              the headlines in
                                              recent months as the
                                              immediate pressure
                            of Covid-19 recedes, and the longer-
                                                                                  King’s Fund. But as she points out,
                                                                                  it was ‘already going in the wrong
                                                                                  direction prior to the pandemic’. So
                                                                                  in fact ‘what the pandemic has done
                                                                                  has increased the pace’.
                                                                                                                            including those with conditions such
                                                                                                                            as autism, is echoed by children’s
                                                                                                                            commissioner for England Dame
                                                                                                                            Rachel de Sousa, who says: ‘Too
                                                                                                                            many of these children weren’t
                            term impact on healthcare services                       Within that headline figure were        getting the right therapies and
                            begins to be understood.                              245,699 children waiting to start         support even before the pandemic
                               The combined effects of routine                    treatment in paediatric services, with    and we know Covid has disrupted
                            work being halted, especially during                  almost a third waiting longer than        these services still further, and
                            the peaks of the pandemic, as well                    the target 18-week period. April was      has had a lasting impact. Three-
                            as staff redeployment, sickness and                   the first time data relating specifically   quarters of families surveyed by
                            self-isolation, and changes to the                    to paediatric services had been pulled    the Disabled Children’s Partnership
                            delivery of service, have seen waiting                out and presented separately.             were experiencing delays to routine
                            lists lengthen significantly as demand                    April’s data also showed that          appointments and treatments during
                            has continued – or even risen – while                 nearly 3000 patients, both adults and     the pandemic, and six in 10 families
                            activity dropped.                                     children, had been waiting for more       were still experiencing these delays
                               The figures are now huge. The                       than two years to start NHS hospital      in April 2021.’
                            latest data revealed that a record high               treatment – another figure captured           Disruption has hit every facet of
                            of 5.1 million people were waiting                    for the first time.                        children’s healthcare. The British
                            for NHS treatment in England in                                                                 Dental Association (BDA), for
                            April. Of those, 385,490 patients                     DISRUPTED AND DELAYED                     example, revealed that from March to
                            were waiting more than a year (NHS                    But even this number doesn’t present      May 2020 more than 50,000 children
                            England, 2021a).                                      the whole picture, even for England       in England had surgery postponed.
                               Five million is a ‘pretty terrifying               alone, focusing as it does on hospital-   It pointed out that tooth decay is
                            number’, says Deborah Ward, senior                    based and consultant-led care. The        the number one reason for hospital
                                                                                  picture for community care services       admissions among children aged five
                                                                                  is far less tangible, but problems here   to nine in England (BDA, 2020).
                             BIG STORY                                            have also been flagged.
                                                                                     A recent Ofsted/Care Quality           ACROSS THE FOUR NATIONS
                            As waiting lists for NHS                              Commission report explored the
                                                                                  impact of the pandemic on children
                                                                                                                            The picture of longer lists and
                                                                                                                            lengthier waits is also repeated across
                            services reach record highs                           with special educational needs and        the four nations. In Scotland, waiting
                            following the pandemic,                               disabilities (SEND). It highlighted the
                                                                                  absence of essential services such as
                                                                                                                            times in general have risen for
                                                                                                                            diagnostics, inpatient and outpatient
                            journalist Juliette Astrup                            physiotherapy or speech and language      appointments – there were 37%
                                                                                  support during the pandemic, and          more new outpatients waiting for
                            takes a look at what it means                         long waiting times for assessment and     an appointment at the end of March
                            for children and families.                            treatment (Ofsted, 2021).                 21 compared with a year previously.

                            IN VAIN

                                                                      COMMUNITY PRACTITIONER | JULY / AUGUST 2021

NEWS Big Story_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 14                                                                         08/07/2021 15:32

         Of the 354,782 waiting, 51.9% had              waiting list, the problem has become              developed and exciting new plans to
         been waiting more than 12 weeks –              so big that children have got lost in it.         transform our ND services, too many
         double the percentage as at the same           A year on a waiting list is such a huge           children are currently waiting for
         time in 2020 (Scottish Parliament              proportion of a child’s life in which             specialist assessments.’
         Information Centre, 2021).                     all the things they are supposed
            In Wales, the total number of               to be doing are interrupted – their               WHAT DOES IT MEAN FOR
         patients referred but waiting for              development, education, family life.              CHILDREN AND FAMILIES?
         treatment has risen each month since              ‘And when you think about                      Professor Steve Turner, registrar
         May 2020, to 595,272 at the end of             conditions such as scoliosis, for                 at the Royal College of Paediatrics
         April 2021. This is the highest since          example, there is a time-critical                 and Child Health (RCPCH), says
         comparable data was first collected in          window in which children need                     that while the child healthcare
         2011, and 34.8% higher than in April           surgery and treatment – it is a very              community across primary and
         2020 (Welsh Government, 2021).                 big worry if children are missing                 secondary adapted well during
            And Northern Ireland’s waiting              that window because of the list. We               the pandemic – developing ‘very
         lists are the worst of any UK region,          have heard of families                            good systems of provision for
         with more than 330,000 patients                paying privately for                              ongoing care’ – ‘services have been
         waiting for their first consultant-             scoliosis treatment,         ‘THE MOST PRESSING   substantially redesigned.’ This may
         led outpatient appointment; more               going to places like         CASES WILL BE        have meant some patients met
         than 110,000 waiting for inpatient             Turkey for surgery.                               problems with gaining face-to-face
         or day case treatment; and some                We also know many
                                                                                     PRIORITISED, BUT     access to services, and operations
         130,000 waiting for a diagnostic test          parents are now              AN OPERATION         for children had been cancelled
         (Department of Health, 2021).                  paying privately for         CONSIDERED NON-      and delayed, as they have across
            Again, children are being                   autism assessment                                 the NHS.
         impacted: between March 2020                   because the wait is          URGENT, SUCH AS A       Steve adds: ‘Surgical waiting lists
         and March 2021 the percentage of               too long.                    HERNIA TREATMENT,    are painfully long and it will take a
         children on the list waiting more                 ‘ENT and                                       long time to catch up. Additionally,
                                                                                     WILL NOW HAVE A
         than a year for their first consultant          dermatology have                                  specialist tests that children may
         outpatient appointment doubled                 long waiting lists too.      LONGER WAIT’         need – a brain scan or endoscopy –
         from 22% to 41% (Information                   When you have a child                             things that would have been routinely
         Analysis Directorate [IAD],                    who is poorly, that                               done pre-Covid have been impacted
         2020a; 2021b).                                 impacts on the whole                              too, which is terribly frustrating and
            And the proportion waiting more             family too, siblings in particular.’              worrying for parents.
         than a year for inpatient/day case                Professor Sally Holland, children's               ‘Clearly the most pressing cases
         appointments under a paediatric                commissioner for Wales, says:                     will be prioritised, but an operation
         speciality increased from 40% to               ‘Neurodevelopmental [ND] waiting                  considered non-urgent, such as a
         69% over the same period (IAD,                 lists have also continued to be a real            hernia treatment or a tonsillectomy,
         2020b; 2021b).                                 worry throughout the pandemic, and                will now have a longer wait.’
            Koulla Yiasouma, NI commissioner            here in Wales a lower proportion of                  While there would be ‘delay in
         for children and young people, says            referrals are accepted for face-to-               some investigations and a likely delay
         waiting times are ‘devastating’ for            face assessments than in the rest of              for operations that aren’t urgent’
         families there.                                the UK.’                                          compared with pre-pandemic waits,
            She says: ‘With one in four people             She continues: ‘While I’m                      he says parents ‘shouldn’t expect
         in Northern Ireland now on an NHS              encouraged by some recently                       there to be an additional delay in

                                                            COMMUNITY PRACTITIONER | JULY / AUGUST 2021

NEWS Big Story_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 15                                                    08/07/2021 15:32

                            A CLOSER LOOK AT CHILD AND
                            ADOLESCENT MENTAL HEALTH
                            SERVICES (CAMHS)                                                                SCOTLAND
                            With between one in six and one in seven                                       The number of children waiting
                            UK children having a recognised mental                                         over a year to begin treatment
                            health problem, pre-Covid-19 waiting lists                                     was over 2000 at the end of
                            had already been ‘unwieldy’, with ‘a lot of                                    March 2021, a record high and
                            unmet need’, says Professor Steve Turner                                       more than double the figure
                            of the RCPCH. Covid-19 made things more                                        from a year before.
                            difficult, as well as exacerbating anxiety
                            for children during the pandemic.                                              Of all the 11,007 who were
                              But Steve indicated that children                                            on the waiting list at the end
                            and young people had found remote                                              of March this year, more than
                            video consultation and assessment                                              half had been waiting longer
                            ‘very acceptable and very successful at                                        than 18 weeks, compared to
                            delivering socially-distanced care’.                                           44% a year before.
                                                                                                           Public Health Scotland 2020; 2021

                             NORTHERN IRELAND                                                                                          ENGLAND
                            Numbers waiting longer than                                                                               Last year, just 20% of
                            the nine-week target period                                                                               children referred to services
                            fell from over 700 in March                                                                               started treatment within
                            2020 to 174 in October, before                                                                            four weeks, with 6% – 34,550
                            beginning to rise again, with                                                                             children – waiting longer
                            374 patients waiting longer                                                                               than 12 weeks.
                            than nine weeks in January                                                                                NHS Digital, 2020
                            2021. Health and Social Care Board, 2021
                                                                                                                                      Over the past year both
                                                                                                                                      urgent and routine referrals
                                                                                                                                      have almost doubled for
                                                                                                                                      eating disorder treatment
                                                                                                                                      in England. The number of

                                                                                                                                                                        The Children and Young People’s Commissioner Scotland was unavailable for comment.
                                                                                                                                      patients waiting more than
                                                                                                                                      12 weeks to begin treatment
                                                                                                                                      is at a five-year high, having
                                                                                                                                      risen from 45 in the last
                                             WALES                                                                                    quarter of 2019-20 to 278 in
                                                                                                                                      the same period in 2020-21.
                                            In January 2020, less                                                                     NHS England, 2021b
                                            than 20% of patients
                                            were waiting for a first
                                            appointment over
                                            the four-week target,
                                            rising to 52.9% in Jan
                                            2021 – but in March 21
                                            that figure was down to
                                            24%, compared to 31%
                                            a year previously.

                                            StatsWales, 2021

                                                                          COMMUNITY PRACTITIONER | JULY / AUGUST 2021

NEWS Big Story_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 16                                                                            08/07/2021 15:33

         getting a child seen by a senior                                      created a ‘backlog of things that         critical window for development
         decision-maker for a diagnosis’, and                                  haven’t been picked up’.                  and education, and a delay in being
         could be assured that ‘if investigation                                  The other aspect, she says, is that    processed through health services
         and treatment is needed to be done                                    ‘many of those people on the waiting      will potentially have a much greater
         now it will be done’.                                                 lists for routine surgery, for example,   impact on a child than an adult,
                                                                               or cancer treatment, are also parents     particularly if that child is missing
         FLATTENING THE CURVE                                                  and grandparents, and that unmet          school as a result.’
         But as Barbara Evans, a community                                     need creates a great deal of additional      Deborah says: ‘We need resources
         nursery nurse in the East Midlands,                                   stress for their families too, which is   to bring down the backlog, and it’s
         points out, it is not only waiting                                    important to be aware of’.                also an opportunity to innovate – we
         list delays that are a concern, but                                      In addition, there is the              can’t catch up just by doing more of
         delays in referral and treatment due                                  increasingly well-documented              what we were doing before. But we
         to changes in the way services were                                   impact of lockdown on the mental          must also be honest about how long
         provided during the pandemic.                                         health of children and young people,      it will take to get things better – it’s
             ‘Anecdotally, we’ve heard about                                   with issues potentially going missed      going to take several years. We need
         appointments being cancelled or                                       as children have been out of school.      to acknowledge that and support
         delayed, and parents waiting a long                                                                             people who will be on waiting lists
         time to see a paediatrician, and then                                 WHERE DO WE GO                            for long periods of time.’
         it’s a phone call – which might be                                    FROM HERE?                                   ‘The pandemic has further exposed
         fine initially, but isn’t the best way,’                               Moving forward, Steve says it is          social and economic inequalities
         says Barbara.                                                         vital that paediatric waiting lists are   between children’s experiences
             ‘There are subtleties you can only                                factored into recovery plans. ‘Across     and access to services,’ notes
         see face to face, and we are now                                      the four nations, chief executives        Sally. ‘There needs to be a focus on
         seeing a lot of speech delay and some                                 have very much encouraged a               ensuring that children who may
         developmental delay that wasn’t                                       focus on adult cancer services and        have missed out more during the
         picked up before.                                                     waiting lists for operations, but I       pandemic are supported to access
             ‘Hearing tests also stopped for                                   think it is also important to make        specialist services they need. This
         a long time, and we know hearing                                      special mention of waiting times          includes disabled children, those
         issues can impact speech, behaviour                                   for children.                             living in poverty, and children from
         and many things.                                                         ‘We’re not saying children are         black, Asian and ethnic minority
             ‘For a child, any delay in diagnosis                              more important, but they are in a         backgrounds.’
         and treatment is significant. The right                                                                             Rachel adds: ‘We should thank
         intervention early on can flatten                                                                                all the NHS staff for their work over
         the curve of that trajectory, but
                                                        ‘CHILDREN WANT TO KNOW HOW                                       the last year, not just in fighting
         the longer you wait, the bigger the            WE CAN HELP THEM, NOT JUST TO                                    Covid, but in trying to maintain a
         development gap gets and the worse             GET BACK TO NORMAL, BUT TO DO                                    health service for children and young
         it is in the long term.’                                                                                        people – from the paediatricians
             Janet Taylor, CHPVA Executive              EVEN BETTER IN FUTURE. IMPROVING                                 helping children manage long-term
         chair, also points to a temporary              SERVICES CAN BE SOMETHING WE                                     conditions as the world around
         drop-off in referrals in some areas,                                                                            them was turned upside down to the
                                                        DELIVER TO THANK CHILDREN FOR
         as parents have stayed away, either                                                                             health visitors who continued to go
         through fear or a reluctance to                THEIR SACRIFICES’                                                into homes despite all the risks, to
         burden the NHS at that time, which                                                                              help protect children at risk.’

                                                            COMMUNITY PRACTITIONER | JULY / AUGUST 2021

NEWS Big Story_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 17                                                                     09/07/2021 15:43

          Rachel concludes: ‘As we come out                    THE WAITING GAME
       of the pandemic, children will want
       to know how we can help them, not

                                                                                    1 in 3
       just to get back to normal, but to
       do even better in future. Improving
       services can be something we deliver
       for children to thank them for the                                           children are waiting
       sacrifices they have made over                                               longer than 18 weeks
       the last year.’

       WHAT CAN CPs DO?
       Janet says community practitioners
       have a vital role in that support for
       families: ‘You have the situation
       where a child might have significant
       behavioural issues, for example,
       and needs to be referred to the
       consultant paediatrician and the
       multidisciplinary team – but can’t
                                                                                                                               people have been waiting
       be seen for six months, and there is
                                                                                                                                  two years or more
       nowhere they can go in the interim,
       which creates an enormous amount
       of stress for that child, their parents,
       their siblings.
          ‘That is where public health nurses
       – health visitors, nursery nurses,
       school nurses – are providing the
       glue in the system that holds these
       families together while they wait for

                                                                                      5.1 million
       that appointment.
          ‘They are someone that parents can
       go to for advice and coping strategies,                                                                                            The proportion
       who can help them understand                                                            people waiting for NHS                     of patients who
       what’s happening, and link them                                                          treatment in England                      should be seen
       with sources of information and                                                                                                    within 18 weeks
                                                           NHS England, 2021a

       support, such as the NSPCC or                                                                                                      under the NHS
       local parenting groups. Even just
       listening helps.
          ‘We can’t wave a magic wand,
       but we can provide that therapeutic
                                                                                                people have been waiting for
                                                                                                more than a year
       relationship and support families
       where we can.’
                                                                                                                                                                 ISTOCK / SHUTTERSTOCK

                                                                            COMMUNITY PRACTITIONER | JULY / AUGUST 2021

NEWS Big Story_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 18                                                                      09/07/2021 15:44
CPJULY2021.019.indd 19   05/07/2021 15:50

       In part one of our series, the chief nursing officers (CNOs) for
       Northern Ireland, Scotland and Wales reflect and thank CPs
       for their efforts during the pandemic, and beyond.

       Professor Charlotte McArdle, CNO for Northern Ireland

                         As I pause and reflect on the
                         past 18 months, we could
                         never have imagined the
                         challenges we would face
                         as individuals, professionals,
                         countries – as humanity
                         as a whole.
          There is no doubt that this period has
       been one of the most challenging ever faced
       by the health and social care system. The
       evidence indicates the significant impact
       the pandemic has had on children, young
       people and their families in relation to social
       isolation, separation from family supports,
       school closures and limited access to services.
          But I can say with certainty that, as a
       profession, health visitors, school nurses
       and support staff have courageously risen
       to the challenge in a positive, proactive and
       solution-focused way to ensure the delivery
       of safe, effective and compassionate care to
       children, families and communities.

                                                                                                                                                            INTERNATIONAL COUNCIL OF NURSES / SHUTTERSTOCK
       HEALTH EQUITY REPORT                                 addressing the social determinants of health     to create the conditions needed to
       The response has driven forward innovations          and building an equitable and sustainable        better incorporate addressing the social
       across health visiting and school nursing            society for our children, young people,          determinants of health into their work.
       in adapting to new ways of working and               families and communities.                           As we start to rebuild our health and
       moving towards digital transformation                   It has been a great privilege that my team    social care system from the pandemic,
       to meet the needs of our children, young             and I worked with the World Innovation           this resource will play an important role in
       people and families. ChatHealth, virtual             Summit Health, Professor Sir Marmot,             supporting nurses, HVs and school nurses to
       contacts and virtual group work have been            Dr Hannaway and Dr Rosa to publish the           enhance their focus on promoting wellbeing,
       introduced where face-to-face contacts have          report – Nurses for health equity: guidelines    preventing illness and protecting health.
       not been possible.                                   for tackling the social determinants of health      As CNO, I am extremely proud and
          Community practitioners have been                 ( It aims to raise           grateful to you all for your dedication,
       the true leaders in delivering the Covid-19          awareness across health and social care          commitment and professionalism
       vaccination programme. As nurses, HVs and            systems worldwide, with guidelines and           throughout this unprecedented time.
       school nurses, we have a significant role in          actions to support and enable nurses             Thank you for everything you do.

                                                           COMMUNITY PRACTITIONER | JULY / AUGUST 2021

OPINION CNOs_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 20                                                                  08/07/2021 15:34

              Amanda Croft, CNO for Scotland
                               Much focus during the pandemic
                               has rightly been on our older
                               adults, acute services and those
                               in care homes. But it is important
                               that we also acknowledge the
                               responsive innovation of HVs,
                               school nurses, community
              midwives and all our community health staff.
                 The commitment of our community
              practitioners has shone through – they
              transformed modes of service delivery almost
              overnight, swiftly incorporating IT solutions to
              engage to support families, ensuring continued
              support and advice was readily available and
              accessible. The uniqueness of the health visiting
              role, engaging with almost all babies through
              to pre-school children in Scotland, proved
              critical by enabling continuity of support from
              a health professional and the continuation of
              key child health promotion and developmental
              surveillance. School nurses moved into roles, in
              some areas, they were not familiar with and their               Sue Tranka, incoming CNO for Wales
              concentration on supporting our most vulnerable
              children will have been vital for their development
              and protection.                                                                  I have been very        CPs HAVE SHOWN
                 Most children and young people may not have                                   impressed with what     FLEXIBILITY, WILLINGNESS
              been directly impacted by COVID-19, but the                                      I have heard and
                                                                                                                       AND ACCEPTANCE OF
              indirect effects have been considerable. We have                                 seen of the dedicated
              seen increases in child protection concerns,                                     hard work of HVs,       THE NEED FOR RAPID
              domestic abuse, and child and maternal mental                                    school nurses and       AND SIGNIFICANT
              health problems. The continued contribution of                                   other community
              our community children’s health staff throughout                nursing practitioners during the
                                                                                                                       CHANGE IN THE
              the pandemic has been fundamental, in the                       pandemic. They have shown                EMERGING HEALTH CRISIS
              provision of early support and wherever possible                flexibility, willingness and
              preventing escalating need, mitigation of trauma                professional acceptance of the need
              and risk from adversity.                                        for rapid and significant change in       who were shielding and ensuring
                 The contribution of HVs, school nurses,                      the emerging health crisis, and they     every child remained seen, heard and
              midwives and community health staff has been                    are now vigorously addressing the        supported. This dedication, when
              invaluable as part of the whole NHS response.                   longer-term impacts of the pandemic      some staff were redeployed to areas
              I know the pandemic has impacted all of us in                   resolving the build-up of health need    where their extensive expertise was
              some way, which is why I want to wholeheartedly                 in our communities.                      required to support other clinical
              thank this workforce for their continued efforts,                  Their expert knowledge, skill and     areas, has been inspiring.
              leadership, resilience and professionalism                      experience in population-based             I will be joining the team in
              throughout. I applaud each and every one of you.                public health has been drawn on to       September, helping to take forward
                                                                              support a practical on-the-ground        the challenges of recovery and
                                                                              response, delivering –among other        support the dedicated staff in meeting
                                                                              things – the first-class response to      the needs of the people of Wales. I
                                                                                                                                                                 SCOTTISH GOV / SHUTTERSTOCK

                                                                              mass vaccination that has seen Wales     would like to thank the contribution
                                                                              lead among the UK nations.               HVs, school nurses and other
                                                                                 Innovative change has transformed     community nursing practitioners
                                                                              health provision within the              have made not only in the response to
                                                                              community, including utilisation of      the pandemic but on the foundations
                                                                              virtual technology, working together     they are laying to make Wales a
                                                                              across professional boundaries,          healthier, happier and more equitable
                                                                              supporting children and families         place to live.

                                                           COMMUNITY PRACTITIONER | JULY / AUGUST 2021

OPINION CNOs_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 21                                                                   08/07/2021 15:34

                       HERE’S WHAT
                      YOU TOLD US…
                 Sharing some key findings from the Community Practitioner
                                  2021 readership survey.
                                                                    REACH AND BENEFIT                            More than

                                                      88%                                                        1/3
                                                                                                                 of you felt the journal

           of you usually
           pass on your copy
                                                      of you consider
                                                      Community Practitioner
                                                      to be a key benefit
                                                      of your Unite-CPHVA
                                                                                                                 has been a source of
                                                                                                                 support during the
                                                                                                                 Covid-19 pandemic

           of Community                               And for 70%, the journal rnal
           Practitioner to one                        influenced your decisionsion
           or two other people                        to join in the first place

                                                                   PRACTICAL CONTENT

       of you think the
       articles in Community
                                                                        think the research
                                                                        paper summaries
                                                                                                                              content and
       Practitioner are                                                                                                       research are
       clearly written and                                              in the journal and                                    important to
       easy to understand                                               full online versions                                  readers, with
                                                                        inform practice                                       an appetite for
                                                                                                                              reflections (45%
                                                                                                                              want to read more)

                                             80% 73%
                                             say the journal has
                                             improved practice
                                                                                           have used tips and
                                                                                           advice given in the
                                             knowledge or                                    journal at work

                                                            COMMUNITY PRACTITIONER | JULY / AUGUST 2021

OPINION Reader S_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 22                                                     08/07/2021 15:34

                                                                                                                                                                        More than

                                                                                      think the number of
                                                                                                                                                            9 in 10
                                                                                                                                                            think the journal’s design is either
                                                                                                                                                            attractive or helps to improve the
                                                                                      images used in the                                                        overall reader experience

                                                                                     journal is about right

                                                                                                                            think the same for the
                                                                                                                             colour scheme used

                                                                                                       WHO TOOK PART                                                   THANK YOU
                                                                                                                                                                     AND WELL DONE!

                                                                            ¾ 72%
                                                                            of respondents
                                                                            work for the NHS,
                                                                                                                         of you listed practice as the
                                                                                                                         main function of your role
                                                                                                                                                                         A big thanks to
                                                                                                                                                                      everyone who took
                                                                                                                                                                       the time to fill out
                                                                                                                                                                         the survey, and
                                                                                                                                                                      congratulations to
                                                                                                                                                                     the two respondents
                                                                            the majority as
                                                                            health visitors (59%)                                                                      (including Elspeth
                                                                                                                                                                     Amos) who each won
                                                                            The varied list of                                                                        a £75 M&S gift card
                                                                            other professions                                                                          in the prize draw.
                                                                            included school nurses,
                                                                            community nursery
                                                                            nurses, team leaders
                                                                            and practice teachers

                                                                                                                                           and                       Gift card
      270 members completed the survey between 2 March and 28 April 2021.

                                                                             of respondents
                                                                              were female                                              over
                                                                                                                                       aged 55-64                         ANY MORE

                                                                                                                                                                       If you didn’t manage to
                                                                                                                                                                      complete the survey, but
                                                                                                                                                                     would still like your voice to

                                                                                                                                                                      be heard, or you have an
                                                                                                                                                                      article suggestion, please
                                                                                                                                                                       email the editor aviva@
                                                                                                        a parent or carer                                 

                                                                                                              COMMUNITY PRACTITIONER | JULY / AUGUST 2021

OPINION Reader S_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 23                                                                                                         08/07/2021 15:35

                                                               HEALTH AND
      A round-up of the
      inaugural one-
      day Unite-CPHVA
      virtual conference
      2021 – from
                                                               FOR ALL AGES
      sustaining your
      own workplace
                                                                                        Janet Taylor
      resilience to                                                                                    2:58

      the impact of
      lockdown on
      babies, expert
      speakers explored
      the issues for CPs
      through the lens of
      Covid and beyond.

                    anet Taylor, chair of the CPHVA

          J         Executive, welcomed both speakers
                    and delegates, setting the scene
                    with a few words about challenges
       of the past 18 months, adding: ‘Personally, on
                                                                         McArdle 7:25
       behalf of Unite-CPHVA, I would like to thank
       you all. Throughout this journey we have
       learned a lot, and had many challenges, but you
       have maintained services and continued to visit,
       regardless of circumstances.’
          She also welcomed special guest speaker                                                             Really fascinating talk
       Charlotte McArdle, chief nursing officer for
       Northern Ireland, who spoke to delegates ahead
                                                                                                              from @MarkWilliamsFMH
       of the start of the conference, praising their                                                         on paternal MH. As a
       work during the pandemic, including their                                                              male entering health
       ‘leadership ability’, ‘extreme dedication’ and
       contribution to the vaccination programme.
                                                                                                              visiting it’s a topic that
          Charlotte stressed how important it is ‘to say                                                      really resonates with me
       it’s okay to say you’re not okay’, and spoke of
       the need to rebuild with optimism and the role
       of nurses and midwives as ‘holders of hope and                                                         PAUL WRIGHT
       champions of change’.                                                                                  @lefty22_

                                                            COMMUNITY PRACTITIONER | JULY / AUGUST 2021

PRACTICE Confere_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 24                                              08/07/2021 15:39

            MENTAL HEALTH
            AND RESILIENCE
                                                       ‘AN EXPERIENCE THAT WILL HAUNT
            Tips and ideas to support
                                                       ME FOREVER’
            resilience, especially when                                                                                  Sam Williams
                                                        That’s how Sam Williams, health visitor with                                    12:47

            working remotely, peppered
                                                        the Flying Start service in one of the most
            chartered psychologist
                                                        deprived areas of South Wales, described the
            Dr Derek Mowbray’s
                                                        experience of her redeployment to an intensive
            presentation as he led delegates
                                                        therapy unit (ITU) for eight weeks at the
            through aspects of mental health
                                                        epicentre of the first wave of the pandemic. But
            and wellbeing at work.
                                                        her time at Aneurin Bevan University Health
               He began by setting out the
                                                        Board was also a time of learning.
            four pillars of resilience: self-
                                                           She said: ‘I don’t think anything prepares you
            esteem, self-efficacy, motivation
                                                        for seeing death every shift, caring for patients
            and mental control.
                                                        in full PPE, communicating with families over
               He spoke about ‘resilience as
                                                        the phone, while relearning critical care nursing
            a choice’, urging people to give
                                                        skills and worrying about infecting my family.’       and virtual consultations had not captured
            time to list out what ‘makes you
                                                           There were positives too, including reigniting     the true picture of families’ vulnerabilities,
            feel great about yourself’, and
                                                        her passion for health visiting, being inspired       especially for those where no previous triggers
            ‘what things entice you out of
                                                        to complete her master’s, and sharing her             or risks had been identified.
            your normal comfort zone’.
                                                        expertise with her team around PPE.                      She also found families ‘really grateful’ for
               Other tips included dividing
                                                           She describes a ‘mixed bag of emotions’,           the return of home visiting, which made them
            the remote working day into
                                                        including guilt at leaving families in ITU and        realise ‘they weren’t on their own’, and an
            bite-sized activities, taking
                                                        at leaving her own team. She also felt unable         influx of families asking for support.
            time to both plan and review,
                                                        to share what she’d experienced because she              Sam spoke too about the continued effects
            anticipating adversity,
                                                        didn’t want to frighten colleagues and was still      of the pandemic on public health, which she
            expressing gratitude and
                                                        processing it herself.                                called the ‘overlooked frontline’.
            assessing your own wellbeing.
                                                           On her return to health visiting and home             The pandemic had shown how ‘unique and
               He urged the conference
                                                        visits, she said it became obvious that telephone     important’ the role of the health visitor is.
            attendees to ‘tell yourself how
            fantastic you are in the mirror’
            first thing in the morning, and
            reflected on the importance                 HOW ARE                                     Mark
                                                                                                   Williams   5:56
                                                                                                                                  From sleep deprivation to
            of social time with colleagues             YOU, DAD?                                                               post-traumatic stress disorder,
            and the need for work to be fun
                                                       Paternal mental health                                                  to feelings of guilt and
            and rewarding.
                                                       campaigner Mark Williams                                                inadequacy and worries about
               He also advocated for ‘more
                                                       spoke about the importance                                              bonding, fathers have many
            leadership, less management’, a
                                                       of including fathers in the                                             of the same issues as mothers
            shift that includes giving control,
                                                       conversations around perinatal                                          in the postnatal period,
            instead of taking it, and nurturing
                                                       mental health, sharing his own                                          explained Mark.
            and prioritising the team.
                                                       struggles with mental health                                               He said one in 10 dads
                                                       after the birth of his son.                                             suffers postnatal depression,
                                                          He began by describing                                               and up to half of fathers
                                                       his first panic attack in                                                experience depression if they
                       Dr Derek
                       Mowbray    9:10
                                                       hospital when he was told his                                           are looking after partners with
                                                       wife needed an emergency                                                postnatal depression.
                                                       C-section: ‘Thinking that my                                               ‘We’ve got to start asking
                                                       wife and baby were going                                                why aren’t we screening
                                                       to die in front of me, for me       ‘couldn’t tell anyone’ what he      fathers for mental health when
                                                       personally, was absolutely          was feeling. Years later, Mark      we know the biggest killer of
                                                       horrendous.’                        realised he’d never been able       men under 45 is suicide.’ He
                                                          Mark describes how his           to talk about that experience,      also pointed out that fathers
                                                       personality ‘totally changed’       and he began a support group        experiencing paternal mental
                                                       after the traumatic birth of his    for ‘fathers reaching out           health issues often go missed
                                                       son, but with his wife suffering    to support other fathers’:          and ‘end up in mental health
                                                       with postnatal depression he                    services years later’.

                                                            COMMUNITY PRACTITIONER | JULY / AUGUST 2021

PRACTICE Confere_COMMUNITY PRACTITIONER JULY_AUG_Community Practitioner Magazine.indd 25                                                                  08/07/2021 15:39
You can also read