Controversial questions (part one): what is the right size for a health visiting caseload? 2009

Sarah Cowley, and Christine Bidmead
Florence Nightingale School of Nursing and Midwifery, King's College London.

Questions asked by managers, commissioners and policy makers to find out what is, or should be, happening within health visiting services can seem immensely helpful in focusing the mind or clarifying key points. Alternatively, they may feel hostile and accusative, if their starting assumptions are alien to the everyday experience of health visitors. This paper is the first in a short series of three that draw on the experience of providing evidence to the Health Select Committee's 2008 inquiry into health inequalities. A formal process of seeking written evidence was followed up with specific questions in oral session, asked by committee members, trying to find out about how health visiting services relate to health inequalities. This line of questioning reflects concerns expressed elsewhere about the variability of health visiting services across the country and the lack of clear alignment to areas of deprivation, leading to calls for an increase in targeted services, instead of universal ones. This paper explores the notion of 'caseload', the distribution of services according to levels of deprivation and delivery of a universal or targeted health visiting service.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D002669 Child Welfare Organized efforts by communities or organizations to improve the health and well-being of the child. Adolescent Welfare,Welfare, Adolescent,Welfare, Child
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003152 Community Health Nursing General and comprehensive nursing practice directed to individuals, families, or groups as it relates to and contributes to the health of a population or community. This is not an official program of a Public Health Department. Nursing, Community Health
D004739 England A part of Great Britain within the United Kingdom.
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016526 Workload The total amount of work to be performed by an individual, a department, or other group of workers in a period of time. Employee Workload,Staff Workload,Employee Work Load,Staff Work Load,Work Load,Employee Work Loads,Employee Workloads,Staff Work Loads,Staff Workloads,Work Load, Employee,Work Load, Staff,Work Loads,Work Loads, Employee,Work Loads, Staff,Workload, Employee,Workload, Staff,Workloads,Workloads, Employee,Workloads, Staff
D054624 Health Status Disparities Variation in rates of disease occurrence and disabilities between population groups defined by various factors including socioeconomic characteristics (see SOCIOECONOMIC DISPARITIES IN HEALTH), age, ethnicity, economic resources, or gender and populations identified geographically or similar measures. Health Status Disparity,Disparity, Health Status

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