What is the vision for this profession? Learning environments of health visitors in an English city

Abstract

This paper discusses the attempts by a group of health visitors in a provincial English city to reform their working practices in order to work more collaboratively and, hence, create a more expansive learning environment. The health visitors self-consciously sought to create a ‘community of practice’, a term they felt captured their ambition to move away from the historical conception of health visitors as professionals
working largely on their own but under the direction of others. The paper shows that the outcomes of the health visitors’ attempts to engineer changes to their work organisation were shaped by the constraints and opportunities offered by their relationships with a diverse and fragmented network of fellow professionals, including other health visitors, doctors,
managers and personnel from other social care agencies. Our analysis contextualises the uncertain development of discretion and trust in the work organization of health visitors within the broader horizontal and vertical relationships of the productive system in which they are embedded. The paper argues that, whilst much was achieved and considerable learning took place, the group’s vision was ultimately unsustainable due to the characteristics of the wider productive system.

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