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Evaluating Family Health Nursing Through Education and Practice
ANNEX THREE: SUMMARY DETAILS OF THE 10 FHN SITES
Site
Code | Approximate population served by site PHCT | District* nursing caseload for whole PHCT site (and % receiving input every week or more often) | Staff complement covering District nursing caseload
(mid 2002) | Number in core PCT
(eg. GPs, DNs, other nurses, HV) | "Inherited" District* nursing caseload for
FHN "patch" (and % receiving input every week or more often) | FHN role, grade and hours pre-course | FHN role, grade and hours post-course | Any substantial
change in staffing
complement for DN caseload during year of FHN introduction |
A | 70 | 70 (4%)** | 1 G FHN f/t
1 relief nurse p/t | 2 on site
4 associated | 70 (4%)** | DN/Midwife
G; f/t | FHN; G; f/t | No |
B | 400 | 15 (47%) | 1 G FHN f/t
1 relief nurse p/t | 4 on site
3 associated | 15 (47%) | SN; G; f/t | FHN; G; f/t | No |
C | 520 | 31 (29%) | 1 G FHN f/t
1 Aux nurse 20hrs+ bank | 4 | 31 (29%) | SN/Midwife
F; f/t | FHN; G; f/t | No |
D | 2500 | 90 (59%) | 1 G FHN f/t
1 G DN f/t
1 D SN 30hrs
1 Aux nurse 12hrs | 9 | 34 (44%) | SN; E; f/t | FHN; G; f/t | No |
E | 3600 | 202 (30%) | 2 G DN f/t
1 G FHN f/t
2 E SN 30 hrs
2 Aux nurse p/t | 19 | 48 (31%) | DN; F; 30 hrs | FHN; G; f/t | No |
F | 1900 | 79 (50%) | 1 G DN f/t
1 G FHN f/t
1 E SN 30 hrs
1 Aux nurse f/t | 9 | 33 (50%) | SN/Midwife
F; 30 hrs | FHN; G; f/t | No |
G | 1700 | 202 (21%)** | 1 G DN f/t
1 G FHN 30hrs
2 SN f/t (one F & one E)
1 Aux nurse f/t | 12 | 46 (30%) | DN; F; 30 hrs | FHN; G;
30hrs | No |
H | 1250 | 100 (29%) | 1 G FHN f/t
1 G DN f/t
1 D SN f/t
1 Aux nurse 20hrs | 8 | 55 (23%) | SN/Midwife
F; 15-30 hrs | FHN; G; f/t | No, but short staffed for 6 months until G grade DN recruited |
I | 2200 | 120 (58%) | 2 G DN f/t
2 F SN 15 hrs each
2 Aux nurses 10 & 13.5 hrs | 10 | N/A | SN; E; 15hrs | FHN; G; f/t | Yes, small net increase (see case study) |
J | 1150 | 36 (61%) | 1 G FHN f/t
1 F SN 22.5 hrs
2 relief nurses (DN & SN)
1 Aux nurse (bank hours) | 10 | 36 (61%) | DN/Midwife
G; f/t | FHN; G; f/t
& lead nurse | Yes, service integrating with hospital staff |
*CASELOAD FIGURES: These figures should be treated with much caution. Firstly they are based on snapshots when visiting sites during 2002. Secondly practice varied so much as to what constituted a caseload (eg. what people were visited for; frequency of visiting; entry and exit from caseload lists) that meaningful comparison was very difficult. Routinely collected data on nursing activity was virtually worthless in this regard as recording practices varied so widely. Accordingly the "percentage receiving input every week or more often" figure is our very crude attempt at meaningful comparison. However this does not allow for the type or amount of input (eg. several concurrent terminal care cases at Site G when FHN took on "patch"). At the end of the day, perceived burden of caseload (ie. non-heavy or heavy) proved as useful a proxy indicator as any, especially since this was cross-checked with other members of the PHCT. Thus we have used this indicator in our typology of practice.
** Extreme low percentages often merely reflect the limitations of using the percentage receiving frequent input measure. At Site A the whole population is the caseload. Formal frequent district nursing input is very low, but weekly contact with most of the population is unavoidable and will usually involve informal assessment. At Site G the community nursing register includes a very large proportion of infrequent supervisory or support visits (eg. for over 75 assessment). This large denominator makes the resultant percentage low (despite 42 patients needing frequent input).
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