Opportunities and Challenges of Contemporary Public Health Policy - Essay Example

?Topic:  the opportunities and challenges of contemporary public health policy for specialist community public health nursing Introduction Lowe (2007, p9) notes that health visiting in the UK has legitimacy and combines both nursing and health care for children and young adults and is seen as a means of influencing and ensuring the well being of the families and the community in general. The role of health visiting is evolving with the different governments of UK (England, Wales, Scotland and Northern Ireland) introducing changes or amendments in the existing policy literature which seeks to implement new plans that help address the growing concerns and needs in public health services (The RCN’s UK position on health visiting in the early years, 2011). This paper is a critical review of the available literature on specialist community public health policy in England as applicable to health visiting. Some of the more recent position papers along with several research papers on the role of health visiting nurses, their qualifications and skills and the relevant policies will be reviewed. The advantages of health visiting to the target segment and the various challenges faced by health visitors as well the administration will also be discussed to understand the health visiting environment in England. Specialist community health policy in England Despite recognizing the importance of public health promotion and preventative strategies through community settings, public health issues concerning health visiting still remains a subject that attracts much attention. Health visiting may have evolved from simply being concerned with sanitation to addressing maternal and child welfare; it is now being touted as the most essential of services in the realm of public health. Today, health visiting in England and UK as in other countries is being given the importance that it demands. This concept of health visiting primarily focuses on generating awareness among individuals, families and communities as a whole of the importance of ensuring the wellness of both the child and the family (Carr et al, 2012). However, there is an increasing awareness among practitioners and policy makers alike of the need for effective policies and implementation strategies to cater to the demanding and more complex needs of the changing community settings which are more heading towards being multi-ethnic and diverse in nature. There is evidence of a multi-pronged approach to developing health visiting services in England. This can be seen from the initiative by National Health Services (NHS) in gathering evidence base for improving public health based on a three-tier structure that takes in to account the strategic directions set by a board of advisors in collecting the evidence base, dividing the work based on reference group and forming of user panels to establish a framework for evaluation of the evidence base (Bull et al, 2004). The Royal College of Nurisng (RCN), UK’s largest association of nurses, midwives, health visitors and other practitioners has published a position paper on health visiting (“Pillars of the Community: the RCN UK position on the development of the registered nursing workforce in the community”) which has since been instrumental in contributing to the decision of the Department of Health to endorse the coalition government’s pledge to increase the number of health visitors from 8000 to more than 12000 (an increase by 4200) and also the ‘Health Visitor implementation Plan’ set to guide and strengthen health visiting service in the country, as part of the “A Call to action: 2011’ publication that endorses a four tier model: Community; Universal; Universal Plus and Universal Partnership Plus (Health Visiting Services & Public Health Nursing: a consultation document, 2012). Concerns have been raised on the role of health nurses in the community settings where it seemed to take on the role of surveillance more than support to the families of the different communities. However, specialist community nursing is considered more of a balancing act, the lack of which is considered to be a doomed activity (Robinson, 2004). In spite of the different views and attempts to address health visiting services, there still is an attempt by The Nursing and Midwifery Council (NMC) to classify health visiting in terms of services provided by specialist community public health nurses, nurses and midwives (Standards of proficiency for specialist community public health nurses, 2012). Health visiting nurses Health visiting profession is investment sensitive and the role of the health visitors is more complex today as they need to ensure the well being of the family and protect children in diverse environmental and emotional settings. Family nurse partnership project is one initiative that is being used to draw to define and support the role of health visitors (Action on Health Visiting, 2009). Health visitors are playing an active role in breaking generational cycles of poor health and inequality as evidenced from the work of two health visitors in Falmouth who are responsible of reducing crime rate by 50 percent and postnatal depression by 70 percent in the community they worked in (RCN publishes evidence of the importance of health visitors, 2011). Figure 1 represents key aspects of health visiting nurses: Figure 1: Key aspects of role of health visiting nurses. Source: (Health Visiting Services & Public Health Nursing: a consultation document, 2012). However, there is a need to gather more evidence base from other parts of England which can be empirical tested for similar organizations to push the administration and the government to increase investment and recognize and communicate the urgency of the matter. It is also of primary importance that the quality, safety, costs and staff training be considered for stressing on the investment decisions. In addition, lack of clear measures to evaluate the patient outcomes, costs and benefits of investment for training, etc. still hamper the effective role pinned to health visitors (Evidence Submission: Care Closer to Home, 2011). Despite the lack of clarity in the specific role of health nurses in the community setting, different NHS operations have been taking individual roles seriously and two such trusts have rolled out Department of Health’s (DH) new service vision and model that help new and returning health visiting nurses acquire or enhance their skills through the training provided by four universities (Two West Mids trusts to showcase health visitor drive, 2011). Apart from being trained on improving the relations with the community, health visitors are being trained to work for Sure Start children’s program of the coalition government and also engage in pre-emptive actions to break cycles of generative dysfunctional activities (Griffith, 2010). Lindley et al (2010) argue that the quality of health visitors determines the service delivery of specialist community health visiting profession as there are some challenges faced in recruiting skilled number of practiced nurses as is the lack of clearly defined roles for health visitors. Gaps in implementing specialist community public health schemes or strategies like health visiting in England are being addressed through lean thinking by (Carr et al, 2012; Grove et al, 2010) where they take into consideration the limited investments in this sphere of public health and advocate the need for health visitors as well as providers and commissioning agencies to realize that lean environment they need to work in the present setting and to be able to attract and stress the need for more investment in future by applying their knowledge and skills in the present. Conclusion Specialist community public health services include health visiting that aims at ensuring the well being of the individual, family and the community by supporting mothers and families and protecting children against abuse. Health visiting as a separate concern of specialist community service is gaining importance with the coalition government’s pledge to generate 4200 more jobs by 2015 with a clear implementation plan and also the focused research and practice of some of the leading providers (RCN, etc.) and commissions (NHS, etc.) trying to provide evidence base for further decisions and improvements in health visiting services. This also includes recommendations for improving health visitor’s quality, safety and skills along with increasing investment for providing quality services and training of the staff. References Lowe, R. 2007. Facing the future: A review of the role of health visitors. Queen’s Nursing Institute. Available at www.dh.gov.uk/cno Accessed online: 22nd February 2012. The RCN’s UK position on health visiting in the early years. 2011. Royal College of Nursing: London. Publication code 004 125. Griffith, J. 2010. Joint working with health visitors in early interventions. Communitycare.co.uk. Carr, SM, Pearson P, Young-Murphy L et al. 2012. UK community health visiting: challenges faced during lean implementation. Journal of Healthcare Leadership. Vol 4. DOI: http://dx.doi.org/10.2147/JHL.S16322. Lindley, JP, Sayer, L and Thurtle, JV. 2010. Current educational challenges for specialist community public health nurses following a health-visiting pathway and the consequences of these challenges for public health. Perspectives in Public Health. Vol. 131 no. 1 . doi: 10.1177/1757913910369091. Two West Mids trusts to showcase health visitor drive, 2011. NHS: Local. Bull, J, McCormick, G, Swann, C et al. 2004. Ante- and post-natal home-visiting programmes: a review of reviews. Health Development Agency, NHS. www.hda.nhs.uk/evidence Evidence Submission: Care Closer to Home, 2011. The Lancet Policy Matters. Elsevier. Grove, A.L. Meredith, J.O. MacIntyre, M. et al. 2010. UK health visiting: challenges faced during lean implementation. Leadership in Health Services. Vol. 23, Iss: 3. Health Visiting Services & Public Health Nursing: a consultation document, 2012. Royal College of Nursing. Robinson, 2004. Standards of proficiency for specialist community public health nurses, 2012.Nursing and Midwifery Council. Action on Health Visiting, 2009. Getting it Right for Children and Families: Defining research to maximise the contribution of the health visitor. CPHVA and Unite. Available at: www.unitetheunion.org/cphva Accessed on: 22nd February 2012. RCN publishes evidence of the importance of health visitors, 2011. Royal College of Nursing. Available online: http://www.rcn.org.uk/newsevents/news/article/uk/rcn_publishes_evidence_of_the_importance_of_health_visitors Accessed on: 22nd February 2012. Read More