Conference special 2019: Standing up for change

07 November 2019

All the highlights of this year’s Unite-CPHVA 2019 Annual Professional Conference.

Conference heard fresh takes on the key issues affecting the professions.

Janet Taylor, CPHVA Executive Committee chair, opened the two-day event by saying: ‘Take the time to make friends, because they will be friends for life.’

‘This is an important opportunity to support you in your work practices, because we live in an ever-changing landscape.’

There’s no doubt there are challenges, but the value and importance of your work as CPs, along with your continued drive, was crystal clear.

I’ve loved being involved [with conference]. Being in an environment driven by clinicians and practitioners is really valuable and a great opportunity - Katie Hardcastle, Senior public health researcher, Public Health Wales

When the conference closed, Janet had warm words for attendees: ‘I want to thank you all for making this such a positive experience. I think we need to keep going. The trade union is the way to make sure our profession 
is not devalued.

‘There are so many challenges, both political and professional, but we know that together we are strong and we will make a difference – we can’t afford not to.’

Recognising the CP ‘mental health crisis’ 

School nurses (SNs) and health visitors are suffering a ‘mental health crisis’, said Dave Munday, Unite lead professional officer for North West, North East, Yorks and Humber.

‘We should be shocked

that more than 300 nurses have died by suicide in a year,’ he said. 

Dave also outlined recent CPHVA survey findings that 85.3% of HVs and 79.3% of SNs have been suffering from stress. He praised members for their hard work in helping others, often to their own detriment, saying: ‘You make a difference to the nation’s mental health, even when it’s affecting your own.’

Dave was speaking in the first session, ‘Radical, professional, caring – reclaiming our core value’, with other Unite-CPHVA lead professional officers.

Obi Amadi, lead professional officer for London and Eastern, discussed increasing workloads and highlighted that there are some locations where SNs have caseloads of over 3000 each.

‘These problems are not going to go away on their own, and you are going to feel more pressure for some time,’ she said. ‘But we understand your value and we need to get other people to understand the value of the work you do.’

Jane Beach, lead professional officer for East and West Midlands, also highlighted some worrying statistics, such as the recent 30% reduction in HV numbers in England and the increase in members facing disciplinary action and being referred to the NMC. The latter she attributed to increasing workloads.

Gavin Fergie, lead professional officer for Wales and Scotland, said that in these hard times the value of the practitioner and their practice needs to be recognised and invested in, and that Unite the Union was working as hard as possible to ensure this was the case throughout the UK.


The knock-on effects of early childhood poverty

More than a quarter of children live in poverty due to government changes to taxes and benefits, said Jane Barlow, professor of evidence-based intervention and policy intervention at the University of Oxford.

She said: ‘Poverty has been increasing over the last decade and 28% of children are now living in poverty. The situation has changed quite dramatically since 1998, as a result of tax and benefit decisions made by the Tory government in 2010.’

Early childhood poverty could go on to have profound knock-on effects in later life across areas including nutrition, behaviour and education, she said.

‘We know the pathways to poor outcomes are significantly affected by poverty and we know practitioners, such as yourselves, have a key role to play in reducing poverty. We now need programmes that are flexible and can be individualised.’     


Spotting domestic abuse could ‘save a life’

Remaining vigilant for signs of domestic abuse could save a life, delegates were told.

The session was delivered by Darren Minton, a former detective superintendent and promotions manager of the Bright Sky app.

Bright Sky looks like a normal weather app, but when it is opened, victims can answer questions and be signposted to the nearest relevant support services.

It has the ability to record video, audio and photos, which will be sent to a secret email address and then automatically deleted from the phone.

The app is free to download and supported by the police and the Home Office.

Darren concluded his session by saying: ‘Never walk away when you feel professional curiosity about a situation. If you feel that your gut instinct is that someone is suffering from domestic abuse, then this app could save a life.’  

LAR Awards heads to Lincolnshire

The local representatives supporting the Lincolnshire health visitors on strike were collectively awarded the local representative of the year award, and were undoubtedly the stars of this year’s conference.

The winners were Claire Bradford, Hayley Carter, Karen Hayes, and Nicola Stimson.

Claire said: ‘Thanks to all of you who have supported us – it is not an easy task going on strike.’

Colenzo Jarrett-Thorpe, Unite national officer for health, saluted the winners: 

‘This year we decided to honour the Lincolnshire HVs for their efforts in protecting our profession and protecting their colleagues.

‘We’ve heard a lot about what they’ve had to do and they have been pillars of the community, pillars of the profession and pillars of everyone who meets them.

‘They are the first HVs to take strike action. Isn’t that something?  

‘Our profession is under threat and this isn’t something that we’ve got to take lying down. The Lincolnshire HVs have been the epitome of fighting back.

‘We need to embody the support that they have shown. They have not stopped and they are going to continue. And thanks [to everyone at conference] for the support you’ve shown through raising over £500 in a collection.’

Gangs peddle drugs using supermarket sales methods

Gangs are using supermarket sales techniques to shift more drugs, said John Dunworth, training manager for the government’s Violence and Vulnerability Unit.

‘Rival gangs will offer two-for-one deals to get a better market share,’ he said. Other sales techniques that drugs gangs are using include offering credit, he added.    

He debunked a number of myths about gangs and said they are not always urban and black and not always male.

John went on to explain that the markets being targeted are changing too, with gangs from major towns expanding into the surrounding rural areas, and middle-class drug users being a group that is not often highlighted.

‘Something anyone taking cocaine should think about is that the drugs that they are taking are coming in through routes that exploit young people - there’s blood on the tracks in the way it gets to their dinner party.’

Why Period products should be free    

Period products should be as freely available in public as soap and toilet paper, said Gabby Edlin, chief executive officer and founder of charity Bloody Good Period.

‘Periods are not an emergency, but if you don’t have the products for them, they quickly become an emergency,’ she said. ‘The budget that pays for toilet paper and soap should include period products.

‘The government should be looking after this and it should no longer be something that is taboo.’  

Her charity works with people who struggle to access period products, and 90% of the people they support are asylum seekers.

With asylum seekers receiving £37.75 a week, she said they do not have enough money to meet basic needs, including period products.

‘People in power don’t want to know,’ she said.

She added that she is working with a task force to try and persuade government that a different approach is needed to period products. 

It’s been so interesting hearing what’s it’s like [for other practitioners] in different areas [of the UK] and to be able to share practice- Natasha Dawe, School nurse, Surrey

Put the patient first, not performance

Performance management is based on financial motivation and not what is best for the patient, said Elizabeth Cotton, director of Surviving Work.  

‘We are all working under some form of professional management and it is often based on financial logic rather than clinical logic,’ she said.

Elizabeth also criticised the ‘Uber-isation’ of the NHS and the undermining of patient-facing roles by digital platforms on which people communicate with health professionals.

Her tips for surviving the workplace were: ‘Don’t blame yourself. Don’t stay calm and carry on. Don’t be brilliant. Don’t go it alone.’


All the award winners...

Local Accredited Representative Award  

  • Claire Bradford  
  • Hayley Carter  
  • Karen Hayes  
  • Nicola Stimson

CPHVA Educational Trust Anniversary Awards  

  • Mel Kavanagh, Harrogate and District NHS Foundation Trust  
  • Ciara McCloskey, Western Health and Social Care Trust  
  • Sunderland and Gateshead Family Nurse Partnership Team  
  • Govanhill Health Team, Glasgow

CPHVA Educational Trust Poster Awards  

  • Developing health visitor prescribing group: Regender Athi and Rendeep Kaur, Sandwell and West Birmingham NHS Trust  
  • Understanding perinatal mental healthcare referral decisions among health visitors and midwives: Jo Johnson, University of Worcester.

It was important for me to be here, as professionals in public health have a key role to play [in our work]- John Dunworth, Training manager, Violence and Vulnerability Unit

The slump in school-readiness

As many as 11% of children are not achieving the expected level of communication skills by the age of two.

This figure increases to 17.5% by the age of five, said Alan Emond, emeritus professor of child health at the University of Bristol.

These figures were revealed in a session based on the new, fifth edition of Health for all children, which is edited by Alan.

‘If you go to school not having achieved the expected communication skills, then that sets you up on a gradient for failure,’ he said. ‘We’ve got to change this. Children need to be ready to learn at two and ready for school by five.’

He said there was inequality for children’s communication skills across the country, with rural areas having low levels of school-readiness and a wide variety of levels in urban areas.

Alan went on to explain the changes made for the fifth edition, one of which is that it is now available as an e-book, with links to resources.

The hope is that the online version will be refreshed as new evidence emerges, ‘so it will always be up to date’.

He added: ‘Programmes targeted towards the first 1000 days have the biggest return on investment. Unfortunately, most investment in health takes place around the school years, when we should have been investing earlier.’    

Help for parents climbing the adoption ladder

Unite-CPHVA is to start work on drafting guidance to help members work with adoptive families.

The news came following an emotive session delivered by Brie Purse, a community nursery nurse and an adoptive parent.

After presenting a masterclass last year, she took to the main stage at the 2019 conference.

She outlined the issues that she had faced in adopting and explained her struggles with post-adoption depression.

After her presentation, Janet Taylor, CPHVA Executive Committee chair, said: ‘I certainly feel that we have listened and we would be very keen to involve you in providing some professional guidelines or a toolkit so that people know what to do, because I think we need to do better.’

Brie also revealed the results of a survey of adoptive parents in Dorset, in which 45% of respondents said they had suffered from post-adoption depression.

Only 36% said they had had a positive experience with health visitors and just 28% felt that they had been listened to.    

She concluded: ‘As HVs, you may only come into contact with one adoptive family in your career, but you can make a big difference to their lives.’

Tackle racial discrimination... and save money too

Dealing with racial discrimination in the NHS will improve patient outcomes and save the NHS money, said Yvonne Coghill, CBE, director of Workforce Race Equality Standard Implementation at NHS England.

She said: ‘There is an implication for patient care because people who feel discriminated against can’t give as good care as they would if they felt appreciated.’

Better patient outcomes would lead to financial savings, she added. ‘We have legal and moral cases and now we also have a quality and a financial case.’

Yvonne showed that racial discrimination was still rife in the NHS. Data on Agenda for Change bandings showed that just 6.2% of black and minority ethnic nurses, midwives and health visitors were in Band 8c and 9.

She also said that 12.8% of staff claimed to have experienced discrimination in the workplace, and ethnic background was the most common reason.

It was really exciting to be able to share our project that we’re all so proud of with like-minded professionals- Katrina Sealy, School nurse, Surrey

The secret lives of modern slaves and sex workers

An estimated 136,000 people are trafficked annually in the UK, higher than the rate of human trafficking 200 years ago.

Diana De, senior lecturer at Cardiff University, said people regularly engage with modern slavery in nail bars and car washes but don’t realise it.

The physical clues to slavery and exploitation can vary widely, from cigarette burns and disorientation, to people presenting with dizziness and headaches.

Diana said an often ignored but very important indicator is poor oral health, from missing teeth to bad decay.

She added: ‘We aren’t expecting you to do any dramatic rescues. This is about listening to patients, offering support and building rapport and trust.

‘If possible, you should try and admit the patient but if not, you should try your best to keep lines of communication open and reassure them that you are there to help.’

If you have concerns about a patient, you should contact the Modern Slavery Helpline, which is open to the public too.

A session on sex workers followed, delivered by Nici Evans, former lead officer at the Cardiff Partnership Board.

She said there are an estimated 72,800 sex workers in the UK (88% female).

‘Most of these women are mothers,’ she said.‘They need health services they can go to where the staff are non-judgemental and understand their needs.

‘They don’t want to have to talk through their life story again and again, as this can be traumatic for them, and they need services that are flexible for their chaotic lifestyle.’  

Labour ‘will boost HV numbers’

Len McCluskey, general secretary of Unite the Union, said health visitor numbers would increase under a Labour government.

He said: ‘The need for real investment in the health service has never been more crucial. The only answer to austerity and the underfunding in health is a Jeremy Corbyn-led government.’

‘I was told not to put too much politics into my speech,’ he continued, ‘but I’ve always been as honest as I can be and only Labour puts children, young people and families first.

‘A Labour government will increase the number of health visitors and school nurses,’ he said and added that it would also fund training.

He went on to praise the work of HVs and school nurses before drawing his speech to a close.

‘I would like to thank you all, from all of our Unite members, for what you do day-in, day-out,’ he said.

‘The dedication that you show takes my breath away. You need to know that we value you and that we stand very much behind you.’

Time to party!

This year’s conference celebration took place in the beautiful ballroom of The Majestic hotel. There was a live band, a fun photo booth, plenty of dancing and lots of networking. Glitz and glamour was the order of the night, with sparkling beverages and good food to match.