Mainstreaming Sure Start speech and language therapy services.

Mainstreaming is the process of transferring policy, activity or good practice from a community-based initiative, such as Sure Start, into the core service. This paper will explain how one Sure Start programme developed a strategy for speech and language therapy (S<) that had an impact on the development of mainstream S< provision. The strategy explained here has shown the potential for team working and multi-agency delivery of new services.

Structuring health needs assessments: the medicalisation of health visiting.

This paper draws on Foucault to understand the changing discourse and impact of structured 'health needs assessments' on health visiting practice. Literature about this activity makes little mention of the long-standing social purposes of health visiting, which include surveillance of vulnerable and invisible populations, providing them, where needed, with help and support to access protective and supportive services. Instead, the discourse has been concerned primarily with an epidemiological focus and public health, which is associated with risk factors and assessments.

A structured health needs assessment tool: acceptability and effectiveness for health visiting.

Background: There is, nominally at least, a universal health visiting service in Great Britain, although the frequency of contacts may be severely restricted. Debates about whether home visiting should be universal or selective, therefore, focus on whether health visitors should use professional judgement or structured assessment tools to target attention within their caseload. Research attention has focused mainly on unstructured needs assessments and professional judgment or the development of assessment tools, so that the views of practitioners using structured instruments and their clients are not known.

Health needs assessment in the health visiting service and the impact on the ethnic community.

The purpose of this article is to share the experience of using a health needs assessment tool in health visiting practice in Great Britain, with clients who do not speak English. This is an important issue in developing equity of practice across the growing multi-cultural and diverse populations of the United Kingdom. The paper outlines the findings relevant to these issues drawn from a wider study that used qualitative methods to observe and interview both health visitors and clients regarding the use of the tool.

An empowerment approach to needs assessment in health visiting practice.

This paper examines the usefulness of an integrated approach to needs assessment using an empowerment framework, within a health visitor/client interaction, in the home setting. It is intended to demonstrate the existence of a flexible approach to assessing need that is based on research about necessary processes for carrying out health visiting. The design of the tool described in this paper allows the use of professional judgement as well as fulfilling commissioning requirements to address health outcomes.

Vertical equity in service provision: a model for the Irish public health nursing service.

Aims: This paper analyses the policy and conceptual basis of public health nursing service provision in the Republic of Ireland and situates it within an international context. It draws on the principles of horizontal and vertical equity in proposing a new model of public health nursing service provision. It gives the reader an understanding of a model of service delivery underpinned by the principle of vertical equity.

'Do I don't I call the doctor': a qualitative study of parental perceptions of calling the GP out-of-hours.

The purpose of this study was to investigate how parents use the GP out-of-hours service. There was a lack of information about how parents managed childhood illness and what strategies they put in place to help them to cope before calling the GP. The investigation of parental perceptions was based on a qualitative design using in-depth interviews of 29 families from a semi-rural location in the south-east of England.