The NHS internal market offers community nurses unprecedented opportunity to achieve, through influencing the purchasing process, real improvements in health and health care. Shirley Goodwin outlines what she, as a purchaser, looks for when she commissions community nursing services.
Contracts are about much more than the simple purchasing of services. In an NHS context, they are also about working in partnership with patients, and about good employment practices, writes Judy Hargadon. Here she outlines how contracts can be used to improve health care services, and the health of those involved in both receiving and providing that care.
To community nurses experiencing the chaos of repeated organisational change, the NHS can seem an environment hostile to clinical excellence. But, writes Alison Norman, the changing nature of health service management offers new opportunities for health visitors and school nurses to take the lead in pushing forward the boundaries of clinical practice. Here she examines the concept of leadership, and challenges practitioners to take up the gauntlet.
Since the publication, in April 1993, of A vision for the future, clinical supervision has become a major topic of debate within the nursing, midwifery and health visiting professions. Here the Health visitors' association provides an overview of the present discussions, offering a range of definitions of the term, together with information on the general principles of supervision and the requirements for its effective implementation. The final section lists a range of questions useful for members to raise and discuss when the introduction of clinical supervision is being planned.
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