Making Every Contact Count
DH Nursing Policy and Vision
Pauline Watts – Professional Officer for Health Visiting, PH and
Dementia Nursing
The Challenge: what we are facing and the rationale for change
We face significant challenges to public health …
• England has one of the highest rates of obesity in the developed world.
• Two thirds of adults are overweight or obese, a leading cause of type 2 diabetes and heart disease
• In 2008-10, the gap between areas with the highest and lowest life expectancy was around 12 years
• Smoking claims over 80,000 lives a year.
• 1.6 million people are dependent on alcohol.
• Over half a million new sexually transmitted infections were diagnosed in 2010
• Major health threats persist, ranging from risk of new pandemics to the potential impact of terrorist
incidents.
SoS priorities
… with significant costs to health and to the
economy
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Drug related crime costs £13.9bn per year
Smoking costs the NHS £2.7bn a year
Obesity costs the NHS £4.2bn a year
Dementia costs the UK £17bn a year
Sexual health treatment costs NHS £1.2bn a year
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Long term conditions
Care – quality of care
Dementia
Reducing mortality from preventable
causes
The new Public Health System will build on existing success
Vision /
Outcomes
How do we
see the
future?
• Focused on outcomes: improve and protect health and
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Mission
What does
the PH
system have
to do?
wellbeing for all the people of England and reduce health
inequalities
We will have succeeded if, as a nation, we are living longer, and in
better health; and if the gap in health between rich and poor is
reducing.
Improving outcomes for all at all stages of the life-course
We will improve and protect health and wellbeing – through:
Empowering local leadership and encourage wide responsibility
across society to improve health and wellbeing, and tackle the wider
factors that influence it
Strengthening self-esteem, confidence and personal responsibility
Positively promoting healthier behaviours and lifestyles
Adapting environments to make healthy choices easier
Protecting the public from health threats – with a strong nationally
integrated system that offers expert advice to the NHS, local
government and the public
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Improving care, improving outcomes for individuals families
and communities
Helping people to stay independent, maximising
well-being and improving health outcomes
New relationships …. New responsibilities?
Nurses and midwives opportunities and responsibilities for
‘improving the public’s heath’
Individual/community/
population
Public Health practitioners/SCPHN
Including health visitors, school nurses,
occupational health nurses, specialist midwives
Individual/caseload/
registered list
Nurses and midwives with specific primary and
secondary prevention roles: practice nurses,
mental health nurses, community nurses, sexual health nurses,
Individual
All nurses and midwives maximising their role in health and wellbeing
Every contact counts
Actions to maximise the nursing and midwifery contribution
to improving health and wellbeing at individual level
Core Actions: - applicable to all nursing and midwifery groups
Individual Level
• Provide direct health care to individuals across in all settings
• Adopting an holistic approach to the care of individuals, making
“every contact count” to improve health and wellbeing at every
opportunity
• Offer and provide accurate information on health and wellbeing on
specific issues to others to individuals on how to improve health and
wellbeing
• Signpost individuals to people and agencies that can help them
improve their health and wellbeing
• Communicate with people about their health and wellbeing and the
actions they may take to achieve improvement
• Listen to and support individuals to communicate their views of and
concerns about health and wellbeing, refer others with consent.
A life course approach – initial priorities
National Actions: Policy and Programmes
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Making every contact count
Developing accessible evidence based on NICE guidance
The public health role of midwives
Maximising the leadership role of SCPHN including health visitor and
school nursing programmes
‘No health without Mental Health’
Dementia Challenge
Actively engaging across sectors, leading work effectively,
integrating health, care and support
Local Actions:
• Make ‘every contact count’
• Support nurses and midwives to maximise their contribution to the
Dementia Challenge
• Ensure practice is supported by appropriate technology
Call to Action:
• Develop skills as ‘health promoting practitioners’ making every contact
count
At the start of life : reducing health inequalities and variation
in infant mortality
•Lifestyle indicators
•Breast-feeding rates
•Screening (preconception, sexual
health, baby checks)
•Maternal mental health generally
(post-natal depression particularly
- spotting the risk factors and early
signs)
•Immunisation - mother (pertussis)
and baby
Children, Families and Communities: Health Visiting and
School nursing
•Health and wellbeing of children, young
people families
•Delivery of the Healthy Child Programme
and enabling positive public health
outcomes
•Appropriate infant nutrition and lifestyle
changes to tackle rising obesity and
related illness in later life
•Enabling strong early attachment and
infant emotional wellbeing
•Connecting children, families to resources
Supporting children and families with
additional or complex needs
•Reducing formal safeguarding through
early identification and intervention
•Partnership working
Children, Families and Communities: Health Visiting and
School nursing
‘National model’ – delivering the
HCP 0-19
Delivering the HCP 0-19
Your Community
Universal services :
Healthy child programme
Universal Plus services :
Early identification and intervention
Universal Partnership Plus
services
Ongoing multi agency support
0-5
Led by HV
5-19
Led by SN
S
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Working age adults and older adults: vision for practice
nurses
•Using knowledge to support and deliver
care to individuals and local populations
•Supporting all long term conditions
management including through:
supporting the expert patient
delivering health protection and
health promotion e.g. providing
immunisations, screening and advice
utilising data to ensure targeted care
for groups within practice populations
Optimising health of the population within the
community
No health without mental health
•Tackling stigma and discrimination
•Supporting positive maternal and infant mental health – midwives/HV
•Supporting positive parenting including Nurse Partnership and Health
Visiting
•Supporting work to prevent suicide and manage self-harm
•Improving the mental health and wellbeing of people with long term
physical conditions
•Integrating mental health and wellbeing into campaigns and
communications
Older people : Vision for District Nursing
Making every contact count
Providing opportunistic public health
interventions and supporting the
health and wellbeing of carers
Recognising risk
Reducing social isolation through
supportive care co-ordination
Supporting the needs of carers
Supporting patient choice
Working with patients and carers to
encourage active participation in care
and decision-making
Integrated working with health
and social care
Developing strengthened ways of
working with partners to maximise
resources
Supporting transition of care
Working with partners to provide
seamless support including discharge
planning, transition to residential or
hospice care
Services with strong
foundations
New technology to enhance care
Use of tele-health and mobile
technology to support complex
care in the home
Services embracing innovation
The Dementia Challenge
•Making the importance of the nursing contribution to
dementia care visible and valued
•Maximising our contribution to the dementia challenge
through:
ensuring dementia awareness for all nurses
raising public awareness and reducing social stigma
early identification and signposting to appropriate
services and resources to build community capacity
developing appropriate environment of care
promoting wellbeing and living well with dementia
promoting public health messages of the healthy
heart and healthy head (vascular dementia)
Providing excellent care throughout the care pathway
to the end of life
Nurses and midwives: pioneers in public health – again!
•What needs to happen?
•Generating the ‘will’ across the professions to embrace ‘wellness’ and to act as
health promoting practitioners
•Increasing confidence in nurses and midwives in their contribution to public health
•Increasing capacity and developing competence in new public health skills for
specialist practitioners
•Maximising opportunities e.g. increase in health visitors
•Effective leadership that builds and sustains partnerships
•Active engagement e.g. health and wellbeing boards
Making Every Contact Count