Date Published: 3 March 2016
UK public health nursing
Promotion of good health through education, information and suppor has been part of public health care since the 1850s. Nurses have long played a vital role in the provision of such public health services.
What is Public Health ?
According to www.nurses4ph.org.uk1, a new website launched by the UK Royal College of Nursing (RCN) to publicise the importance of public health nursing, public health can be defined and explained as:
Public health supports individuals, organisations, and society to tackle preventable disease, mortality and disability using:
- Prevention: Reducing the incidence of ill health supporting healthier lifestyle
- Protection: Surveillance and monitoring of infectious disease, emergency response and immunisation
- Promotion: Health education and commissioning services to meet specific health needs.
The government organisation 'Public Health England'2 uses similar definitions and descriptions on its website where it states that it protects and improves the nation's health and wellbeing and reduces health inequalities. Its responsibilities include making the public healthier by encouraging discussions; supporting the public so they can protect and improve their own health; protecting the nation's health through the national health protection service; preparing for public health emergencies; reporting on improvements in the public's health so everyone can understand the challenge and the next steps; and helping local authorities and the NHS to develop the public health system and its specialist workforce (not the full list). It is obvious from the information provided by Public Health England that a significant part of implementation of public health initiatives is, or could be, done or supported by trained nursing professionals.
A recent web-based survey of commissioners and those involved in delivering public health services in the UK, from health visiting to dealing with infectious diseases and environmental health hazards, was followed up with in-depth interviews with a sample of the survey respondents. This research has now been published as 'The Value and Contribution of Nursing to Public Health in the UK'3, a recent report from the RCN. This 40 page document indicates that although the importance of public health nursing is recognised by many commissioners and designers of public health services in the UK, public health nursing is not always used as much as it could be.
Despite nursing expertise being highly valued in many aspects of public health, there is concern that financial constraints have reduced the availability of nursing expertise in some areas in which it would be highly beneficial. The RCN has highlighted some such services on its new website www.nurses4ph.org.uk. This includes examples of schemes in which nurses are making a real difference to public health regarding issues such as consumption of alcohol, smoking cessation, teenage weight management, the importance of Vitamin D, and living with HIV, among may other aspects of health and wellbeing.
Helen Donovan, RCN Professional Lead for Public Health Nursing and an author of the recent report, summarised the findings described in the report4:
“ Nurses have a crucial role in public health – whether it is dealing with outbreaks of infectious diseases, giving lifestyle advice or supporting people and families at home. The staff doing this vital work should be proud that their work is valued and appreciated.
_ There is a clear consensus that nurses have the expertise, the experience, the leadership skills and the local knowledge to make a difference. However, there are not enough of them in the right roles to be there when needed.
_ This report shows the difference individual nurses and their teams can make if they are given the time, support and authority to do so. There are really heartening examples of the difference that can be made, not only to individuals but to future generations. For example, by tackling teenage obesity, nurses can encourage healthy lives and reduce the burden on the NHS in the future ”.
Some themes that have emerged from comments made about the role of nurses in supporting initiatives public health include nurses' ...
- 'soft skills' such as providing appropriate advice in a timely and sensitive way
- ability to provide explanations that are not too simple or too complicated, not condescending or excessively critical
- approachability - trustworthy while, hopefully, within reach of patients and the public
- ability to empower people
Service providers might well be nervous when budget reductions are announced. In this case the UK Department of Health's announcement in November 2015 that the expected cuts to local authority public health cuts will be applied equally to local authorities as a 6.2% budget cut might lead to some difficult decisions about funding for public health nursing. Helen Donovan suggested that failing to invest in some of the high-value public health nursing services would result in missing great opportunities to improve public health.