FAMILIES HOLDING ON HOW WILL THEY BOUNCE BACK AFTER COVID?
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THE JOURNAL OF THE COMMUNITY PRACTITIONERS’ AND HEALTH VISITORS’ ASSOCIATION
MAY / JUNE 2021
COMMUNITYPRACTITIONER.CO.UK
FAMILIES HOLDING ON
HOW WILL THEY BOUNCE BACK AFTER COVID?
A look at how the pandemic
has affected babies, new parents
and those with young children
COVER_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 1 10/05/2021 16:20
CPMAY2021.002.indd 2 05/05/2021 10:24
CONTENTS May / June 2021 | Vol 94 | No 03
21
33
Looking out for the
36 Reflections
from CPs
carers – are those COVER STORY who joined
helping families also the great
supporting themselves? vaccine
push
14
Women should
never have to
28 feel unsafe
at work or in
their daily life
Painful
and rarely
cured:
living with
sickle cell
disease
NEWS 14 BIG STORY 19 RIGHTS AT WORK PRACTICE
Community practitioners A paltry 1% pay rise
7 NEWS IN NUMBERS are trained to expect the isn’t enough. Healthcare 26 ASTHMA’S IMAGE
Your at-a-glance guide unexpected – but how workers deserve more PROBLEM
can you avoid any kind The campaign to stop the
8 PUBLIC HEALTH LATEST of violence or harassment 21 STORIES FROM use of misleading images
A look at what’s new in the first place? THE SHARP END that actually hinder
Joining in on the correct inhaler use
10 PROFESSIONAL UPDATE OPINION vaccine frontline
Your latest round-up 28 CLINICAL
18 FEEDBACK 24 REBUILDING TRUST Behind the curve: playing
12 GLOBAL RESEARCH Celebrating the Mary Why is vaccine catch-up with awareness
Recent findings from Seacole Awards, and how uptake lower in of the pain and worry
around the world to book for conference BAEM communities? behind sickle cell disease
3
COMMUNITY PRACTITIONER | MAY / JUNE 2021
CONTENTS_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 3 10/05/2021 16:21
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WELCOME
FEATURES
33 CARING FOR WHO?
Isolation, home-working and
rising caseloads have taken their
toll on community practitioners,
who are burning out. But is their
from your editor, Aviva
traditional self-reliance stopping
them from reaching out for the The Covid-19 vaccination milestones keep on coming and – after the turmoil that
help they need? has been a ‘normal’ part of everyone’s lives for more than a year now – it’s a beyond
welcome relief to have this hugely positive force available in the fight against Covid.
36 COVER STORY On page 21, four members talk about their experiences of being involved in the
Families of young children are on vaccine roll-out and what it has meant to them. But as we highlighted last issue, there
the brink after months of confusion are still people who remain unsure about receiving theirs. To this end, Unite-CPHVA
and isolation from support held a virtual event with eminent speakers, exploring vaccine uptake among black,
networks. What has this meant for Asian and ethnic minority communities (see page 24).
their health and wellbeing, were While optimism abounds, the pandemic – and its impact – remain for now. Our
there any unexpected positives, cover feature on page 36 looks at how it has affected new parents, babies and parents
and how will the pandemic change of young children. And, vitally we ask, what about the carers (see page 33)? How has
our public health priorities? working as a CP during this time taken its toll on you? And what support is available?
Other topics covered
RESEARCH this issue include asthma
(page 26), sickle cell
44 SOCIAL MARKETING AND disease (page 28) and a
BREASTFEEDING RATES moving look at sudden
This literature review examines unexplained death in
how a social marketing campaign childhood (see page 48).
could support health visitors to Lastly, thank you to
increase local breastfeeding rates all those who completed
the readership survey.
PROFESSIONAL PAUSE The results will be
revealed next issue.
48 EVERY ONE A TRAGEDY Until then, please keep
How to support those parents in touch, and take care.
coping with sudden unexplained
death in childhood, by SUDC UK JOIN THE CO
ONVERSATION
CONVERSATION
chief executive Nikki Speed
aviva@
communitypractitioner.co.uk facebook.com/CommPrac twitter.com/CommPrac
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 aviva@communitypractitioner.co.uk
Institution (UK) £156.45 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 Professional editor Michelle Moseley 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
unitetheunion.org/contact_us.aspx 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 advertising@communitypractitioner.co.uk Any Unite-CPHVA member wishing to
unitetheunion.org cp@c-cms.com 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 comprac@redactive.co.uk
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
5
COMMUNITY PRACTITIONER | MAY / JUNE 2021
EDITORIAL_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 5 07/05/2021 16:29
Advertisement Feature
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◗
NEWS
NEWS IN NUMBERS
60%
of adults in Wales lacked
basic digital knowledge
and skills when the pandemic
closed workplaces and schools
19% of people had no basic
digital skills in 2018-19, higher
than the rest of the UK
11% were ‘internet non-users’
– digitally excluded
Government solutions included
an extra £3m for laptops and
mobile internet for digitally
excluded pupils, and 1100
devices for care homes
The WHO and Public Health
Wales report aims to help
close the health gap in Wales
7.2%
of the adult population –
about 3.7 million adults –
and beyond felt lonely often or always
More than
between October 2020 and
1/2
February 2021, found the
Office for National Statistics.
This is compared with 5% of
of nearly 2000 Unite members aged 18 adults in April to May 2020
to 55 revealed a desire to change career Areas with more young
sectors in a joint survey with FutureLearn people – aged 16 to 24
One of the 3 top industries they – and areas with higher
considered moving to was health rates of unemployment
tended to have higher rates
of loneliness
Of those whose wellbeing had
been affected ‘in the last 7
days’ by the pandemic, 38.6%
(about 10.5 million people)
said it was due to loneliness
Young people and single
people were most affected
by the 7-day measure or
SHUTTERSTOCK
‘lockdown loneliness’
Find links to relevant reports and surveys highlighted in the news stories at bit.ly/CP_news_in_numbers
7
COMMUNITY PRACTITIONER | MAY / JUNE 2021
NEWS In Numbers_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 7 10/05/2021 16:21
NEWS
PUBLIC HEALTH LATEST KEY
FAMILIES WITH CHILDREN SEE THEIR
FINANCES HIT HARDEST BY PANDEMIC Video
earnings. This is compared to 17% of
households without children.
In fact on almost all indicators
of financial hardship, the rate was
doubled for families with children
Report
– compared with households
without children.
Action for Children’s director
of policy and campaigns, Imran
Hussain, said: ‘Serious action is
urgently needed if we are to prevent Campaign
a generation of children from
being scarred by poverty and the
pandemic.’
Mubin Haq, CEO of Standard Life
Foundation added that while ‘much
Poll
support has been provided by the
UK government, there has been a
blinkered approach to children’, and
Four million children are living in a that three million children in the UK that ‘we also need to see significant
family which has lost income since now live in a family that is struggling increases in child benefits, mirroring
the start of the pandemic, with to buy food and other essentials. the approach in Scotland’. Website
1.6 million of these in a family that’s Another crucial finding was The findings were based on the
lost a third or more of earnings. that more than a quarter of UK responses of 6071 people.
A report from Standard Life families with children are living
Foundation, with analysis by the on a reduced income as a direct bit.ly/UK_covid_
University of Bristol, also revealed result of pandemic-related loss of money_family Health
programme
TWO-THIRDS OF STUDENTS SAY THEIR
MENTAL HEALTH IS WORSE DUE TO PANDEMIC
To understand how the health was a little or the delivery of other
pandemic has been much better. support services.
affecting students, the Just under a quarter Ben Marks, CEO of
Higher Education Policy of students described YouthSight, said: ‘For
Institute and YouthSight their mental health as every student who feels
polled more than 1000 the same, while one-fifth their mental health has
full-time undergraduate described their mental improved, over four
students in March. health as much worse. feel it has got worse […]
Almost two-thirds In terms of support, Universities need to put
(63%) said their mental 38% of students were more resource behind
health was a little satisfied with the their mental health (and
or much worse as a delivery of mental other) student services:
result of the pandemic health services, let’s hope the pandemic
compared with just 14% compared with 50% can be a catalyst bit.ly/UK_Covid_mental_
who said their mental who were satisfied with for change.’ health_university
8
COMMUNITY PRACTITIONER | MAY / JUNE 2021
NEWS Public Heal_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 8 07/05/2021 16:37
NEWS
NEW MENTAL HEALTH HUBS
FOR NEW, EXPECTANT OR BEREAVED MOTHERS
of the country had no
access to specialist
perinatal mental
health care
Thousands of new, expectant or bereaved Around five years ago, 40% of the country
mothers will receive help and support for had no access to specialist perinatal mental SUPPORT PEOPLE
mental health problems through ‘dedicated health care, NHS England said. The clinics WITH EATING
hubs’ being set up across the country, NHS will also provide training for maternity staff DISORDERS NOW
England has announced. and midwives.
That’s the priority
By the end of 2021/22, around 6000 Of the 26 sites, 10 are due to open ‘within
recommendation of a
women are expected to receive care and months’, with the remainder to start seeing
national review of services:
treatment for a wide range of mental mothers by April 2022. Every area should have
urgent help for people with
health issues, including a severe fear of one by April 2024.
eating disorders.
childbirth and post-traumatic stress disorder Emily Slater, CEO of the Maternal Mental
Self-help packages,
after giving birth. Health Alliance, said: ‘These new services will
peer support networks and
The 26 hubs have been designed to bring enable more women than ever to access vital
emotional and practical
together maternity services, reproductive perinatal mental health care.
support for families and
health and psychological therapy under one
carers were recommended.
roof as part of the NHS Long-term plan to
bit.ly/ENG_mental_health_mothers The review came in
increase access to psychological support.
response to an increase in
the number and severity of
cases during the pandemic.
BMI SHOULD BE SCRAPPED AND OBESITY STRATEGY IS The Scottish Government
‘DANGEROUS’, SAYS COMMITTEE announced the National
Review of Eating Disorder
The use of body mass index of a ‘health at every size’ Committee chair Caroline Services last year.
(BMI) to assess whether a approach to prioritise Nokes said: ‘Government The 15 detailed
person’s weight is healthy lifestyle choices over action in this area is recommendations are
should stop, according to a correcting weight. limited – we need to see being taken forward by
report on body image by the The report noted mental urgent action. an implementation group
House of Commons Women health minister Nadine ‘The government of stakeholders who are
and Equalities Committee. Dorries’ acknowledgement must ensure its being guided by a ‘lived
The committee concluded that ‘there was “good and policies are not experience’ panel – this
that BMI contributes to bad” in the use of BMI’. contributing includes patients, their
eating disorders and The committee also to body image families and loved ones, and
people’s mental health by reported the ‘devastating’ pressures.’ third-sector professionals.
‘disrupting body image and impact of lockdown on A spokesperson for the
inviting social stigmas’. those with or at high risk of clinicians and psychologists
bit.ly/ENG_scrap_BMI
The report also labelled developing eating disorders, leading the review said
the government’s obesity urging restrictions or even they ‘hope that this review
strategy ‘dangerous’ for a ban on altered images will pave the way to more
people with negative in adverts. equitable, accessible and
body image, calling for an
ISTOCK / SHUTTERSTOCK
supportive services in
independent review, as well Scotland for all people who
as a rethink on how the have eating disorders and
government collects data on their loved ones’.
childhood obesity.
Instead, the committee bit.ly/SCT_ED_
called for the adoption review
9
COMMUNITY PRACTITIONER | MAY / JUNE 2021
NEWS Public Heal_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 9 10/05/2021 16:22
NEWS
PROFESSIONAL UPDATE
‘I am
aabsolutely
det
determined to
pu
put this right.
But I cannot do
th
this alone’
PROTECTION FOR STAFF NEED SUPPORT HEALT MINISTER
HEALTH
STAFF WITH LIFE- TO DEAL WITH MENTAL DETAILS AMBITIONS FOR
LIMITING ILLNESS HEALTH CHALLENGES REBUILDING HEALTH
NHS Scotland is adopting Unite has called for In a keynote statement
the Dying to Work Charter, action, including full to the Assembly in mid-
which affords healthcare staff with consultation with unions, to deal with April, health minister Robin Swann
life-limiting illness extra protections the mental health challenges faced laid out the plans for rebuilding
at work. by staff due to the pandemic. Northern Ireland’s health service.
The charter will ensure these staff Unite commented after a report He repeatedly spoke about the
aren’t dismissed because of their by the NHS Confederation lcalled need to address waiting times, which
condition, unless leaving would for local leaders to ensure staff have were ‘already appalling’ pre-Covid.
benefit them in some way. ‘decompression time’ to deal The minister said: ‘I am absolutely
Championed by the TUC (and with the pandemic’s impact. determined to put this right. But
with backing from unions including Unite national officer for health […] I cannot do this alone. I need
Unite), the charter will provide NHS Jackie Williams said: ‘All workers need the support of this house and my
Scotland staff with ‘greater job and the appropriate help and support to executive colleagues.’
financial security’ at an already recover from their experiences and He revealed upcoming public
stressful time. it is essential that employers treat consultations on waiting times and
All health boards will be asked to these challenges with the maximum cancer care.
make a commitment to the charter amount of sensitivity.’ He also spoke about more
and agree a statement for the NHS She also revealed that Unite’s own immediate trust-rebuilding plans
Scotland attendance policy. research had shown that ‘workers for health and social care.
Boards will be asked to set up across the whole of the NHS [...] are The minister recognised that
employee assistance programmes suffering from increased mental ‘the executive has limited room for
to ‘provide support to affected staff, health issues including depression, manoeuvre in budget terms’, with
including access to counselling and anxiety and in extreme cases post- decisions ‘taken in London’.
financial advice’. traumatic stress disorder’. But he said that he ‘cannot think
Health secretary Jeane Freeman u See page 33 for more on Covid’s of a more pressing issue facing us
SHUTTERSTOCK
said the ‘charter is about choice’. impact on CP wellbeing. than waiting times’.
bit.ly/SCT_protecting_ bit.ly/UK_staff_recovery bit.ly/NI_rebuilding_
unwell_staff health_service
10
COMMUNITY PRACTITIONER | MAY / JUNE 2021
NEWS Professiona_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 10 07/05/2021 16:40NEWS
50%
increase in the number of
education staff promised
by the government to
supervise students on
clinical placememt
CARING DURING COVID: MORE FUNDING FOR NMC CONSULTATION TO
HALF OF WORKFORCE STUDENTS TO ENSURE MODERNISE NURSING
ARE ‘OVERWHELMED’ PRACTICAL EDUCATION EDUCATION STANDARDS
In a survey asking Nursing, midwifery and The NMC has launched a
about the impact of allied health professional consultation on new draft
Covid on their work, 49.3% of health students are set to access alternative education standards ‘to modernise
and social care workers said they clinical placements to ‘support their community and public health nursing
felt overwhelmed by increased practical education disrupted by standards’ in the UK.
pressures, 46.1% felt impacted Covid’, the Scottish Government has The standards, which set out the
but not significantly – and only announced. knowledge and skills needed to
4.6% said that their service had Funding of around £8m will be gain post-registration qualifications
not been impacted or had been used to ease pressure on clinical for SCPHN and specialist practice
stepped down. placement capacity so that students qualifications were last updated more
The UK-wide survey was open to can still gain the required skills and than 15 years ago.
social care workers, social workers, practice hours. The NMC stated that the draft
allied health professionals, nurses University staff will be able to standards are ‘designed to support
and midwives. It received 3499 deliver new placements and practical the innovation in practice that is
responses in its second phase training using ‘innovative technology’. already happening’ across the UK,
(November 2020 to January 2021). The government also said there and are ‘flexible enough to take
The study focused on the mental will be a 50% increase in the number account of future ambitions for care’.
wellbeing, quality of working life, of education staff who supervise Professor Geraldine Walters CBE,
burnout and coping strategies of students on clinical placement. executive director of professional
workers during Covid. This is to include more staff to practice at the NMC, said: ‘Community
Principal investigator Dr Paula support students in care homes and and public health nursing has never
McFadden said: ‘The results […] other health and social care settings. been more important.’
highlight that a systems-level Health secretary Jeane Freeman Unite are encouraging nursing
approach is required to support the spoke of the ‘extraordinary members to respond individually or
health and social care workforce to dedication, resilience and collectively to the consultation,
rebuild, reset and recover.’ commitment’ shown by students. which is open until 2 August 2021.
bit.ly/UK_staff_ bit.ly/UK_NMC_
wellbeing_Covid bit.ly/SCT_student_funding
new_consultation
11
PRACTITIONER | | MAY
COMMUNITYPRACTITIONER
COMMUNITY FEBRUARY
/ JUNE2018
2021
NEWS Professiona_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 11 07/05/2021 16:40NEWS
u For more
information on
these studies, visit
GLOBAL RESEARCH the bit.ly links
USA
PERSONAL STORIES OF VACCINE
SIDE EFFECTS REDUCE THE IMPACT
OF HARD SCIENCE MESSAGES
Expert scientific messages on vaccine safety are effective
at increasing public acceptance of vaccines, but this
benefit is mostly lost when news programmes show a
personal narrative on side effects, research has found.
The study, published in PLOS One, involved a
nationally representative sample of 2345 participants
who were shown one of six edited news programmes
about the measles, mumps and rubella (MMR) vaccine
produced during the 2019 measles outbreak in the US.
They included clips of Dr Anthony Fauci, director of the
National Institute of Allergy and Infectious Diseases,
relaying evidence on the value and safety of the MMR
vaccine, and a mother refusing to vaccinate one child
because another had a severe reaction.
Co-author Dolores Albarracín said: ‘Statistical
information about vaccine trials should be communicated
repeatedly and early, before vivid
narratives of side
effects take hold.’ UK
u bit.ly/
POORER OUTCOMES FOR MUMS
PO_vaccine_ AND BABIES DURING THE PANDEMIC
media_role
Pregnancy outcomes for mothers and babies have
worsened during the Covid-19 pandemic, revealed a
global study.
The review of 40 studies from 17 countries in The Lancet
USA Global Health showed an increase in the chances of
stillbirth and maternal death, particularly in low- and
GENDER DIFFERENCES AND THE INFLUENCE
middle-income countries. Women requiring surgery
OF ACEs ON YOUTH DELINQUENCY
for ectopic pregnancies increased and mental health
Adverse childhood experiences (ACEs) have a significant effect on
outcomes worsened, with reported increases in postnatal
teenagers’ criminal behaviour, at least for girls, according to a study
depression and maternal anxiety.
in the Journal of Research in Crime and Delinquency.
Overall, the study revealed a disproportionate impact
Girls who experienced four or more ACEs by age five, during
on low- and middle-income countries. The study is the
the most sensitive period of brain development, were 36% more
first global assessment of the impact of the pandemic
likely to participate in delinquent behaviour. Boys’ delinquency
on antenatal, birth and postnatal outcomes, though
appeared unrelated to early ACEs. The research looked at data from
it didn’t look at the impact of Covid-19 infection
the longitudinal Fragile Families and Child Wellbeing study, which
in pregnancy.
examined childhood adversity and adolescent behaviour.
Lead author Professor Asma Khalil said: ‘It is clear
Co-author Melissa Jones said: ‘Our analysis points toward the need
from our study and others that the disruption
for gendered strategies in working with children with ACEs, because
caused by the pandemic has led to the
the different ways boys and
avoidable deaths of both mothers
girls are socialised shape how
and babies, especially in low- and
they process trauma.’
middle-income countries.’
u bit.ly/JRCD_ACEs_gender
u bit.ly/TLGH_Covid_perinatal
12
COMMUNITY PRACTITIONER | MAY / JUNE 2021
NEWS Research_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 12 07/05/2021 16:41NEWS
NORWAY
HEALTHY BODY IMAGE PROTECTS AGAINST WEIGHT GAIN IN TEENS
A two-year study of 1225 self-rated health and self- after two years, and self-rated
Norwegians in early esteem. The impact on the health was also associated
adolescence found that latter was particularly strong with a beneficial BMI change
positive ‘self-rated health’ and among girls. Paradoxically, over the two years.
self-esteem protected them the intention of becoming Lead author Professor
against weight gain. thinner was associated with an Eivind Meland said: ‘We
The study, published in BMC increase in body mass index conclude that health
Public Health, also found that (BMI), while the intention of promotive efforts in
girls generally had lower body becoming ‘fatter’ predicted a
adolescence should be based
confidence than boys. decrease in BMI.
on self- and body acceptance.’
The researchers found Positive self-rated health
that teenagers’ body and and self-esteem were both u bit.ly/BMCPH_self-
weight concerns impaired associated with a leaner body esteem_BMI
UK
SHEDDING THE STIGMA
OF CATCHING COVID CAN
HELP DEFEAT PANDEMIC
Feelings of shame and stigmatisation
at the idea of contracting Covid-19
are linked to lower compliance of
social distancing and the likelihood of
reporting infection to authorities and
potential contacts.
FINLAND That was the finding of UK
researchers looking at pandemic
EXERCISE HELPS CURB LOW-GRADE
behaviour in Italy, South Korea and
INFLAMMATION IN CHILDREN
the US last April.
Doing more brisk and vigorous physical activity can However, the study also found that
help curb low-grade inflammation in children with a those who trust their government’s
higher body fat percentage, suggests research in the response to the Covid pandemic and
European Journal of Sport Science. feel a mutual solidarity are more
Being overweight and obese contribute to low-grade likely to report catching the virus
inflammation, and if the inflammation is long-lasting to authorities and acquaintances,
it can increase the risk for type 2 diabetes and although the association between trust
cardiovascular diseases. and compliance was not statistically
The study looked at the associations between significant in the US, found the research
physical activity, sedentary time, diet quality, body fat in Frontiers in Psychology.
content, and low-grade inflammation in 390 children Co-author Giovanni Travaglino said:
aged six to eight years old. ‘Our research highlights the importance
Overall, higher levels of physical activity and lower of managing the stigma associated
levels of sedentary time were associated with a with Covid-19, which may undermine
healthier inflammatory profile. Body fat percentage authorities’ efforts to control it.’
modified these associations.
Lead author Dr Eero Haapala said: ‘The key message u bit.ly/FIP_Covid_compliance_trust
of our results is that increasing physical activity and
reducing sedentary time are key in preventing low-grade
SHUTTERSTOCK
inflammation [from] childhood.’ He added that this is
‘particularly important for overweight children’.
u bit.ly/EJSS_activity_inflammation_children
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COMMUNITY PRACTITIONER | MAY / JUNE 2021
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BIG STORY
EXPECT THE
UNEXPECTED
Women’s safety he idea work – has come into sharp
T
of ‘safety public focus following the
has moved into the at work’ tragic and shocking death
for many of Sarah Everard, who was
spotlight recently, employees is abducted in March while
and community often applied to any equipment
used and the avoidance of
walking home in London.
practitioners – many hazards. However, for many VICTIMS OF GENDER
of whom are female women working as community
practitioners (CPs), there are
Most of the statistical
attention on female safety
– face particular risks other ways to read the phrase. surrounds what is classified
at work. Journalist CPs work in community
locations, in people’s homes,
as ‘sexual assault’, while also
acknowledging that a huge
Radhika Holmström in places that may be out of proportion of sexual assaults go
the way or badly lit, and with unreported. Figures from the
asks how you can clients and patients who may Office for National Statistics
stay safe on the job. be hostile. All this adds up (ONS) suggest that men are
to a potentially dangerous more likely than women to be
situation. And over the past the victims of violent crime,
couple of months, the whole except in cases of domestic
issue of women’s safety – on abuse (ONS, 2020). However,
the streets, at home and at the evidence from women
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about their experiences Wales (GIG Cymru and NHS (Offences) Act 2018 – which A DAILY BATTLE
demonstrates just why so Wales, 2018), 8% in Scotland is now being extended with
many women feel unsafe in – rising to 20% of nursing longer penalties – covers anyone
public. A recent UK-wide staff (Scottish Government, providing or supporting NHS
survey on sexual harassment 2015) and 14% – rising to 26% services. The Northern Ireland
found that more than 70% of of nursing staff – in Northern Assembly is also considering
women in the UK say they have Ireland (Quality Health Ltd, similar legislation.
experienced sexual harassment 2016). Once again, black and The health and safety
in public (UN Women
UK, 2021).
Successive studies bear
Asian staff were more likely to
experience such incidents.
No figures were readily
executive in all four nations
has also produced policies
to protect the safety of lone
Over 70%
of women in the UK say
this picture out. A significant available for assaults on workers (in all sectors), with they have experienced
proportion of these assaults CPs specifically, but nurses additional policy work aimed sexual harassment in public
take place in public spaces, working in the community at protecting health workers.
including on public transport face unique problems. Not only NHS England published
(Mayor of London Office for
Policing and Crime [MOPAC]
are they regularly travelling to
and from work, but they are
its violence prevention
and reduction standard at
14.5%
and NHS England, 2016). working in different places, the beginning of this year, of NHS staff had
Younger women, and black and with potentially difficult or stating that organisations and experienced at least
Asian women, are also more hostile clients, and they are commissioners should review
one incident of
physical violence in
likely to be subjected to assaults often working alone. ‘Even if their work against this twice
the past 12 months
(MOPAC, 2019). CPs aren’t doing a physical risk a year (NHS England, 2021).
A vast proportion of these assessment, they’re constantly Some guidance also singles out
crimes are not reported; risk-assessing what they lone workers: NHS Employers
they’re accepted as part of encounter,’ says John McLaren, published Improving safety
daily life. One problem is that a former practising health for lone workers: a guide for
organisations define sexual visitor and now the employee managers (NHS Employers,
harassment in different ways,
so that women often feel that,
director (a union role) at NHS
Borders and a senior rep for
2013) and Improving safety
for lone workers: a guide for
1.2
however uncomfortable or
dangerous their experiences,
Unite-CPHVA.
‘Most will have at the
staff who work alone (NHS
Employers, 2018), NHS Wales
million
an incident may not count forefront [of their minds] not published its lone worker violent incidents in
as a crime. The UN Women their own safety but the safety procedure (GIG Cymru and England and Wales in the
UK report defines sexual of those around them. If you Public Health Wales, 2018), year to March 2020
NHS and Survey Coordination Centre,
harassment as ‘the continuum think there’s a risk to a child or while NHS Scotland’s health
2021; ONS, 2021; UN Women UK, 2021.
of violent practices against woman in that environment,
women and girls’; and, it’s going to be further
importantly, this is a wide complicated.’ He adds that
continuum (see What constitutes recent concerns about Covid-19 WHAT CONSTITUTES
sexual harassment?, right). and PPE have increased the
tensions involved.
SEXUAL HARASSMENT?
RISK TO HEALTHCARE u Being cat-called or wolf-whistled
PROFESSIONALS THE LAW AND POLICIES u Being stared at
Healthcare professionals face There is some legislation u Unwelcome touching, body rubbing, or groping
particular risks – and over around violence and assault u In-person comments or jokes
the past year the risks have that specifically protects health u Unwelcome sexual advances or requests for
increased. The latest NHS Staff workers. In Scotland, the sexual favours
Survey for England shows that Emergency Workers (Scotland) u Being physically followed
14.5% of staff had experienced Act 2005 includes ‘registered u Indecent exposure
at least one incident of physical medical practitioners’ and u Online comments or jokes
violence in the past 12 months ‘registered nurses’ in the u Sharing of suggestive or indecent content online
(NHS and Survey Coordination categories of people who can or in person
SHUTTERSTOCK
Centre, 2021). Similar staff invoke this legislation if they are u Being forced into participating in sexual behaviour
surveys in recent years show assaulted in the course of their u Having images taken and/or shared without
that 11% had experienced work. In England and Wales, the your consent.
physical violence at work in Assaults on Emergency Workers UN Women UK, 2021
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and safety guidelines has
a section on lone workers RISK FACTORS FOR LONE WORKERS
(Scottish Government, 2003).
u Abnormal and hazardous conditions, u Lone worker wearing uniforms,
So overall, there is an
overlapping set of documents such as an isolated work place, poor travelling between certain environments
and policies in this area lighting and so on. or settings and visiting the same
u Risk to lone worker with medication on destination over a number of occasions
that give overall guidance,
some of it mandatory. Many their person, particularly controlled drugs. especially at the same time.
u Staff delivering unwelcome information u Lone workers carrying equipment
trusts have also produced
their own policies to support or bad news. that makes them a target for
u Increased risk of violence from service theft or makes them less able
lone workers. NHS Glasgow
and Clyde, for example, has users/clients/patients due to alcohol to protect themselves.
or drug abuse, drug misuse or non- u Evaluation of capability to undertake
produced comprehensive
guidance, issued staff with compliance in relation to their clinical lone working – for example, being
electronic alarms, and has condition or response to treatment, and inexperienced, pregnant or having
risk-assessment policies. the risk of violence from their carers, a disability.
Jacalyn Williams, Unite’s relatives or visitors. GIG Cymru and Public Health Wales, 2018
national officer for health,
says: ‘Clearly, employers
have a duty to carry out risk and campaigns officer at the work, around violence and
assessments, address women’s Suzy Lamplugh Trust, suggests aggression, so all CPs should
health and safety concerns, using a personal alarm (many be able to at least de-escalate
and then decide first how the health organisations already things that are getting difficult
risk can be eliminated, and, if issue these), and planning – sometimes the safest thing is
that isn’t possible, minimised some strategies for a quick to withdraw and seek help.
or controlled. They should getaway if necessary. ‘For ‘We encourage people to
develop an action plan to deal example, you could say “I’m think first and foremost about
with the risks women face at sorry, I’ve left some paperwork their own safety, and then
RESOURCES
work, setting out what will I need in the car”. This could support them with what they Suzy Lamplugh Trust
be done to keep women safer give you time to de-stress need to do to make it safe for suzylamplugh.org
and healthier, and this should before returning, or could those around them.’ He says UN Women UK
be communicated to women allow you to phone from the safety is on the agenda in a way unwomenuk.org
workers so that they know the safety of your car, saying that it may not have been in NHS England violence
risks faced, and the steps that you have been called back to the past. ‘We’ve got more risk prevention and
will be taken to deal with them.’ the office and will rearrange assessments and more tools to reduction standard
Women workers themselves the appointment.’ use as practitioners to stay safe bit.ly/NHS_violence_
have a part to play in this Violet also recommends not and to keep our clients safe.’ standard
process, she adds. ‘As part of going in at all if something To conclude, Janet Taylor, GIG Cymru and Public
this, it’s vitally important that seems a bit ‘off’. ‘Conduct chair of the CPHVA Executive, Health Wales lone
they are communicating with your own “dynamic risk provides some advice for CPs: worker procedure
the safety representatives and assessment” before you ‘Never put yourself in danger; bit.ly/PHW_lone_workers
the workplace representatives, enter,’ she says. ‘If the person do a risk assessment, and Scottish Government
because they will know what you expected to meet isn’t maintain safety at all costs. Managing Health at
the specific issues are that this there, don’t go in – say you’ll If you feel you’re threatened Work Partnership
workforce is facing.’ return later or rearrange the or feel at risk, or that this Information Network
appointment. And if you do go is a house where someone (PIN) Guideline
PERSONAL PROTECTION in and feel at all uncomfortable, may make you feel at risk, bit.ly/SCT_lone_workers
However, in practice, many make an excuse and leave. Trust go back and discuss it with 2015 HSCNI
female CPs and other women your instincts. If something your manager. Put safety Staff Survey
do continue to feel unsafe doesn’t feel right, or you feel mechanisms in place. Of bit.ly/NI_staff_survey
during the course of their work unsafe in any way, act on it. It’s course, you can’t rule out
or other daily activities. And better to be over-cautious than the unexpected, but remove
SHUTTERSTOCK
some of the standard advice, under-cautious.’ yourself and seek help. No
For references,
such as using well-lit routes, John says: ‘We [at NHS member of staff should be visit bit.ly/CP_news_
may simply not be practicable. Borders] do have personal in that situation. Never put big_story
Violet Alvarez, senior policy safety training as part of our yourself in danger: not ever.’
16
COMMUNITY PRACTITIONER | MAY / JUNE 2021
NEWS Big Story_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 16 07/05/2021 16:43The National Health Service (NHS) recommends a daily vitamin D supplement
from birth for breastfed infants. Baby Ddrops®JTBTDJFOUJţDBMMZQSPWFOBOE
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Surveys show that UK toddlers’ vitamin D consumption is only 22% of the reference nutrient intake.2
80% of UK parents also reported that they are looking for more information about vitamin D and
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1
Fink C, Peters RL, Koplin JJ et al. Factors affecting vitamin D status in infants. Children 2019; 6(7). Doi: 10.3390/children6010007. 2 Cribb V.L., Northstone K., Hopkins D., Emmett P.M. (2015) Sources of vitamin D and calcium in the diets
of preschool children in the UK and the theoretical effect of food fortification. J Hum Nutr Diet. 28: 583–592 10.1111/jhn.12277. 3 Day et al. We still don’t know that our children need vitamin D daily: a study of parents’ understanding
of vitamin D requirements in children aged 0-2 years. BMC Public Health (2019) 19:1119 https://doi.org/10.1186/s12889-019-7340-x. 4 Grant et al. Vitamin D During Pregnancy and Infancy and Infant Serum 25-Hydroxyvitamin D
Concentration. Pediatrics 2014;133;e143; originally published online December 16, 2013; DOI: 10.1542/peds.2013-2602.
DDrops FP.indd 2
CPMAY2021.017.indd 17 20/04/2020 10:27
05/05/2021 16:14OPINION
FEEDBACK
LOOKING
FORWARDS
Recognising fantastic work, plus the
importance of adapting and wellbeing.
BOOK NOW!
CELEBRATING THE MARY SEACOLE AWARDS UNITE-CPHVA
This year’s virtual Mary Seacole Manchester Metropolitan an exploration of factors ONE-DAY
Leadership and Development University – Achieving Care influencing the uptake in a VIRTUAL
Awards had a slightly different Together (ACT) Project. deprived area of Kensington CONFERENCE
focus. Due to Covid, much and Chelsea, London.
The inaugural one-day
of the awardees’ (for 2019- MALKO ADAN, senior research Unite-CPHVA national
2020) project work is still midwife, Imperial College AMANDA FIRTH, PhD student conference is being held
underway – and has involved London/Imperial College at the University of Bradford, virtually on Wednesday
the awardees having to adapt Healthcare NHS Trust – Bridging senior lecturer in midwifery, 9 June 2021. Entitled
and innovate. So the evening the inequality of outcomes University of Huddersfield – ‘Health and wellbeing
was a chance to celebrate experienced by black African Perinatal depression in refugee for all ages’, the aim is to
their achievements so far, and black Caribbean women in and asylum-seeking women: help tackle some of the
with plenty of inspiration spontaneous pre-term birth: a investigating the issue at key problems posed by
the pandemic.
and reflection. service evaluation. a service user, clinical and
Topics will include
The Mary Seacole Awards system level.
staff wellbeing, parental
provide opportunities to Development awards mental health (fathers),
undertake specific healthcare REBECCA AGBOOLA, ANGANIE SEECHARAN, school age wellbeing,
projects that benefit the health health visiting team lead, diabetes specialist nurse, London and babies in lockdown.
outcomes of black, Asian and Central London Community North West University Healthcare Speakers will include
ethnic minority communities. Healthcare NHS Trust – NHS Trust – An evaluation of paternal mental health
Those being celebrated were: Increasing the uptake of group session for people with expert Mark Williams and
Leadership awards two to 2.5 years child health type 2 diabetes on insulin Sally Hogg of the Parent-
EULA MILLER, senior lecturer, reviews among black and amongst black, Asian and other Infant Foundation.
programme lead mental health, Asian minority ethnic groups: ethnic minority communities.
THE COST TO ATTEND IS
AS FOLLOWS:
u Members: £20 (students
YOU
SAID IT! and nursery nurses £10)
u Non-members: £30
MICHELLE MOSELEY
@shel_e_moseley DR MICHAEL (Students and nursery
FANNER SCPHN (HV)
HV) nurses £15)
m
Great to see this in print from @PostDocHV
Nicola Rooke @cardiffuniscphn hn To book your place, visit
Looking forward to
students perspectives of cphvaconference.org/
safeguarding education and browsing this issue
ue signup
practice within a pandemic of @CommPrac
with a
Please let us know how you’re doing and what practice is like for you now. As always, we’d love to hear from
you, so to give any feedback on the journal or to talk about your work projects, tweet us @CommPrac, or email
aviva@communitypractitioner.co.uk
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RIGHTS
AT WORK
YOU’VE EARNED IT Colenzo Jarrett-Thorpe, Unite national officer for
health, explains why Unite-CPHVA is campaigning
for the pay rise all NHS workers deserve.
HEALTH VISITORS:
I n March, the UK Government’s
evidence to the NHS Pay THE UNITE EVIDENCE
consultation and trade unions are set to report
the outcome of the consultation on 12 May.
Review Body (PRB) delivered
the sledgehammer news that it was
recommending a paltry pay rise of 1% for
70% WALES AND NORTHERN IRELAND
The Wales and Northern Ireland governments
of HVs who took our pay survey
NHS workers this year. This was despite the last November were either also await the recommendation. Neither
praise heaped on NHS workers during the dissatisfied or very dissatisfied government submitted evidence to the PRB
pandemic. The announcement falls well with their pay asking for a 1% increase for NHS workers.
short of Unite-CPHVA’s pay claim of £3000 The NI Government will give a one-off £500
or 15%, whichever is greater. payment to NHS workers, and the Welsh
Unite-CPHVA assembled a team to give
oral evidence to the PRB on 23 March, after
78% Government £735.
submitting our written evidence back in
of HVs always or frequently For more information contact your CPHVA
worked more than their
January (see statistics, right). Our lay activists LAR or Unite the Union district or regional
contractual hours in a
did a fantastic job to portray what a decent typical week office. Information in this article was correct
pay rise would mean for NHS workers. as of 26 April 2021.
Many NHS staff who remained at the top of
their band have seen a 19% real decrease in
their pay since 2010. In the same time, MPs
79%
have seen a real increase in their pay of 2%. of HVs had experienced staff
We can afford a decent pay rise shortages over the past year
– independent analysis by London
Economics has showed that increasing the We will not be idle waiting for the
Agenda for Change pay bill by 10% has a PRB report and are ready to conduct an
net cost of just £0.66bn. Remember the indicative ballot for industrial action should
government is planning to spend £37bn on the pay award not meet our expectations.
an unfit-for-purpose test and trace system. Please ensure your membership details are
up to date on the Unite website.
WHAT NEXT?
We will continue to campaign on this issue. SCOTLAND
We have urged members to write to MPs At the end of March, the Scottish
and encouraged members from across the Government made an offer of 4% on the
Unite family to share photos displaying their pay bill of the Scottish NHS backdated to
support for NHS workers. Please continue to December 2020 with any Barnett formula
SHUTTERSTOCK
use our materials and share them with your consequentials that flow from any PRB
colleagues and friends, so the government settlement. The government also will give
will not get away with this poor treatment of a one-off £500 payment to NHS workers as
NHS staff. a thank you. The pay offer has been out to
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COMMUNITY PRACTITIONER | MAY / JUNE 2021
Rights at work_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 19 07/05/2021 16:44JOBS
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Community Practitioner Jobs
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Community Practitioners
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communitypractitioner.co.uk/jobs
To advertise your vacancy please contact the recruitment team:
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CPMAY2021.020.indd 20 10/05/2021 10:26OPINION
STORIES FROM
THE SHARP END
As the vaccination roll-out continues apace, four
members supporting the programme – from Unite
staff volunteering alongside their day jobs to a retiree
returning to practice – reflect on their experiences so far.
An unexpected
return to work
I retired from the NHS just over four years ago after a career as We have vaccinated in sub-zero
a nurse, health visitor, public health practitioner and clinical conditions, torrential rain and
nurse manager. I enjoyed all of my roles to at least some storm-force winds. But we have
degree, and liked nearly all of the people I worked with – but kept vaccinating.
I have absolutely loved life in retirement. I did a modicum of Having solved some
bank health visiting immediately after retiring, but found that inevitable teething troubles,
it interfered too much with my leisure activities. And then the centre has provided a
along came the first pandemic for more than 100 years. highly organised vaccine
By this time early last year, I was no longer a registered delivery system. Its staff
nurse or HV. My registration had lapsed at the end of January come from all over
2020 and I hadn’t been planning to renew it. But the Covid the NHS and further
crisis prompted the government, through the NMC, to afield. They have all been
temporarily restore those nurses whose registrations had fabulously helpful and kind, especially the traffic controllers,
recently expired back onto the register. who are out in all conditions patiently guiding drivers around
Last year I volunteered to return to the NHS and underwent the site. The clinical staff have a wide range of backgrounds
a rather tortuous induction process with NHS Lothian. And – from midwives to dental specialists – with some adding
then, just before Christmas, the health authority emailed to extra hours to their day jobs and many others, like me,
ask me to support the mass vaccination programme over the coming out of retirement to ensure that the programme
first half of 2021. I agreed. proceeds as smoothly as possible. Crucially, the calm, skilled
After a mostly online vaccination induction programme and effective manager in charge of their work has earned
– which, given the speed and scale of the operation, was everyone’s confidence.
remarkably thorough and well delivered – I was offered a I have found the experience hugely positive and rewarding
temporary part-time contract at the vaccination centre on the so far. While I’ll be happy to return to retirement and fade
Musselburgh campus of Queen Margaret University, starting into the sunset, I’m immensely proud to have been able to
in early February. play a small part in this incredible effort.
The site offers a drive-through service, so I thought it
might be the coldest and windiest vaccination centre in
John Boyce,
SHUTTERSTOCK
Lothian. In its first weeks of operation, it certainly was. Edinburgh
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OPINION Vaccine_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 21 07/05/2021 16:45OPINION
Back in uniform
after 20 years
I’m employed by one of the largest health boards in the UK.
As a senior nurse in health visiting during the pandemic, I was
working from home providing strategic support for HV practice,
education and students who’d been reassigned to work in acute
Covid-facing care. I was offering both professional and emotional
support for people who were really stretched and going the extra
mile to help Covid patients.
In my other role as a senior shop steward, I was also meeting up for the occasion, as this was an exciting outing for them,
managers to discuss issues such as PPE provision and staffing especially as we were based in a large exhibition centre. The
levels while the response to the Covid crisis progressed. After patients saw it as a liberating experience.
I was nominated to represent staff during the vaccination While I was vaccinating people, it was a great opportunity
planning process, I saw an opportunity to make a direct, to check in on their wellbeing and remind them about the
practical contribution to the Covid response in my capacity as a importance of maintaining Covid-safe practices, such as social
registered nurse. I was joined in our immunisation bank by many distancing and wearing masks. I was impressed that many
of my peers and also some former colleagues who were coming patients had great knowledge of the vaccines on offer.
out of retirement. One weekend I worked on a second-vaccination clinic for the
My motivation to get involved at the practice level was also residents and staff of a large care home for military veterans. It
personal: my husband needed to shield, while other close felt amazing to help these patients, many of whom had served in
relatives, including my new grandchild, were living in the USA. the Falklands, the Gulf and even the second world war.
My participation in the vaccination programme may in some way This has been a fulfilling experience so far. I’m so pleased to
help us return to a more normal family life, allowing us all to see be part of the vaccination programme and I look forward to
each other face to face again sooner rather than later. continuing my work.
First, I trained myself in the use of Pfizer’s vaccine and then
AstraZeneca’s, using resources produced by NHS Education
Scotland. Then, in January 2021, I started putting in 12-hour Annie Hair
clinical shifts. It was my first time in uniform for two decades. Senior nurse practice development at NHS
The clinics were well organised, helping to make each shift Greater Glasgow and Clyde; chair of Unite’s
a joy. We initially welcomed over-65s. Many of them dressed Health Visitor Organising Professional Committee
When the pandemic hit, my normal routine of travelling the country for Unite was
Taking the thrown into a weird kind of turmoil. I found myself spending most of my time working
at the kitchen table, getting to see my wife and children every day.
While my nursing and HV family was going through this global crisis, I wanted to
plunge after play my part. I tried to head back on to the wards as a staff nurse but, with a gap of 17
years since my previous shift, I realised that, without more staff around to support my
development back into practice, this ambition was a non-starter. The experience also
a false art resulted in my catching Covid-19 and spending a day in hospital as a patient.
Fast-forward to December 2020, when I volunteered to join the vaccination
programme through my local hospital. I found jumping through the hoops to do all my
training was relatively easy, as I’d already completed a number of modules to get on
to the ward. By the end of the next month, I’d completed my first shift at the Greater
Manchester mass vaccination centre on the Etihad Campus. As a healthcare registrant
member of staff, I spend my shifts either consenting people for the vaccination or
22
COMMUNITY PRACTITIONER | MAY / JUNE 2021
OPINION Vaccine_COMMUNITY PRACTITIONER MAY_JUNE_Community Practitioner Magazine.indd 22 07/05/2021 16:45You can also read
