The Impact of Screening on Families – A Health Visiting Perspective.
Helen Johnstone, Public Health Practitioner, Healthy Living Centre, Carlise.

Screening has, until very recently, been an integral part of traditional health visiting practice. In 2003, the fourth Hall Report - Health For All Children (H4HFAC) was published. In the past, Hall Four's three predecessors have provided a research based framework from which strategic health authorities could hang their child health service provision. Hall advocates that children's services should be needs-led, or targeted, and responsive to change. It could be argued that H4HFAC (2003) sets out very clearly significant changes as to how the National Screening Programme should be delivered across the UK.

Nationally, health visiting has undergone significant changes, and the profession is embracing many of the challenges set out as the 'new core programme' in H4HFAC. Along with this has come a radical change to how traditional screening programmes are delivered, which ultimately has had an effect on the number and types of contacts health visitors have with families. Therefore, health visiting is currently trying to balance the following issues: By offering a revised (arguably reduced) core programme, how can we be sure that what we're doing enhances the service offered? How do we confidently take on this new way of working when many have worked in traditional roles for years? How do we best support families through these professional changes, and how are we going to evaluate their effectiveness?

Therefore, with a backdrop of developments in practice and strategic levels, what impact does the National Screening Programme have on families? Health visitors are just one group of professionals at the sharp end of screening programmes. The process of screening can have a profound effect on families, and the support offered is vitally important – irrespective of the screening outcome. One example of this in practice is the introduction across North Cumbria of Otoacoustic Emission (OAE) testing by health visitors. This has been taking place for the past 4-5 months and is providing many new challenges to both health visitors and families.

This presentation provides an outline of how health visiting is adapting to the changes in the traditional screening programme, as set out by H4HFAC, and goes on to discuss how health visitors can best offer support to families, using the practice example of OAE testing in North Cumbria.