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Health visitor workforce motivated by making a difference to children and families

Posted on 03/09/2013

New research, completed by the National Nursing Research Unit, reveals that health visitors are motivated by a primary desire to make a difference to children and families. This is the key to recruitment and retention of the health visiting workforce.

The researchers used an asset based approach to explore the experiences of students and qualified health visitors, identifying motivations and aspirations that encourage students to start and qualified practitioners to stay with their careers as health visitors.

The research reveals that students and practitioners remain committed to their career choice, even in periods of heightened workload pressures, when service managers and practice teachers shape working and learning environments in ways consistent with health visitor’s ideology of practice.

The project was led by Dr Karen Whittaker with support from Professor Jill Maben, Director of the National Nursing Research Unit and Professor Dame Sarah Cowley, Emeritus Professor of Community Practice Development and Health Visitor, who was honoured with a DBE in the 2013 New Year’s Honour lists for services to health visiting.

Dr Karen Whittaker, lead author comments: “the research shows the sense of privilege health visitors can experience when working closely with families and the importance of enabling them to practice their role in ways that they knew would be helpful for families. Such experiences help sustain them and impacts positively on workforce retention.”

Professor Dame Sarah Cowley, Emeritus Professor at King’s College London and report co-author comments: “The research shows that supporting health visitors to deliver a high quality service to families, especially where there is a high level of need, is the key to retention and recruitment.  It is encouraging that motivating factors for health visitors chime so closely with the needs of the children, families and communities.”

This innovative study undertook workshops and focus groups with 22 practising health visitors and 17 student health visitors in two study sites in England. The students, managers and health visitors interviewed used the phrase making a difference to families to signify the purpose of health visiting and define worthwhile work that provides professional and personal reward. The research found four key aspects of health visiting practice were consistently perceived to contribute to making a difference, these were:

  • connecting with families and communities
  • working in collaboration with others
  • using knowledge, skills and experience
  • professional autonomy to respond appropriately and flexibly to needs

Experienced health visitors found it particularly rewarding to work with families seeking asylum; and those experiencing post-natal depression or domestic violence or other forms of abuse. Although work of this type was personally and professionally demanding, health visitors derived the greatest sense of achievement and privilege from it. Some new working arrangements and large workloads were felt to limit health visitors’ ability to make a difference.

When the work felt as if it was just ‘more of the same’, health visitors could lose sight of their original aspirations. The absence of career progression opportunities posed a threat to retention. Recruits to health visiting would have liked more information about the health visitor role to make an informed decision to change career, and they thought it would have been particularly valuable to spend time with existing students and practising health visitors before applying for student posts. Practice teachers had a pivotal role in helping maintain students’ enthusiasm for a career in health visiting.

The report includes recommendations for researchers, community health organisations, educators and policy-makers.

Professor Viv Bennett, Director of Nursing at the Department of Health and Public Health England, said: “Health visitors are a skilled and strong workforce, who lead and deliver the Healthy Child programme to all children and families to give them the best start in health and well-being. Within an appropriate framework of supportive management and professional leadership health visiting offers a rewarding career, where professionals can realise aspirations to invest their energy in action aimed at promoting life chances and creating good health.”

Download the full research report, Start and Stay: The Recruitment and Retention of Health Visitors.

This research was funded by the Department of Health Policy Research Programme. This is an independent report commissioned and funded by the Policy Research Programme in the Department of Health. The views expressed are not necessarily those of the Department.

For more information or interview opportunities contact:

Oliver Stannard
Communications Officer
Florence Nightingale School of Nursing & Midwifery, King’s College London
T: 020 7848 3062 M: 07941 863 881

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