« Previous | Contents | Next »
Listen
Evaluating Family Health Nursing Through Education and Practice
PREFACE
Since devolution in 1997 a number of distinctive policy developments have influenced the practice of health, education and social services within Scotland. Changes in the structure of the health service, a refocusing on public health and the development of policy pertaining to social justice have led to the introduction of a programme of initiatives at grass-roots level that attempt to develop services and annexe previously uncharted health ground. This is exemplified by the various social inclusion programmes which have been developed across Scotland; the redesign of health services especially in remote and rural areas; and the introduction of the role of public health practitioners. The initiative to "pilot" 1the World Health Organisation (Europe)'s Family Health Nurse concept in remote and rural areas of Scotland can be seen as part of this greater impetus to look at new ways of working within health and social care.
In attempting the co-ordinated introduction of this new, national level, generalist community nursing role the Scottish Executive has taken forward a bold and ambitious initiative. This initiative has sought to simultaneously develop and integrate a new community nurse education programme and a new practice role within a short period of time. Such work is complex and has involved co-ordination over a large geographical area and across disciplines. Those involved in change management in primary care services will recognise the magnitude of this challenge, especially given the established culture of specialist community nurse education and practice within the UK.
Leadership work of this type entails willingness to take some risk in the process of moving forward. At the project's inception, the Scottish Executive commissioned this concurrent, independent research evaluation so that lessons could be learned and shared about the operation and impact of family health nursing. This aspiration has enabled our work as evaluators and in this spirit the report seeks to contribute a perspective that is both critical and constructive.
The report presents a detailed account of the evaluation and is aimed at those with an in-depth interest in the subject matter (e.g. particular health service staff; educationalists; researchers). It is organised in five chapters, each of which is designed to be sufficiently free-standing that it can be viewed in isolation by the reader with a particular interest. Chapter 1 sets the scene by establishing the context of the evaluation. Chapter 2 overviews educational context before presenting a detailed examination of the educational preparation of the Family Health Nurses. Chapter 3 examines the family health nursing practice that took place during 2002. The Scottish primary care policy and practice context is then examined in Chapter 4 as a basis for consideration of the implications for further development of the FHN role in Chapter 5. The report includes several annexes, but full details of the research tools and procedures used are available separately on CD Rom from the authors.
The report focuses very much on the Scottish experience of implementing the Family Health Nurse concept. At WHO Europe level it was initially suggested that 17 other continental European countries would also be taking part in the development of the new FHN role through parallel processes of education and implementation. These linked national initiatives were to be termed "pilot" projects and would include evaluation of structures, processes and outcomes. During the past three years, however, it has become increasingly apparent that Scotland is very far ahead of other counties in terms of enactment. This is curious and cannot wholly be explained by the fact that different countries will start from different levels of readiness. Further investigation of the reasons for this would be beneficial to any subsequent action-based simultaneous development of nursing practice and education across different nation states.
However we hope that this report will prove of some interest to other European countries. As it seems likely that a range of different audiences may be interested in various aspects of the Scottish experience, other formats for dissemination have been prepared. In addition to this full report, a very concise summary of the research findings is available to download from the Scottish Executive Social Research website ( http://www.scotland.gov.uk/socialresearch). Finally the Scottish Executive has published a concise process and policy orientated report on the project to date and this includes consideration of the evaluation findings detailed in this document.
« Previous | Contents | Next »