[ad_1]
900� British�Journal�of�Nursing,�2013,�Vol�22,�No�15
© �2
01 3�
M A
�H ea
lth ca
re �L
td
T he� challenges� to� the� NHS� over� the�coming�years�to�maintain�and�enhance�public� health� and� wellbeing� are� vast�and� complex.� Lifestyle� choices� and� the� causes� of� ill� health� are� now� more� fully� understood� by� health� professionals� who� have� strategies� at� their� disposal� to� support� people� better� in� making� decisions� and� choices� that� are� positive� for� their� general� health.� In� June� 2013,� to� help� accelerate� this� process,� Public� Health�England�published�Nursing and Midwifery Contribution to Public Health� (Public� Health� England,�2013).�This�new�guidance�document� is� designed� to� illuminate� the� specific� roles� of� specialist� public� health� nurses,� but� also� to� reinforce� the� pivotal� health-promoting� practitioner� role� that� every� registered� nurse� and� midwife� has� in� making� every� patient/ client�contact�count.
Background A� report� by� The� King’s� Fund� (2012)� has� shown�that�high�levels�of�admission�to�hospital,� especially� of� elderly� patients,� can� often� be� attributed� to� poor� coordination� between� the� different� elements� of� the� healthcare� system,� in�particular�between�primary� and� secondary� care.� Furthermore,� the� King’s� Fund� believe� that� emergency� admissions� among� people� with� long-term� conditions� that� could� have� been�managed�in�primary�care�cost�the�NHS� £1.42� billion� per� year,� a� figure� that� could� be� significantly� reduced� through� investment� in� primary� and� community-based� services.� Key� to� this� aspiration� is� promoting� the� role� of� nursing� and� midwifery� in� protecting� and� improving� public� health� care,� one� of� the� six� key� action� areas� of� the� national� nursing� midwifery� and� care� strategy,� Compassion in Practice�(DH,�2012).
This� strategy� is� designed� to� support� the� delivery� of� the� values� and� behaviours� of� the� ‘6Cs’,� now� the� principal� driver� for� nursing� in� the�wake�of� the�publication�of� the�Francis� Inquiry,�which�revealed�suboptimal�standards�of� care�at�the�Mid�Staffordshire�NHS�Foundation� Trust�(Francis,�2013).
To�help�achieve�this,�Public�Health�England�� (PHE)�has�prioritised�five�key�areas�for�action: ■■ Designing� strategies� to� promote� longevity� and� improved� health� outcomes� by� tackling� preventable� deaths� and� ill� health� associated� with� smoking,� hypertension,� obesity,� poor� nutrition,� suboptimal� mental� health,� insufficient�exercise�and�alcohol�abuse ■■ Decreasing� the� personal� suffering� caused� by� disease� and� disability� by� concentrating� resources�on�preventing�and�recovering�from� the�long-term�conditions�that�have�significant� impact�on�lives,�including�dementia,�anxiety,� depression�and�drug�dependency ■■ Safeguarding�the�population�from�infectious� diseases�and�environmental�hazards,�including� antibiotic-resistant� infections.� PHE� has� reported�that�cases�of�measles�in�England�are� at� their� highest� recorded� levels� since� 1994,� with�1168�confirmed�cases�between�January� and�May�2013 ■■ Helping�families�to�give�children�and�young� people� the� best� chances� in� life� through� working� with� health� visiting� and� school� nursing,� family� nurse� partnerships� and� the� Troubled�Families�programme�(Department� for� Communities� and� Local� Government,� 2013).� Through� this� programme,� the� government� is�committed� to�working�with� local� authorities� and� their� partners� to� help� the� estimated� 120�000� troubled� families� in� England� to� improve� their� life� trajectories� radically� by� 2015.� This� is� because� the� government� is� committed� to� ensuring� that� the� children� in� these� troubled� families� are� afforded� a� better� life� and� simultaneously� reducing�the�burden�on�the�Exchequer ■■ Improving� health� in� the� workplace� by� encouraging� employers� to� support� their� staff,�and�those�moving�into�and�out�of�the� workforce,�to�lead�healthier�lives. To� achieve� these� priorities,� PHE� will�
promote�‘place-based’�public�health�systems.�In� simple�terms,�‘place-based’�approaches�are�one� strategy� to� improve� the�health� and�wellbeing� of� local� communities� where� specific� groups� of� individuals� can� be� targeted� for� health�
interventions.� The� Tasmanian� Government,� Australia� (2012),� has� produced� a� detailed� position� paper� on�‘place-based’� public� health� systems,� in� which� stakeholders� engage� in� a� collaborative� process� to� address� health� issues� within� a� geographic� space,� such� as� a� neighbourhood� or� specific� community.� This� system� recognises� that� there� is� a� complex� relationship�between�people,�place�and�health.� People� who� live� in� disadvantaged� areas� and� who� may� be� affected� by� social� exclusion,� unemployment,� poor� education� and� poor� physical�environments�may�have�a�greater�risk� of� poor� health� and� wellbeing� than� those� in� affluent�areas.�It�is�this�difference�between�the� health� and� wellbeing� outcomes� of� poor� and� wealthy�communities�that�can�be�described�as� ‘place-based� health� inequity’.� Given� the� UK� economic� downturn,� it� is� not� surprising� that� ‘place-based’�public�health�systems�are�seen�as� a�way�of�targeting�precious�health�resources.
Independence, wellbeing and health The� first� action� area� of� ‘Compassion� in� Practice’� concentrates� on� helping� people� to� stay� independent,� maximising� wellbeing� and� improving� health� outcomes.� It� is� this� action� area� that� the� nursing� and� midwifery� contribution�to�public�health�focuses�on.�
Helping all nurses and midwives to maximise their role in public health This�aspect�of�the�new�guidance�document�is� designed� to� illuminate� the� contribution� that� all�registered�nurses�and�midwives,�irrespective� of� their� place� of� work,� can� make� to� helping� people�mange�their�own�health�and�wellbeing� better.�Nearly� 20� years� ago,�Nutbeam� (1996)� was� arguing� for� the� necessity� of� accurately� defining�what� constitutes� evidence�of� success� in� health� promotion;� the� nursing� profession� is� now� helping� to� build� this� evidence� base.� The� government� believes� that� nurses� should� take� opportunities� at� every� patient� contact� to� maximise� wellbeing� and� improve� health� outcomes� and,� where� possible,� reduce� inequalities.� It� needs� to� be� stressed� that� the�
Professor Alan Glasper discusses the latest Department of Health initiative to enhance the public health role of nursing and midwifery in improving health and wellbeing in society
The nursing and midwifery contribution to public health
British�Journal�of�Nursing,�2013,�Vol�22,�No�15� 901
healthcare policy ©
�2 01
3� M
A �H
ea lth
ca re
�L td
government� itself� has� been� accused�of� empty� rhetoric� after� it� was� revealed� in� the� popular� press� that� it� had� shelved� plans� to� make� plain� packaging� of� cigarettes� compulsory� and� abandoned� its� much-vaunted� aspiration� to� introduce�a�minimum�unit�alcohol�price�(Mail� Online,�2013).�Despite�this,�the�new�guidance� document� illuminates� how� nurses� can� make� every� person� contact� count� in� the� vision� for� improved� public� health,� both� locally� and� nationally.�Measures�include,�among�others: ■■ Promoting�compassion�in�practice�in�social- care�settings ■■ Developing� the� nursing� and� midwifery� contribution� to� the� promotion� of� good� mental� health� and� the� reduction� of� health� inequalities� for� people� with� learning� disabilities ■■ Maximising� the� leadership� role� of� public- health�nurses�and�developing�a�new�model�to� promote�the�public-health�role�of�midwives ■■ Enabling�nurses�to�learn�the�skills�of�health� promotion�to�optimise�every�patient�contact ■■ Enhancing� school� nursing� to� improve� the� health�and�wellbeing�of�children�and�young� people ■■ Supporting�nurses� in�better� helping�people� with�dementia� ■■ Promoting� health� visiting� to� showcase� its� pivotal� role� in� helping� children� and� their� families� get� the� best� start� in� life.� It� is� important� to� direct� efforts� towards� the� prevention�of�child�abuse�and�neglect�before� patterns� of� abuse� are� established� within� families�(MacMilllan�et�al,�2005)�� ■■ Ensuring� that� nurses� are� given� access� to� appropriate� technology� and� highlighting� the�contribution�of�the�National�Institute�of� Health�and�Care�Excellence�(NICE)�through� development�of�an�accessible�evidence�base� for�public�health�nursing ■■ Promoting�interagency�working.
What can nurses do to maximise the ‘nursing and midwifery contribution to public health’? There�are�a�number�of�actions�that�nurses�and� midwives� can� take� to� make� this� new� vision� for�public�health�work,�configured�around�the� individual,�the�community�and�the�population: ■■ Public health and the individual:�The� vision�for�public�health�seeks�to�make�every� nursing� contact� count,� with� every� nurse� being� able� to� offer� up-to-date� advice� to� patients� and� their� families,� based� on� best� evidence�pertinent�to�health�and�wellbeing.� Nursing� advice� that�helps� individuals�make� lifestyle� choices� to�prevent�health�problems� should�be�given�at�every�opportunity.�Nurses�
should�be�able�to�signpost�individuals�to�the� appropriate�people�or�agencies�that�can�best� help�them.�Additionally,�the�role�of�the�nurse� is�to�help�patients�identify�and�set�achievable� health� goals,� and� be� able� to� refer� them� to� others� within� the� multiprofessional� team� when�concerns�are�identified ■■ Public health and the community:� Nurses�working�in�the�community�should�be� able� to� assess,�plan�and�provide�community� needs,� especially� within� hard-to-reach� groups,� such� as� traveller� communities,�who� fail� to�access�health� services.�As�part�of� this� new� vision,� community� nurses� need� to� be� enabled� to� engage� with� communities� and� those� who� commission� services,� and� to� plan,� implement� and� subsequently� review� health� ‘place-based’� projects.� To� achieve� this,� community� nurses� need� to� develop� enhanced� communication� strategies� to� be� more�able� to�articulate� the�health�concerns� of� their� areas� of� health� jurisdiction,� and� to� collect� and� use� population-level� data� to� underpin�their�assertions ■■ Public health and the population: Community�nurses� and�midwives� need� to� be� more�able�to�influence�and�configure�both�the� political�and�policy�agendas�directly,�so�that�they� can�better�represent�their�healthcare�constituents.� This�will�result�in�maximised�opportunities�for� improving� population� health� and� addressing� health� inequalities.� Better� engagement� with� strategic�partners�and�the�public�is�necessary�to� identify� health� need,� set� objectives� and� health� priorities,�and�the�methods�to�measure�success� accurately.� In� building� sustained� community� health� capacity,� improvement� of� health� and� wellbeing,�and�reduction�of�health�inequalities,� should� be� achievable.�To� bring� this� vision� to� fruition,�the�nursing�and�midwifery�community� teams� must� be� enabled� to� develop� the� skill� toolkit� they� need� to� deliver� the� envisaged� service�improvements.�
Conclusion The� Public� Health� Outcomes� Framework,� launched�in�May�2013,�is�designed�to�improve� and�protect�the�nation’s�health�and�wellbeing� with� a� rapid� improvement� in� the� health� of� the� poorest� members� of� society.� This� new� guidance� document,� Nursing and Midwifery Contribution to Public Health,� recognises� that� nurses� and� midwives� are� pivotal� in� making� this� vision� for� the� nation’s� health� a� reality.� The� whole� of� the� nursing� workforce,� wherever�and�whenever� they�work,�must�be� enabled� to� contribute� to� improvements� in� public�health� at� every� level—promoting� the� health� of� the� individual,� the� community� in� which� they� work� and,� ultimately,� the� entire� population.��� BJN
Department� for� Communities� and� Local� Government� (2013)� Helping Troubled Families Turn their Lives Around.� https://www.gov.uk/government/policies/helping- troubled-families-turn-their-lives-around� (accessed� 23� July�2013)
Department� of� Health� (DoH)� (2012)� Compassion in Practice.� http://www.england.nhs.uk/wp-content/ uploads/2012/12/compassion-in-practice.pdf� (accessed� 23�July�2013)
DoH�(2013)�Public�Health�Outcomes�Framework�2013�to� 2016� and� technical� updates.� http://tinyurl.com/d45acrg� (accesssed�23�July�2013)
Department� of� Health� and� Human� Services,� Tasmania,� Australia� (2012)� Place-Based Approaches to Health and Wellbeing.� http://www.dhhs.tas.gov.au/_data/…/Place- ased_Issues_Paper_V1.0.pdf�(accessed�23�July�2013)
Francis�R�(2013)�Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry.� http://www.midstaffspublicinquiry.� com/sites/default/files/report/Executive%20summary.� pdf�(accessed�23�July�2013)
King’s� Fund� (2012)� Data Briefing: Emergency Hospital Admissions for Ambulatory Care-sensitive Conditions.�http:// www.kingsfund.org.uk/publications/data-briefing- emergency-hospital-admissions-ambulatory-care- sensitive-conditions�(accessed�23�July�2013)
MacMillan�HL,�et�al�(2005)�Effectiveness�of�home�visitation� by�public-health�nurses�in�prevention�of�the�recurrence�of� child�physical�abuse�and�neglect:�a�randomised�controlled� trial.�Lancet�365(9473):�1786–93
Mail� Online� (2013)� Stubbed Out.� 23� July.� http://tinyurl. com/kxxtqlg�(accessed�23�July�2013)
Nutbeam�D�(1996)�Health�outcomes�and�health�promotion:� defining�success� in�health�promotion.�Offic J Aust Health Promot Professionals�6(2):�58–60
Public� Health� England� (2013)� Nursing and Midwifery Contribution to Public Health.� https://www.gov.uk/ government/publications/nursing-and-midwifery- contribution-to-public-health�(accessed�23�July�2013)
Key PoInTs
n The challenges to the NHS over the forthcoming years to maintain and enhance public health and well-being are vast and complex
n The new guidance document which describes the nursing and midwifery contribution to public health is designed to address the challenges to the health and well-being of people in society.
n Every registered nurse and midwife has a duty to make every patient /client contact count in promoting public health.
n Place-based approaches are one strategy which can be used by community nurses and midwives to improve the health and wellbeing of local communities.
n The government want to maximise the leadership role of public health nurses and midwives.
Copyright of British Journal of Nursing is the property of Mark Allen Publishing Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder’s express written permission. However, users may print, download, or email articles for individual use.
The post 900� British�Journal�of�Nursing,�2013,�Vol�22,�No�15 appeared first on Infinite Essays.
[ad_2]
Source link