NHS Lanarkshire
University of the West of Scotland
Best Possible Start Programme
Training and Development Needs of
Health Visitors: 27-30 month Universal
Child Health Review
Best Possible Start Programme
A joint collaborative programme between NHS
Lanarkshire and the University of the West of
Scotland to implement a suite of national policy
documents aimed at improving maternal, infant
and child health outcomes in the early years to
ensure Lanarkshire’s children have the best start
in life.
Programme Context
Policy Context
Overall aim:
Strengthen ‘Health for all
Children (2005)’ to ensure the
best quality care and support is
delivered to children and
families in the vital early years
Key aspect:
Reintroduction of the 27-30
month child health review
NHS Lanarkshire Response
 National Guidance issued to NHS
Boards– December 2012
 Promotion of strong early child
development
 Promotion of child healthy weight
 GIRFEC framework
 Short-Life Working Group established Chair : Harpreet Kohli, Director of
Public Health, NHSL
Preparatory Training and
Development Needs
 BPS Research and Evaluation Group
 Expert Practitioners
 Mixed methods approach
 Ethics Approval
 Recruitment : Purposive sampling method
Data Collection
 On line survey questionnaire to all HV’s
Based on a range of core competencies of 27-30
month review (trends and not precision). Reminder
web link
 Focus Groups
Semi structured interview schedule (more probing
and clarity)
 Competence measured by rating staff level of
confidence 1-4 scale
Criteria for rating perceived
level of competency
Rating
Very confident
Indication for training
Respondents currently have specialist knowledge / skills / experience of the issue /
topic area described and that they can and do act as a mentor, advisor or consultant to
others.
Confident
Respondents currently have considerable knowledge / skills / experience of the issue /
topic area described.
Fairly confident
Respondents have some knowledge / skills / experience but do require further training
(revision) to refresh and meet their needs in that particular issue / topic area.
Not confident
Respondents do require further training (more indepth) to meet their needs in that
particular issue / topic area.
Response Rate
 On Line Survey Questionnaire to all HV’s
Response rate 61% (n=109 of 180)
 Focus Groups
5 groups with 38 participants.
Thematic analysis of focus group transcripts/field
notes
Data Analysis
Categorisation:
 Priority Training and Development Needs
 Refresher Training and Development
 No Training and Development Needs
Developmental toolkit
Home Observation for Measurement of the…
Eyberg Child Behaviour Inventory (ECBI)
Strengths and Difficulties Questionnaire (SDQ)
Sure Start Language Measure (SSLM)
Modified Checklist for Autism in Toddlers…
Ages and Stages Questionnaire 3 - Social…
Schedule of Growing Skills 11 (SOG S11)
Ages and Stages Questionnaire 3 (ASQ 3)
Parents Evaluation of Developmental…
Parents Evaluation of Developmental Status…
0
Very Confident
Confident
20
40
Fairly Confident
60
80
Not Confident
100
120
Assessment of Normal Child
Development
Physical activity and play
Dental and oral health
Hearing
Vision
Immunisation status
Nutritional status
Behavioural issues
Cognitive development
Emotional development
Personal and social development
Language development (Speech…
Physical development
0
Very Confident
Confident
20
40
Fairly Confident
60
80
100
Not Confident
120
Staff Comment
Asset Based Approach
Use promotional interview skills
to affect behavioural change
Provide parenthood education
using a strength / asset based
approach
0
Very Confident
Confident
20
40
Fairly Confident
60
80
100
Not Confident
120
Staff Comment
Summary Top 3 Development
Needs Identified
Priority Areas for Training and
Development
Priority Areas
Child development
Vision
Hearing
Assessment of
children with long
term conditions
Tools for assessing child
development
Strength/asset based
approaches
E.g. Autism and
physical disabilities
Documentation, shared terminology, professional roles and Request
for Assistance Pathways should be embedded in all forms of training
Refresher Areas for Training
and Development
Revision Sessions
Childhood development
Emotional
Dealing with
challenging
situations
Childhood obesity
management
Optimal child nutritional
advice
Dealing with difficult families
Cognitive
Social
Speech,
language
Documentation, shared terminology and Request for Assistance
Pathways should be embedded in all forms of training
Areas not Requiring Training or
Development
No Training Required
Person centred
approach
Health
promotion
issues
Building
parent's
capacity for
positive
parenting
Having difficult
conversations with
parents
Referrals and
multiagency
working
Vulnerable
families and
those with
specific issues
Learning Preferences
Attendance on training
courses.
Mentoring.
Not Effective
On the job training.
Effective
Very Effective
Job shadowing.
E- Learning.
0
20
40 60 80 100 120
Tiered Training and
Development Approach
 Large Group awareness raising SCPHN- HV’s:
Introduction to the Review/Process/Toolkit
 Master class SGSII : Training the Trainer approach (GL
Assessment)
 Locality/Team Practice Development roll out programme
Learning Points
 Policy context focusing attention on early years and
pivotal role of health visitors in Scotland to achieve
outcomes for children and families
 Policy into Practice approach essential for success
 HV’s supported and clear in identifying training and
development needs
 Informed Strategic Plan for in service training
 Continuous Improvement journey
 Follow up study to monitor impact
Further Information
 Jean Rankin, Senior Lecturer in Research,
University West Scotland
 Sandra MacInnes, Programme Manager (Best
Possible Start)
Rankin J, MacInnes S (2014) Training and Development
Needs of Health Visitors : 27-30 month child health
review, Journal of Health Visiting, Volume 2, Issue 8
Service Provision