Page created by Jeanette Parsons

                                                                                               FEBRUARY 2019


                                                                                                  DARK TIMES
                                                                                              TACKLING CHILD
                                                                                             SLEEP DISORDERS

                                                                                          ‘BIOLOGICAL CHAOS’
                                                                                               SPOT THE SIGNS
                                                                                              OF ENCEPHALITIS

                                                                                               COUNTRY LIFE
                                                                                            ARE CPs ISOLATED
                                                                                          IN RURAL SETTINGS?

                                            A clear picture of health-visiting services
                                                  across the four UK countries

COVER_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 1                                30/01/2019 13:23
p02.CPFEB2019.indd 2   28/01/2019 15:35
CONTENTS            February 2019 | Vol 92 | No 1

           30          COVER STORY
                                                                             inflammation of the
                                                                             brain may be rare but
                                                                             it can be deadly

                                                                                                                          When nurses
                                                                                                                          hang up their
                                                                                                                          uniforms and
                                                                                                                           become HVs

                                                                                                                                 Stepping in to

                                                                             42                                                 children
                                                                                                                                 hildr online

                                                                             Rural practice: the view
                                                                             from the countryside

                                                       A bad night?
                                                  Sleep disorders in
                                                  children increase

       NEWS                                    14 BIG STORY                           20 THE BIG QUESTION            PRACTICE
                                                  How can CPs help                       Why is it important that
       6   NEWS IN NUMBERS                        safeguard children and                 members find the time       22 24 HOURS WITH...
           Your at-a-glance guide                 their data in a world                  to complete our                Debbie Fawcett,
                                                  that is increasingly                   readership survey?             specialist health visitor
       8   PUBLIC HEALTH LATEST                   lived online?                          The journal’s team at          for homeless families
           A look at what’s new                                                          Redactive respond
                                               OPINION                                                               24 CLINICAL
       10 PROFESSIONAL UPDATE                                                         21 RIGHTS AT WORK                 A brain under siege:
          Your round-up of                     18 FEEDBACK                               Unite national officer         when encephalitis strikes
          professional news                       Crunching caseload                     Colenzo Jarrett-Thorpe
                                                  numbers, data protection               asks if the NHS long-       28 THE RIGHT MOVE?
       12 GLOBAL RESEARCH                         and the Named Person,                  term plan is just another      What motivates nurses
          Recent findings from                    and HVs named in the                   pledge to be broken by         to become HVs and what
          around the world                        New Year’s Honours list                the government                 skills do they need?

                                                             COMMUNITY PRACTITIONER | FEBRUARY 2019

CONTENTS_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 3                                                                    30/01/2019 15:14
9                                   #CPHVA19

                             EARLY BIRD DEADLINE
                                      28TH JUNE
                                           16-17 October 2019,
                                Harrogate International Centre

                 Book now:

p04.CPFEB2019.indd 4                                             28/01/2019 15:35
       30 COVER STORY
          We shine a light on the reality of
          practice across the four nations and
          look at the unique challenges faced
          by health-visiting services
                                                                              from Emma and Aviva
       38 WAKING UP TO THE CHILD                                              A warm welcome back from your New Year break… It’s only the second month of
          SLEEP CRISIS                                                        2019, and already there is movement afoot in health and social care, with the January
          Healthy sleep patterns are key to                                   release of the NHS long-term plan. Unite national officer for health Colenzo Jarrett-
          child health and wellbeing, but                                     Thorpe looks at what the plan means for you now and moving forward on page 21.
          sleep problems are on the rise and                                     Meanwhile, on page 30, we shine a light on health visiting in the UK - what is the
          support can be patchy                                               true picture of practice, the real challenges and demands in the four UK countries
                                                                              among budget cuts, workforce capacity issues and commissioning problems? And
       42 THE LAY OF THE LAND                                                 how is all this taking its toll on you as dedicated HVs who want to provide the best
          What approaches do CPs take to                                      possible service, and on the families and children you serve? Are there any quick
          caring for families and what extra                                  answers, and what is the best way forward? Some of you have already contributed
          skills do they need to work in rural                                your views (thank you), but we would love to hear what others think of the issues
          and remote settings?                                                reported - perhaps you have aspects to add, or maybe it sounds all too familiar.
                                                                                 Some of the latest topical issues affecting CPs in this month’s journal include the
                                                                              digital footprint of the children you care for (page 14), the current sleep crisis among
        RESEARCH                                                                                                                          young people (page 38),
                                                                                                                                          and the realities of being
       45 PSYCHOLOGICAL SUPPORT                                                                                                           a CP in rural parts of the
          FOR RAPID RESPONSE STAFF                                                                                                        UK (page 42).
          Coping and recharging strategies                                                                                                   A year on from the redesign
          following the death of a child                                                                                                  and refresh of your journal,
                                                                                                                                          we have devised an online
                                                                                                                                          readership survey so that
        PROFESSIONAL PAUSE                                                                                                                you can tell us exactly what
                                                                                                                                          you think (find out how on
       48 THE BUILDING BLOCKS                                                                                                             page 17). We look forward
          OF LEARNING                                                                                                                     to hearing from you. Until
          Kirsten Asmussen of the EIF                                                                                                     next month...
          advises on aiding early years                                                                      JOIN     CONVERSATION
                                                                                                              OIN THE CO
          cognitive development

                                                 Non-member subscription rates                    Editorial team                            Printed by Warners
                                                 Individual (UK)                 £135.45          Managing editor Emma Godfrey
                                                 Individual (rest of world)      £156.45          Deputy editor Aviva Attias                © 2018 Community Practitioners’ and
                                                                                                                                            Health Visitors’ Association
                                                 Institution (UK)                £156.45         ISSN 1462-2815
                                                 Institution (rest of world)     £208.95          Content sub-editor James Hundleby
                                                 Subscription enquiries may be made to                                                      The views expressed do not necessarily
       Unite-CPHVA                                                                                Professional editor Jillian Taylor        represent those of the editor nor of
       Existing Unite-CPHVA members with         Community Practitioner subscriptions             Senior designer Nicholas Daley            Unite-CPHVA.
       queries relating to their membership      Redactive Publishing Ltd                         Picture editor Charlie Hedges
                                                 PO Box 35                                                                                  Paid advertisements in the journal do
       should contact 0845 850 4242 or see                                                        Advertising                               not imply endorsement of the products for     Robertsbridge TN32 5WN                                                                     or services advertised.
                                                 01580 883844                                     Senior sales executive Joanna Holmes
       further details.                                                                                                                     Any Unite-CPHVA member wishing to
       To join Unite-CPHVA, see                                                                   020 7880 6231                             change their contact details must get                         The journal is published on behalf of                                                      in touch with their local Unite office.
                                                 Unite-CPHVA by Redactive Media Group,            Production
       Unite-CPHVA is based at                   78 Chamber Street, London E1 8BL                 Production director Jane Easterman                 Recycle your magazine’s plastic
       128 Theobald’s Road London WC1X 8TN       020 7880 6200                                                                                       wrap – check your local LDPE
                                                                                                  Unite health sector officers
       020 3371 2006                                                                                                                                 facilities to find out how.
                                                 Editorial advisory board                         National officers Jacalyn Williams and
       Community Practitioner                    Karen Adams Obi Amadi Lucretia Baptiste          Colenzo Jarrett-Thorpe
       Unite-CPHVA members receive the journal   Mandy Brimble Victoria Button Toity Deave        Lead professional officers Obi Amadi
       free. Non-members and institutions may    Barbara Evans Gavin Fergie Elaine Haycock-       Jane Beach Gavin Fergie Dave Munday
       subscribe to receive it.                  Stuart Sarah Reddington-Bowes Janet Taylor       and Ethel Rodrigues

                                                                 COMMUNITY PRACTITIONER | FEBRUARY 2019

EDITORIAL_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 5                                                                                                     30/01/2019 13:19


                   deaths and 6 cases of heart disease would be prevented if 1000
                    people moved from a low-fibre to a high-fibre diet. Low fibre is
                      defined as less than 15g and high as 25g to 29g each day
                                                                                                           Mental health patients
                                                                                                           who miss 2 or more GP
                                                                                                          appointments within the
                                                                                                            space of a year are

                                                                                                        more likely to die than those
                                                                                                               who miss none

                                                                                                           Of those who missed
                                                                                                         appointments in Scotland,

                                                                                                          were addicted to alcohol
                                                                                                          and drugs. Among those
                                                                                                         who subsequently died, the
                                                                                                        average age of death was 49

       1 in 10
        men   are affected by                                                                            £30m
           postnatal depression                                                                            a year is needed to meet
              during the first                                                                             the demand for medical
             year after birth in                                                                        students in Northern Ireland.
           Scotland, and are to                                                                          A report found that at least
            be helped in a new                                                                           100 more medical students
            initiative, How Are                                                                           are needed a year to meet
                 You, Dad?                                                                                 the demand for doctors

                                                               COMMUNITY PRACTITIONER | FEBRUARY 2019

6-7 NEWS In Numbers_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 6                                               30/01/2019 13:19

                                                                                               prescriptions for antibiotics were written in
                                                                                              Northern Ireland last year. That is about 1 per
                                                                                             person living in the province – the highest rates
                                                                                            in the UK. Antibiotic resistance could lead to 10
                                                                                            million people dying each year around the world

         additional funding is to be
         made available to improve                                                                                      Cutting the speed limit to

         the mental health of
         children and young people
         in Wales. £1.4m is also being
         invested in mental health
         in-reach support for schools


                                                                                                                      in all urban areas could help
                                                                                                                       counter Scotland’s obesity
                                                                                                                       epidemic, by encouraging
                                                                                                                     more families to get outdoors
                                                                                                                        with their youngsters and
                                                                                                                     take part in physical activities,
                                                                                 of all food and drink                        says the RCPCH

                                                                                 products in prominent
                                                                                 locations in the
                                                                                 supermarket (such as
                                                                                 aisle ends) contribute
                                                                                 significantly to children’s
                                                                                 sugar and calorie intake                of Scottish youngsters
                                                                                                                         aged 2 to 15 are at risk
                                                                                                                          of being overweight

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

                                                               COMMUNITY PRACTITIONER | FEBRUARY 2019

6-7 NEWS In Numbers_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 7                                                            30/01/2019 13:19

             PUBLIC HEALTH LATEST                                                                                                              KEY

                                                             NEW GUIDANCE ON OBESITY IN PREGNANCY

                                               outcome for both
                                               o                              DURING PREGNANCY, WOMEN
                                                mother and baby,
                                                m                             SHOULD FOCUS ON EATING HEALTHILY
                                                the RCOG has said.
                                                DDuring pregnancy,
                                                                              AND BE SUPPORTED WITH ADVICE ON
                                                                              DIET AND THE RISKS OF OBESITY                                    Report
                                                tthey should focus on
                                                 eating healthily and
                                                 be supported with
                                                  advice on diet and
                                                  a                           why it is crucial there        health spending, we know
                                                  the risks of obesity.       are support services           that providing these
                                                     Latest UK figures        available for anyone           services is becoming            Campaign
                                                  show that around            wanting to manage their        increasingly difficult, so we
                                                  22% of pregnant             weight, especially couples     hope that the publication
                                                   women are obese,           wanting to start or expand     of this new guidance acts
                                                   28% are overweight         their family.                  as the catalyst needed to
                                                   and 47% are within           ‘With cuts to public         reverse these cuts.’
             The Royal College of         a normal range.
             Obstetricians and               Responding to the                    OVERWEIGHT AND OBESITY IN PREGNANT WOMEN
             Gynaecologists (RCOG)        publication, Dr Max
             has published new
             clinical guidance on
                                          Davie, officer for health
                                          promotion at the Royal
             obesity management           College of Paediatrics                                                                              Website
             before, during and
             after pregnancy.
                                          and Child Health, said:
                                          ‘Overweight parents are                                                  22%
                Women who are obese       much more likely to have
             should be supported          overweight children, and                                %
             in losing weight before      they as a family are more                      OVERWEIGHT                                          Government
             conception and between       likely to suffer from life-                                                                          website
             pregnancies to ensure        changing conditions such             
             the healthiest possible      as type 2 diabetes. That’s

                             £4M TO DRIVE CAMHS RECRUITMENT
                Another 80 staff in child and                 and the Convention of Scottish Local
                adolescent mental health services             Authorities to review CAMHS published
                (CAMHS) will be recruited in Scotland         its delivery plan for improving services.
                following a £4m investment.                      It recommended preventing young
                  The new staff – psychologists,              people being referred to specialist care
                nurses, allied health professionals and       by default, treating more in primary and
                administration workers – will help reduce     community-based care, and providing
                pressure on CAMHS and support new             more information on what to expect
                services, said mental health minister         from CAMHS and how the system works.
                Clare Haughey.
                  The funding comes as a taskforce          

                appointed by the Scottish Government

                                                                COMMUNITY PRACTITIONER | FEBRUARY 2019

8-9 NEWS Public Heal_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 8                                                                  29/01/2019 18:14



              in external income was generated                                                                        BREASTFEEDING
                                                                                                                      CRUCIAL FOR
                   to support PHW research                                                                            INFANT DENTAL
                                                                                                                      HEALTH, SAYS PHE
                                                                                                                      Public Health England
          Public Health Wales (PHW) has published                   include breaking the generational cycle of        (PHE) has highlighted how
          its Research and development report                       crime, mental health support and training         important breastfeeding
          2017-18, highlighting the depth and breadth               for secondary school teachers, and adverse        is in protecting infant
          of its work.                                              childhood experiences and resilience.             dental health.
             Achievements include 77 academic                          Dr Alisha Davies, head of research and             It says that dental teams
          publications, 20 active research projects                 development division at PHW, said: ‘Our work      should continue to support
          in any single month and nearly £1m in external            cuts across policy agendas and engages a wide     and encourage mothers to
          income generated to support research.                     range of partners.                                breastfeed, that not being
             PHW also secured a £6.8m Home Office                      ‘By generating new knowledge and seeking       breastfed is associated with
          grant to develop the Early Action Together                to answer big questions, our research plays a     an increased risk of infectious
          programme with criminal justice partners,                 fundamental role in achieving PHW’s vision for    morbidity, and breastfeeding
          and has been recognised as a World Health                 a healthier future for Wales.’                    up to 12 months of age is
          Organization Collaborating Centre on                                                                        associated with a decreased
          Investment for Health and Wellbeing.                                       risk of tooth decay.
             Project areas also highlighted in the report                                                                 Further advice for dental
                                                                                                                      teams can be found in
                                                                                                                      Health matters: child dental
                                                                                                                      health (2017), which states:
                                                                                                                      ‘Health professionals, such as
                        CHILDREN EXCEED HEALTHY SUGAR LIMIT BY AGE 10                                                 midwives and health visitors,
                                                                                                                      should support and encourage
                                        The average                 versions of yoghurts,    search ‘Change4Life’     women to breastfeed.
                                        child has already           juice drinks and         online to help               ‘Creating the right
                                        exceeded the                cereals, for example.    them find lower          environment to promote
                                        maximum sugar                  On average,           sugar options.           this is crucial. The Unicef
                                        intake recommended          children consume            Popular brands will   UK Baby Friendly Initiative
                                        for an 18-year-old by       eight excess sugar       display the ‘Good        provides a robust evidence-
                                        the time they turn 10,      cubes a day – around     Choice’ badge            based framework to develop
                                        says Public Health          2800 a year.             online, in-store and     a whole-systems approach
                                        England. Now it has            Families are          throughout their         to breastfeeding.’
                                        launched a new              encouraged to look       advertising for              Unicef said it welcomed
                                        campaign to help            for the Change4Life      healthier options,       the statement and urged
                                        families cut back           ‘Good Choice’            and customers            UK governments to
                                        on sugar.                   badge in shops,          can also find            recognise breastfeeding in
                                           Change4Life is           download the free        these options            all other relevant policies,
                                        encouraging parents         Food Scanner app or      in supermarkets.         including sustainability.
                                        to ‘make a swap
                                        when you next shop’,                                                       
                                        choosing healthier

                                                         COMMUNITY PRACTITIONER
                                                            COMMUNITY           | DECEMBER
                                                                       PRACTITIONER  | FEBRUARY
                                                                                           / JANUARY
                                                                                                2019 2019

8-9 NEWS Public Heal_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 9                                                             29/01/2019 18:15

                     PROFESSIONAL UPDATE
                                                                      Starting                                    ‘Increasing
                                                                                                               investment in
                                                                      salary of                               health visiting
                                                                      £32,222                                   is one crucial
                                                                                                              way to support
                                                                                                            children’s cognitive

                       ‘RED BOOK’ AND                              HVs BUMPED UP TO                          PREPARE DISADVANTAGED
                       MATERNITY RECORDS                           BAND 7 ARE PAID £5K                       YOUNG CHILDREN FOR
                       ARE GOING DIGITAL                           MORE THAN REST OF UK                      SCHOOL, HVs TOLD
                                    The child health record                      New health visitors will                  Health visitors should
                                    ‘red book’ is going                          be paid ‘significantly                    play a greater role in
                       digital, along with maternity records,      more’ than their counterparts in          preparing disadvantaged young
                       under new plans to modernise                England, Wales and Northern Ireland,      children for school, says a new
                       neonatal and maternity services.            under a new deal negotiated by            report from the Early Intervention
                          The Department of Health and             healthcare unions.                        Foundation (EIF).
                       Social Care has announced its aim to           Those choosing to work in Scotland        The EIF called for a greater
                       improve safety, quality and continuity      will now start on Band 7, with a          focus on boosting the cognitive
                       of care, backed by a funding increase       starting salary of £33,222. Health        skills of disadvantaged children at
                       of £20.5bn every year by 2023-24 for        visitors in other areas usually start     an early age. It says health visitors
                       the NHS in England.                         at Band 6, with starting salaries of      should be backed by investment
                          Further plans include improving          around £28,050.                           to ensure they can provide
                       accommodation for critically ill               It is hoped the change will boost      intensive home-visiting support
                       newborns, making physiotherapy for          the number of health visitors by          for low-income families during
                       women who experience incontinence           attracting more skilled nurses.           their children’s first two years.
                       after childbirth more widely available,        Gavin Fergie, Unite’s lead                The report points to evidence
                       and asking all maternity services to        professional officer for health in        that shows by the age of three,
                       offer an accredited evidence-based          Scotland, said: ‘Unite is pleased that    middle- and upper-income
                       infant-feeding programme, such as           the higher banding is a recognition       children have a vocabulary at
                       the Unicef Baby Friendly Initiative.        of the professional dedication and        least twice the size of their low-
                          Matt Hancock, secretary of state         quality of service provided by health     income peers.
                       for health, said: ‘Each child will now      visitors in Scotland.’                       EIF chief executive Jo
                       be able to start life using the best           But he added that the re-banding       Casebourne said: ‘Increasing
                       of modern technology – in a way             ‘must not come at the expense of          investment in health visiting is
                       that’s easier for parents and fit for       other colleagues in the wider health      one crucial way to support

                       the future.’                                sector and result in future cuts’.        children’s cognitive development.’


                                                                 COMMUNITY PRACTITIONER | FEBRUARY 2019

10 -11 NEWS Professiona_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 10                                                           29/01/2019 18:16

                                                                                                            of those surveyed knew
                                                                                                              that co-sleeping on a
                                                                                                             sofa or armchair was a
                                                                                                            main risk factor for SIDS

           STAFF TRAINING                                       NHS STAFF BECOME                         REDUCE THE RISK OF
           BUDGET INCREASES FOR                                 ‘CORPORATE PARENTS’                      SUDDEN INFANT DEATH
           FIFTH YEAR IN A ROW                                  TO VULNERABLE YOUNG                      SYNDROME, SAYS PHA
                         The Welsh Government                                A new ‘corporate                         The Public Health
                         is to increase its                                  parenting’ training                      Agency (PHA) is calling
           investment in education and                          resource has been launched for NHS       for greater awareness of sudden
           training for healthcare professionals                workers to help them understand          infant death syndrome (SIDS) after
           in the next financial year by £7m                    their duty to promote the interests of   a new survey found many adults
           – its fifth consecutive annual rise.                 young people who are or have been        didn’t know about the risk factors.
              Overall, it will invest £114m in                  in care.                                    Only 4% of respondents were
           education and training places to                        Developed by NHS Education            aware of the messages of the 1990s
           support a range of roles including                   for Scotland (NES) and charity           ‘Back to Sleep’ campaign.
           health visitors, nurses and midwives.                Who Cares? Scotland, the resource           Emily Roberts, designated nurse
           However, it will not mean an increase                describes the legal duties of            for safeguarding children at the
           in training places for nurses.                       corporate parenting for young            PHA, said: ‘We need to increase
              Since 2014, there has been a 68%                  people up to the age of 26,              everyone’s knowledge, including
           increase in overall nurse training                   identifies negative effects that ‘care   among relatives and friends who
           places. Health visitor training places               experience’ can have on wellbeing,       may help out with childcare, of the
           have increased by 88%, and a 43%                     and encourages staff to think about      risk factors for sudden infant death.’
           increase in midwifery training places                how they could further promote the          She said that only 8% of
           last year will be maintained.                        interests of these young people.         respondents knew that co-sleeping
              The new money is intended to                         Judy Thomson, corporate               on a sofa or armchair was a risk
           support advanced practice/extended                   parenting lead at NES, said:             factor for SIDS, and just 5% knew
           skills programmes and healthcare                     ‘It’s about doing the things that        that a baby sleeping in a different
           support worker development.                          parents would: paying attention,         room to its parents for the first six
              Health secretary Vaughan Gething                  appreciating when they need extra        months could have an impact.
           said: ‘This record level of funding will             support and removing the barriers           She also urged parents to ‘talk to
           support the highest ever number of                   that can get in the way of them          your health visitor, who can provide
           training opportunities in Wales.’                    achieving their full potential.’         practical advice’.


                                                                COMMUNITY PRACTITIONER | FEBRUARY 2018

10 -11 NEWS Professiona_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 11                                                   29/01/2019 18:16

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

           Research has shown that most healthy
           babies aren’t sleeping through the night
           – even at one year old.
              Investigators found that at six months
           of age, 38% of typically developing
           infants were not yet sleeping at least six
           hours at a stretch at night and 57% weren't
           sleeping eight hours. At 12 months old, 28%
           of infants weren't yet sleeping six hours straight at
           night, and 43% weren't staying asleep eight hours.
              The study, published in Pediatrics, also found no
           association between infants who didn't sleep for
           six or eight consecutive hours and problems with
           psychomotor and mental development.
              Babies who didn't sleep through had a
           significantly higher rate of breastfeeding.
              Researcher Marie-Hélène Pennestri said: ‘Our
           findings suggest parents might benefit from more
           education about the normal development of – and
           wide variability in – infants’ sleep-wake cycles.’

                                                                                            AUGUST BABIES MORE LIKELY TO BE
                                                                                            DIAGNOSED WITH ADHD AT SCHOOL
           USA                                                                              Children who start school as the youngest in their year are
                                                                                            far more likely to be diagnosed with ADHD, scientists say.
           PROBIOTICS DON’T HELP CHILDREN WITH                                                 A study from Harvard University, published in The
           ACUTE GASTROENTERITIS                                                            New England Journal of Medicine, shows that, in those
           A study across 10 paediatric A&E departments found that giving                   states where the cut-off date for school enrolment is
           probiotics to children with gastroenteritis did not help their recovery.         1 September, children born in August are 30% more
             Researchers enrolled more than 900 children aged between three                 likely to receive an ADHD diagnosis compared with
           months and four years with a diagnosis of acute gastroenteritis. They            those born in September enrolled in the same grade.
           were randomly assigned a course of either a probiotic or a placebo.                 Among the 407,000 elementary school children
             Results published in The New England Journal of Medicine showed                studied, no such differences were observed in states
           no difference in length of vomiting or diarrhoea with or without                 with different cut-off dates.
                       probiotic use. A second study, run in Canada using a                    ‘Our findings suggest the possibility that large
                             different probiotic strain, showed similar results.            numbers of kids are being overdiagnosed and
                                 Study leader Dr David Schnadower said: ‘Because            overtreated for ADHD because
                              of the popularity of probiotics, it was important to          they happen to be relatively
                              make sure their use is worth the cost. In this instance,      immature,’ said study lead author
                              probiotics added no measurable benefit.’                      Timothy Layton.

                                                               COMMUNITY PRACTITIONER | FEBRUARY 2019

12-13 NEWS Global Rese_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 12                                                            29/01/2019 18:16

          The body mass index (BMI) remains useful         on 230 different traits                                               Our study asked
          for assessing obesity and health, despite        relevant to metabolism and                                       how useful it really is for
          criticism that it cannot distinguish fat         future heart disease risk.                       detecting the health effects of obesity
          from lean mass, a study suggests.                   The study, published in the Journal           by pitching it against more objective
             Researchers examined body scans               of the American College of Cardiology,           body scan measures.
          from 2840 young people aged 10 to                showed that higher BMI had similar                  ‘We found that […] simple BMI gives
          18 from Bristol’s Children of the 90s            effects to higher total and trunk fat,           very similar answers to more detailed
          population study, comparing BMI findings         reflecting a close overlap between               measures. This is good news since
                                                                                                            BMI is widely measured and costs
          with more precise measures of body fat.          the measures.
                                                                                                            virtually nothing.’
             They studied the effects of total fat,           Bristol University’s Dr Joshua Bell, who
          as well as fat in the trunk, arms and legs,      led the study, said: ‘BMI is often criticised.   

                                                                                                                       POSTNATAL DEPRESSION
                                                                                                                       RISK FAR HIGHER IN
                                                                                                                       MOTHERS OF BOYS
                                                                                                                       The odds of developing postnatal
                                                                                                                       depression (PND) increased by up to
                                                                                                                       79% when mothers had baby boys
                                                                                                                       rather than girls.
                                                                                                                          Researchers from the University of
                                                                                                                       Kent, using data from 296 women, also
                                                                                                                       found that women whose births had
                                                                                                                       complications were 174% more likely to
                                                                                                                       experience PND compared with women
         SWITZERLAND                                                                                                   who had no complications.
                                                                                                                          Lead authors Dr Sarah Johns and
         NOSE BACTERIA MAY                                                                                             Dr Sarah Myers set out to discover
         DICTATE SPEED OF BABIES’                                                                                      any relationship between the sex of
         RECOVERY FROM THEIR FIRST COLD                                                                                infants and PND, because of the known
         Babies with a wide variety of different bacteria living in                                                    link between inflammatory immune
         their noses tend to recover more quickly from their first                                                     response and the development of
         respiratory virus compared with those who have less                                                           depressive symptoms.
         variety, say researchers.                                                                                        A pregnancy with a male fetus
            The study, published in ERJ Open Research, offers                                                          and birth complications have both
         clues as to why some babies recover quickly from their                                                        previously been linked with increased
         first cough or cold, while others suffer for longer.                                                          inflammation yet, until this study,
            Dr Roland Neumann from University Children's                                                                published in Social Science &
         Hospital of Basel said: ‘The respiratory tract is home                                                           Medicine, the relationships
         to a wide variety of bacteria, and we are beginning                                                               with PND were unclear.
         to understand that the types and numbers of these                                                                     Dr Johns said the finding ‘gives
         bacteria can influence our respiratory health.’                                                                      health practitioners two new and
            The study cannot explain the link, and researcher
                                                                                                                                                                      ISTOCK / SHUTTERSTOCK

                                                                                                                               easy ways to identify women
         Professor Urs Frey adds: ‘We do not yet know what                                                                      who would particularly benefit
         combination of bacteria would be “ideal”, and this                                                                     from additional support in the
         would need to be known before we understand how                                                                         first few weeks and months’.
         we might manipulate it.’

                                                               COMMUNITY PRACTITIONER | FEBRUARY 2019

12-13 NEWS Global Rese_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 13                                                                    29/01/2019 18:16

                          hildren’s  digital footprints – the body

         C                of information that exists on the internet
                          as a result of online activity relating to
                          them – are now vast. By the time they
                          reach the age of 13, the average child
       will have had 1300 photos and videos of them posted to
       social media by their parents. And children between 11
       and 16 will themselves post on social media on average
       26 times a day – which means by the age of 18 they
       are likely to have posted 70,000 times (Office of the
       Children’s Commissioner, 2018).
          But it is not just social media. A new report from the
       Office of the Children’s Commissioner for England
       – Who knows what about me? – explores how huge amounts                                            information that could put them
       of children’s data are collected through the screens they                                         at risk of bullying or abuse, but the
       watch, the websites and apps they access, through smart                                           report warns that this generation will
       speakers, tracking watches, school databases, classroom                                           be at an increased risk of identity
       apps, biometric data in schools, retail loyalty schemes,                                          theft and fraud as they grow up.
       travel passes and medical records.                                                                Their data profile could influence the
          Even the youngest children are not exempt, thanks to                                           adverts they are targeted with, and
       a new wave of internet-connected interactive toys aimed                                           even whether they are offered a job,
       at children as young as three. Last year, two million voice                                       insurance or credit in the future.
       messages gathered by CloudPets – app-connected cuddly                                                Aside from this, there is the matter
       toys which allow children and their family members to                                             of a child’s right to freedom and
       share recorded messages via the internet – were found to                                          independence, and the question of
       be stored unprotected online.                                                                     how these children can understand
                                                                                                         their right to privacy, when they and
       DIGITISED FROM BIRTH                                                                              others share personal information
       As the report points out, this is the first generation to be                                       so readily.
       ‘digitised’ from birth, growing a vast digital footprint that                                        As Anne Longfield, the children’s
       has the potential to shape their lives now, and as they                                           commissioner for England,
       mature, in ways which neither they, nor the adults around                                         emphasises: ‘We simply do not know
       them, can fully appreciate.                                                                       what the consequences of all this
         Not only can these bodies of data reveal personal                                               information about our children will
                                                                                                         be. In the light of this uncertainty,
                                                                                                         should we be happy to continue
       Today, the average child’s                                                                        forever collecting and sharing
                                                                                                         children’s data?’
       digital footprint is broader                                                                         Work certainly needs to be done
       than ever. What do                                                                                in policy and education, and action
                                                                                                         taken by companies producing these
       community practitioners                                                                           toys and apps.
       need to know when it                                                                                 The report makes a number of
                                                                                                         recommendations to that effect,
       comes to advising parents                                                                         including calling for clearer

       and helping to                                                                                    packaging on products that capture
                                                                                                         information about children, and new
       safeguard children?                                                                               lessons in schools to help children

     FOLLOW THE                                                                           14
                                                                COMMUNITY PRACTITIONER | FEBRUARY 2019

14-16 NEWS Big Story_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 14                                                      29/01/2019 18:20

          understand how and why their data       Too often we find the child hasn’t
          is collected.                           even been asked, or if they have
             A spokesman for the Information      expressed a negative feeling about              TOP 10 TIPS FOR STAYING
          Commissioner’s Office (ICO) says          it, been ignored.                               SAFE ONLINE
          that its forthcoming age-appropriate       ‘Nobody should be saying parents
          design code for providers of websites,  mustn’t post anything – that’s                 FOR CHILDREN
          games and apps will be ‘a key step      unrealistic and frankly silly, but             1. Stop and think when you’re about to share
          in ensuring that providers of online    again the dialogue with children               some personal information.
          services take their responsibilities to about this is crucial. Practitioners           2. Read the Digital 5 a dayy guide if you
          the children who use their services     have that trickiest of tasks to make           spend lots of time online and on social
          seriously, and design their products    judgement calls about this, and the            media at
          with children                                             best thing is to             3. Look through terms and conditions to
          in mind’.                                                 start with some              see what data is collected when you use
             But what                     ‘CPs ARE IN A             kind of dialogue             websites and gadgets at
          can be done on                                            with the parent.’            4. Mute smart speakers when you don’t want
                                       KEY POSITION TO                                           them to listen to you.
          an individual                                                Anne accepts
          level? What do             EDUCATE AROUND                 that tackling                5. Talk to an adult you trust if you are
          practitioners need            SAFE USE OF THE             parents’ personal            worried about someone else knowing
          to know? And                                              choices is harder            something about you.
                                        INTERNET, DATA
          how can they best                                         than clear-cut
          advise parents              PROTECTION AND                safeguarding                 FOR PARENTS/CARERS
                                                                                                 6. Don’t post photos and videos which reveal
          navigating this                EXPLOITATION’              issues. ‘Often just
                                                                                                 personal information about your children.
          unfamiliar territory?                                     outlining who
                                                                    owns an image,               7. Change the default passwords on all the
          ‘THE TRICKIEST                                            how many people              gadgets your children use.
          OF TASKS’                               can see it, what it might say about            8. Make sure the gadgets you buy your
          From sharing birthday messages that     the child that possibly hasn’t been            children are genuine. Counterfeit versions
          show a child’s date of birth, to ‘first  considered and, it won’t surprise              can be even less secure.
          day at school’ photos, which often      you that I say this, what the child’s          9. Watch out for security updates and install
          reveal a child’s location or identity   view about it is, will often at least          them as soon as you are prompted.
          through details such as school logos    get parents thinking a bit more                10. Talk to organisations that hold
          and street signs, the potential to      about the issue.’                              information on your child about what
          unwittingly create risks is huge.          She continues: ‘Advise families             information they collect and why.
             Anne says: ‘Oversharing by parents   to think about who and for what
          can be a problem on lots of levels.     reason they are giving their data

        FOOTPRINTS                                                                        15
                                                                COMMUNITY PRACTITIONER | FEBRUARY 2019

14-16 NEWS Big Story_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 15                                                     29/01/2019 18:20

                                                                                               around children is adults talking to other adults about
                                                                                               what another set of adults should do for children,’ she
                                                                                               says. ‘That should be the end of the process, with the start
                                                                                               cutting out all those adults and just talking with children.
                                                                                                  ‘We have found giving advice is fine, but providing
                                                                                               frameworks for children and adults to have their own
                                                                                               discussions about something is actually more effective.’
                                                                                                  And while she finds that children in the UK are ‘actually
                                                                                               pretty savvy about safety issues and often well advised
                                                                                               on what to do and not do to stay safe’, there is a need to
                                                                                               address other issues which ‘don’t really come under the
                                                                                               banner of safety’.

       away, and if CPs are collecting it, just                                                EDU
                                                                                               EDUCATING CHILDREN – AND OURSELVES
       be transparent about what it’s for and d                                                ‘We neneed them to learn that things you wouldn’t do
       what will be done with it.’                                                             in rreal life are not appropriate in a digital sense, that it
                                                                                               doesn’t make them lesser people if their photos don’t
       THE ROLE OF CPs                                                                         get hundreds of likes, that sending people vicious
       Safeguarding expert Michelle                                                            messages direct to maybe their bedroom late at night is
       Moseley, CPHVA Executive member                                                         not behaviour that can or should be tolerated – asking
       for Wales, believes that CPs ‘are in                                                    themselves always “Do I want to post this?” and “Who am
       a key position to educate parents                                                       I really talking to?”’
       and children around safe use off the                                                       Anne doesn’t want to see children online shut up in
       internet, data protection and sexual                                                    ‘some digital backyard’. ‘But we need them to be armed
       exploitation’.                                                                          with the tools to explore both safely, and confident in
          One step is making parents more                                                      the knowledge that they know what’s what and how to
       aware of the steps they can take to                                                     handle it without upsetting their overall wellbeing.’
       protect their children online. ‘There                                                      As the report says, educating children ‘early and
       is no need to place children's photos                                                   com
                                                                                               comprehensively about the many ways in which
       on social media, faces can be blacked                                                   their ddata might be used is an important way to foster
       out,’ she explains. ‘Practitioners                                                      digita
                                                                                               digital resilience and to help rebalance the power
       can advise parents to have high                                                         be
                                                                                               between children and those that gather or use their
       security settings – this is available                                                   personal information’.
       on all platforms.                                                                          But, with these digital natives far more at home in this
          ‘They need to be aware of the risksks                                                space than the adults around them, perhapserha we must first
       themselves, access training and look                                                    take steps to better educate ourselves..
       at appropriate resources; the Child
       Exploitation and Online Protectiontion
       (CEOP) unit ( has a
       whole range of appropriate resources
       for children and parents.’                                                                  FURTHER GUIDANCE
          And if a practitioner is uneasy                                                            Parentzone offers a free online
       about how a parent posts on social                                                            safety guide to digital family life
       media, especially if they feel it is                                                          at
       exploiting the child in some way,                                                             ThinkUKnow raises awareness of
       even unintentionally, she urges                                                               online child abuse and exploitation
       them to ‘address it with the parent,                                                          at
       provide evidence-based advice and
                                                                                                     Childline offers children advice on
       assess whether this has been taken
                                                                                                     taking care of their digital footprint
       on board’.
          But perhaps parents and
       practitioners should not expectt to
       have all the answers. There is a lot
       they can learn from engaging with                                                                  For references, visit
       and talking with children, says Anne.                                                    
          ‘Too often, our public debate

                                                                COMMUNITY PRACTITIONER | FEBRUARY 2019

14-16 NEWS Big Story_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 16                                                                  30/01/2019 13:20

                                                                                                                     £M5&0S S
                                                                                                                         C   HER

     Readership survey 2019
       It’s been two years, but it’s that time again
       when we ask readers for their invaluable
       feedback on their professional
                                    onal journal.

       Community Practitioner was redesigned 12 months
       ago, just part of the process of evolution that has
       made it the journal it is today. Some significant
       and impactful changes were made, offering
       members an improved reader journey, even
       more news-driven and relevant content, regular
       columns and insightful articles. Peer-reviewed
       research is still positioned within the publication’ss
       pages, as is the latest research news. But what
       do you think about your professional journal?
       We would really like to know.

       Does the content work for you?

       Is it interesting and useful?

       What would you like to read about?

       Do you like the present design?

       How important is the research
         element of the journal?

       By taking a few moments to complete the online
       survey – see right for the link – you’ll play an
       instrumental role in shaping the future of your
       publication. We want the journal to be the best it
       can be, with the most informative and relevant                                                    ACCESS THE SURVEY
       content, and the most appealing design. To do this,,
       we need your input. And you could be in with the
       chance of winning one of two £50 M&S vouchers,                                                    The deadline is 28 February
       if you fill in your details at the end of the survey.

                                                                COMMUNITY PRACTITIONER | FEBRUARY 2019

17 Opinion Readersh_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 17                                             30/01/2019 13:20


                 ARE HV CASELOADS
                    ADDING UP?
                        As one member crunches caseload numbers, another
                      looks at data protection and the Named Person, and we
                       highlight the HVs named in the New Year’s Honours list.

       I read with interest Dave Munday’s Caseload
       crunch article in November 2018’s journal. His
       article outlined the changes in health visitor
       staffing numbers following the end of the
       Health Visitor Implementation Plan and the
       transfer of commissioning to local authorities
       in October 2015.
          The article quotes the number of children
       on the average whole-time equivalent
       (WTE) caseload and compares it with the
       250 children per WTE caseload benchmark
       recommended by Unite-CPHVA. The
       article reported health visitor caseloads in
       Worcestershire of 514. The methodology used
       to calculate the current average caseload is
       inaccurate for Worcestershire as we monitor
       active caseloads and work within integrated
       skill-mixed teams.
          As all health visitors will know, there is
       a rich mix of needs within each caseload
       from those children and families requiring
       a Universal approach, to those requiring               children, approximately 6% require some        predominantly universal the caseload
       intensive support at a system level. All               additional support (Universal Plus) and        size is 231 children per WTE.
       children within Worcestershire receive                 3% require intensive support (Universal           Enabling health visitors to safely support
       a public health service guided by the                  Partnership Plus).                             children and families is essential to ensuring
       Healthy Child Programme up to the age                     Worcestershire Health and Care NHS          the best possible outcomes for the child and
       of 27 months. At this stage, if their needs            Trust health visitor caseloads are monitored   family, and therefore I would not support
       are assessed as being Universal they are no            on a monthly basis by the service, taking      a caseload in excess of 500, which – as the
       longer considered ‘active’ on the caseload.            into account the needs of the children         article states – is more than double the
       Should their needs change, they will be                and families. The average caseload for our     recommended number.
       reinstated on the caseload and receive a               registered health visitors is 217 children
       Universal Plus or Universal Partnership                per WTE. In locations where there are          Sally-Anne Osborne is service delivery unit
       Plus service. Based on our current caseload,           significantly higher levels of need, the        lead for children, young people and families
       this accounts for 91% of children under                average caseload size is 207 children          and specialist primary care, Worcestershire
       the age of five years. Of the remaining                 per WTE, and where the needs are               Health and Care NHS Trust.

                                                       COMMUNITY PRACTITIONER | FEBRUARY 2019

18-19 feedback_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 18                                                                        30/01/2019 15:15

                                                                                                                     IT’S AN HONOUR
                                                                                                                     In the 2019 New Year’s
                                                                                                                     Honours list, Ruth Oshikanlu,
                                                                                                                     health visitor, parenting
                                                                                                                     expert and author, has been
                                                                                                                     appointed as a member
                                                                                                                     of the order of the British
                                                                                                                     Empire (MBE) for services to
                                                                                                                     community nursing, children
                                                                                                                     and families, and named an
                                                                                                                     ambassador for the health-
                                                                                                                     visiting profession.
                                                                                                                        Gail Powell, senior nurse and
                                                                                                                     professional lead for health
                                                                                                                     visiting at the Aneurin Bevan
                                                                                                                     Local Health Board, was also
                                                                                                                     awarded an MBE for services
                                                                                                                     to health visiting.


                         The GIRFEC [Getting it right for every        information-sharing without consent
                         child] Practice Development Panel has         is likely to remain at the level of
                         been meeting regularly since early 2018       ‘safeguarding’ the child’s wellbeing.
                         to support the development of a binding          If practitioners cannot share or receive
                         code of practice in relation to information   information without consent to promote
                         sharing by and with Named Persons.            and support (that is, enhance) the child’s
                            While all involved believe in the GIRFEC   wellbeing, there seems little ‘added value’
                         principles of providing early help and        to the Named Person role in legislation
                         support to children and families who          without a very real concern of only
                         need it, Unite-CPHVA aims to ensure           damaging the health visitors’ relationship
                         that information-sharing by practitioners     with families by stigma creep.
                         is lawful and in accordance with data
                         protection regulation, human rights and the   Annette Holliday is a health visitor
                         common law of confidentiality. It is equally   and Unite-CPHVA Executive
                         concerning and frustrating that lawful        member for Scotland.

                                            WHAT DO YOU THINK? The following are just a few of the topics that we hope to cover in the
                                           next few issues of the journal. If you would like to suggest an aspect of a topic that we should
                                           explore, if you have expertise in any of the areas, or if you would like to be interviewed on
        ALAMY / ISTOCK

                                           a subject, please get in touch. Future topics will include Brexit, the anti-vaccine movement,
                                           tongue-tie, bereavement, foodbanks, and autism. And, as always, if you would like to
                                           comment on any of our published articles, email,
                                           tweet us @CommPrac, or reach us at

                                                                   COMMUNITY PRACTITIONER | FEBRUARY 2019

18-19 feedback_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 19                                                              30/01/2019 15:15

                                                                                                         THIS MONTH WE ASK

      THE BIG                                                                                           Why is it crucial that
                                                                                                        members find the time to
                                                                                                        complete the CP readership

      QUESTI ? N                                                                                        survey? The journal’s team
                                                                                                        at Redactive respond.

       JO MARSH                                     NICHOLAS DALEY                                                          AVIVA ATTIAS
       Director                                     Senior designer                                                         Deputy editor

                          hank you to                                  aking              content is always visually                            s you know,

                  T       those who’ve
                          already taken
                 the time to participate
                                                                T      part in
                                                                       the online
                                                              readership survey
                                                                                          engaging, with interesting
                                                                                          imagery and colours, as well
                                                                                          as layout designs that are easy
                                                                                                                                                we gave
                                                                                                                                      Practitioner a bit of a
       in the latest readership survey              is very important. Your               to navigate and that simplifies    makeover this time last year.
       about Community Practitioner.                feedback helps to shape               the complex language of data      The aim was to keep providing
       If you haven’t yet, then please              the way your journal looks.           and sensitive topics into an      all the content you enjoyed,
       take a moment to respond.                    Your answers ensure that the          understandable format.            but in clearer sections, with a
       Your answers to these questions                                                                                      greater focus on practice, plus
       will be used to help develop                                                                                         more member voices and some
       the brand and identify areas                                                                                         brand new formats. We’ve had
       you think may benefit from                    EMMA GODFREY                                                            lots of positive feedback so far,
       improvement. You do not have                 Managing editor                                                         but we want to ensure your
       to answer all the questions, but                                                                                     professional journal continues
       the more answers you provide,                                                                                        to serve both your personal and
       the more robust our survey. We                                  here’s just        version online for example –      professional needs in the best
       would like to broaden the range
       of advertising in Community
       Practitioner and exhibitors at
                                                                T      under three
                                                                       weeks left
                                                              to take part in the
                                                                                          a change you were keen for
                                                                                          us to make in the last survey.
                                                                                          If you think we should be
                                                                                                                            way it can. So your feedback
                                                                                                                            is vital. While you can get in
                                                                                                                            touch at any point, we have
       Unite-CPHVA events like the                  journal’s readership survey           doing it differently, we’d like   crafted a number of questions to
       annual professional conference.              and I would like to urge              to know. The design of the        cover all aspects of the journal
       With your feedback and insight,              as many of you as possible            journal has changed, even         in our readership survey.
       we can approach new brands                   to take a few moments to              the size – all improvements       Please take a few moments out
       to increase the diversity of                 respond. I understand how             we’ve made with you in            of your busy schedules to let
       advertisers in the title. Your               busy you all are and that             mind and to enhance your          us know what you think. We
       answers will be treated in                   we’re asking you to complete          reading experience. If we         look forward to hearing your
       strict confidence, but they are               yet another questionnaire,            are getting right, or we’re       thoughts, as always.
       necessary to help provide key                but your input is invaluable.         not, we want your thoughts.
       information to attract a wider               We’ve made some changes               And you could be in with the
       commercial market to help                    to the journal since the last         chance of winning one of two         To take part in the
       sustain the viability of these               survey and we want to know            £50 M&S vouchers - just a            survey, visit
       CPHVA member benefits. Thank                  what you think. The research          small thanks for your time.          CP_survey_2019
       you for your help and good luck              now consists of shorter               I look forward to reading            The deadline is
       in the prize draw.                           summaries with the full               your opinions.                       28 February.

                                                               COMMUNITY PRACTITIONER | FEBRUARY 2019

20 OPINION Big Ques_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 20                                                                 29/01/2019 18:22

                                                                                 AT WORK

                        A ROAD TO NOWHERE?
                                         Colenzo Jarrett-Thorpe, Unite national
                                         officer for health, takes us through the
                                        reaction to the NHS long-term plan from
                                          Unite and community practitioners.

                               anuary saw the launch of         to local government in October 2015,              UNITE HEALTH
                  J            the NHS long-term plan
                               for England following the
                               government’s commitment
                last year to increase levels of spending on
                                                                the number of health visitors in England
                                                                had fallen by almost 25% at August
                                                                2018, and school nurses by almost 20%.
                                                                There are consequences to this fall in
                                                                                                                  SURVEY RESULTS
                                                                                                                   Both 80% of HV and
                                                                                                                    school nurse respondents
                the NHS until 2023-24 by £20bn.                 numbers, judging by the feeling of health           frequently or always work
                   Community practitioners should               visitors and school nurses taking part in           through their breaks.
                note the following: the proposal to             last November’s Unite health members’              Compared with the
                create a children and young people’s            pay survey.                                         previous year, 76% of
                transformation programme, which should             Some of the salient points that indicate         school nurses and 80% of
                underpin the plan to expand and invest in       why they are feeling under pressure                 HVs believe that morale is
                access to community-based mental health         or leaving the service and not being                worse or a lot worse. This
                services; improving the responsiveness of       replaced, can be seen in Unite health               compares with 73% across
                community health crisis response services;      survey results, right.                              all respondents.
                and a proposed £4.5bn new investment               The NHS long-term plan must tackle the          When asked why this is the
                to fund multidisciplinary teams aligned         issues of why so many skilled and dedicated         case, the leading answer
                with new primary care networks based on         professionals are leaving, and prevent              from HV respondents was
                neighbouring GP practices.                      this, as well as investing in the CPs of the        an increase in workplace
                   The long-term                                                         future. So much of         stress (87%), and the
                plan is high on                                                          the funding that has       leading answer from
                ambition and                                                             been earmarked for         school nurse respondents
                aspiration, but                                                          investment in our          (77%) was dissatisfaction
                low on detail and                                                        public health services     with the quality of care
                                                            THE LONG-
                the mechanics                                                            is simply replacing        they feel they are able
                of how it is                                TERM PLAN                    the funds that have        to provide.
                possible to meet                            IS HIGH ON                   been systematically       83% of HV respondents
                these ambitions                                                          removed over the           frequently reported
                in the spaghetti
                                                            AMBITION                     last nine years. Does      staffing shortages in their
                junction of                                 AND                          the plan signal a          department or working
                confusion                                   ASPIRATION,                  bright new future for      area in the last 12 months,
                and chaos in                                                             the NHS or does it         with 65% of school nurse
                the English
                                                            BUT LOW ON                   merely add to the list     respondents frequently
                NHS structure.                              DETAIL AND                   of this government’s       reporting staff shortages.
                   Following                                MECHANICS                    broken pledges?           80% of HVs and 75% of
                the transfer of                                                                                     school nurse respondents
                commissioning of                                                          See more results         have raised concerns
                0 to 5 community                                                         from the survey in         regarding safe staffing

                health services                                                          our cover story on         levels, compared with 62%
                from the NHS                                                               page 30.                 of all respondents.

                                                               COMMUNITY PRACTITIONER | FEBRUARY 2019

21 OPINION Rights @_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 21                                                    29/01/2019 18:23


             Debbie is a specialist HV for
             homeless families at Central London
             Community Healthcare NHS
             Trust and a Queen’s Nurse.
             MY ALARM GOES OFF AT…                 signpost them                                             severall years   MY PR
             6.30am, but I’m usually the last      to services                                               before being     ACHIEVEMENT IS…           the
             one to leave for work. So I take      and local                                                offered more      support from management and
             advantage of a quiet house and        support.                                                 permanent         recognition of the specialist role
             respond to emails on my laptop.                                                               housing. Lack      by commissioners, which led to
             My role means I’m in contact          A VISIT                                               of stability can     a team of two! My colleague
             with a range of statutory and         CAN                                                 impact on a parent’s   Nicola Ford joined me last
             voluntary colleagues, from social     INVOLVE…         addressing                       emotional wellbeing      August and we hope to continue
             services, schools and housing to      and signposting issues such as            and decision-making.             to develop our role. The most
             charities offering support.           housing, benefits, domestic                                                 challenging part of my job
                                                   violence, mental health, drug             THE BEST PART OF MY              is knowing that as soon as a
             I AM RESPONSIBLE FOR…                 or alcohol use, as well as the            JOB IS… knowing I can            family are re-housed, another
             families living in temporary          practicalities of finding a school,        make a difference. I am in a     family will move in, and this
             accommodation units, including        GP and children’s centre. There           unique position to recognise     will continue until the current
             B&Bs, women’s refuges, young          are many barriers to accessing            challenges and offer emotional   housing shortage is addressed.
             mothers’ accommodation and            services when homeless, not               support as well as practical
             private units for families placed     least that every time a family            strategies. I love being able    OUTSIDE OF WORK…
             by housing authorities, and           moves, referrals may close due            to visit families in their       I enjoy walking my dog, which
             traveller communities moving          to address or GP changes.                 temporary accommodation          also gives me the opportunity
             through and on fixed sites.                                                      and getting to know each one.    to reflect and enjoy the
                                                   PARENTING ADVICE                          It’s very rewarding to be part   countryside. I tend to head off
             I AIM TO…      meet every new         NEEDS TO REFLECT…                         of their journey, and I often    to bed around 11pm.
             family on arrival. Families           the home environment                      get calls after they’ve moved
             dealing with homelessness face        families are placed in. Families          telling me about their
             many stresses, and maximising         presenting as homeless at                 new homes. I can also
             engagement means being flexible        their local council are often             advocate for individual
             and responsive. The initial contact   placed in a studio flat with               families as well as raise

             is an opportunity to assess the       limited facilities, far from              awareness of the impact
             family’s current needs, and to        familiar social networks, for             of homelessness.

                                                                COMMUNITY PRACTITIONER | FEBRUARY 2019

PRACTICE 24 Hour_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 22                                                                        30/01/2019 13:21


                                                                                                       OW DO YOU DO IT?
                                                                                                     1 Visit the journal website at
                                                                                                     and log on.
                                                                                                     2 Choose which category most interests
            Do you need more support
                                 upport iin
                                          n                                                          you or you feel would be the most
            achieving your CPD goals?? A   re you                                                    beneficial, click on this and then choose
                                                                                                     which specific module appeals.
            interested in a streamlined online                                                       3 Read the content, scrolling down to the
            solution? Then read on…                                                                  references at the end.
                                                                                                     4 Click on the blue and white box ‘Click
            As part of our commitment to                expanding these as more companies
                                                                                                     here & complete CPD module’ and a
            you, and the desire to evolve our           and organisations get involved.
                                                                                                     separate window will open.
            support of you and your work,                  We know that continuing
            we’ve launched an online, journal-          professional development is crucial          5 Answer the five multiple-choice
            affiliated CPD hub.                           for all practitioners in your growth         questions given.
               In partnering with some of               and learning throughout your                 6 Complete your details and a certificate
            the leading healthcare brands,              career, and we are acutely aware             will be emailed to you to confirm your
            we’ve generated some interesting,           of the requirements of the NMC’s             completion of the module.
            insightful and informative courses          revalidation process too (see                7 Add the certificate to your portfolio.
            aimed to expand your knowledge     So this
            and broaden your skill-set in               will go some way to supporting
            relation to your core job role and          you in that. If you complete                               You can, of course,
            responsibilities. At the moment,            the interactive self-assessment                            complete as many modules
            the courses fall into six categories        questions at the end of the course,                        as you wish. They are free to
            – behaviour, child development,             you will receive a certificate to add                       all Unite-CPHVA members.
            conditions, mental health, nutrition        to your professional portfolio. What         Look out for alerts in your inbox when new
            and safeguarding – but we will be           could be simpler than that?                  modules become available.

                                                               COMMUNITY PRACTITIONER | MONTH 2018

CPD_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 23                                                                      29/01/2019 18:37

                                                                                                         may be rare,

                             UNDER                                                                       but when it
                                                                                                         strikes it can be

                                                                                                         and even
                                                                                                         deadly –
                                                                                                         especially for
                                                                                                         children and
                                                                                                         young people,
                                                                                                         writes journalist
                                                                                                         John Windell.

                                                                                                                           ncephalitis is not a

                                                                                                                           common condition:
                                                                                                                           according to the
                                                                                                                           Encephalitis Society
                                                                                                                           (2017), the UK
                                                                                                         sees around 6000 cases in a typical
                                                                                                         year. The global figures are more
                                                                                                         alarming, with some 4.3 million cases
                                                                                                         a year leading to 150,000 deaths,
                                                                                                         indicating just how devastating
                                                                                                         encephalitis can be (GBD 2015
                                                                                                         Disease and Injury Incidence and
                                                                                                         Prevalence Collaborators, 2016; GBD
                                                                                                         2015 Mortality and Causes of Death
                                                                                                         Collaborators, 2016).
                                                                                                            Put simply, encephalitis is an
                                                                                                         inflammation of the brain. It has a
                                                                                                         range of triggers, although in most
                                                                                                         cases the cause is a viral infection
                                                                                                         that finds its way into the brain.
                                                                                                            These viruses tend to be routine
                                                                                                         varieties, such as herpes simplex
                                                                                                         or those responsible for measles,
                                                                                                         rubella and chickenpox. Most of the
                                                                                                         time, these trigger an infection that
                                                                                                         manifests itself in the symptoms
                                                                                                         of the primary condition, such as
                                                                                                         feeling poorly or developing a rash,
                                                                                                         which the body takes a few days to
                                                                                                         deal with. But on occasions, the virus

                                                                                                         manages to cross the blood-brain
                                                                                                         barrier and infect the central nervous

                                                                COMMUNITY PRACTITIONER | FEBRUARY 2019

24-26 PRACTICE Clinica_COMMUNITY PRACTITIONER FEB 2019_Community Practitioner Magazine 24                                                  30/01/2019 13:22
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