The Information Needs of the Frontline Public Health Workforce

Jill Rutland
My Background
 Public Health Library
 Service to Public Health Professionals
 Need to reach out to ‘frontline’ staff
 Interested to know more
 Use results to inform library and knowledge service
Policy Background
 Choosing Health (2004)
 Wanless Report (2004) Securing health for the whole
 Our health, our care, our say: a new direction for
community services (2006); Darzi 2008
 PHRU (2008) Public Health Skills and Career
Framework (for Practitioners)
 Individual professional areas – have own guidance
with regard to promoting public health
 Literature search
 Qualitative – explorative
 Phenomenological approach – describe everyday
experience to achieve understanding
In-depth semi-structured interviews
Representatives of 8 professional groups
Ethical review
Taped, transcribed interviews
Analysis of data – categories – themes – tables – colours
Needs, barriers, where needs met
 Children’s Centre Manager
 Lack of time, lack of knowledge about access to health
libraries, need for local resources, named contact,
current awareness, course support
 “if we are informed, we can try to do something about
them. By encouraging parents to undertake some
exercises or pram pushing, or working with children
regarding obesity, we are contributing to the much
wider public health agenda”
Community development worker
 Lack of support from employers, lack of information
from above, need for training in finding info. Lack of
time, lack of awareness if what is available.
 “it is quite difficult for me to identify what I’m missing
and for my line managers because their background
isn’t community development either”
Community Midwife
 Lack of IT. Need training in literature searching,
named contact, current awareness, local website
 “something like that would be really good because it’s
difficult for me to get hold of figures like that when I
go to meetings”
District Nurse
 Local information, national targets and policies, access
to relevant library, training, targeted current
awareness, lack of managerial support and
communication of information
 “the targets that the government set, how they impact
on what we are doing, they are all of interest...we
would hope that our managers would be cascading it
down to us, but it doesn’t happen”
Health Visitor
 Lack of IT, lack of management support, lack of
cascading information, lack of time, lack of training
 “I feel I have to put on GMTV or pick up the Daily Mail
to find out what I need to know today”
 “they are missing an absolute treat because health
visitors are very well placed...we are actually there,
with the community, people are letting us into their
house when they don’t have to...we could deliver so
much of the public health agenda, but there is no
regard for us. I feel we are bottom of the pile”
 Need training in effective use of internet, knowledge
of what is available, targeted current awareness, “too
much information”
 “a lot of pharmacists don’t even have an email address.
One of our issues is that we can’t email them
information, for example, when we do projects or there
are things we are trying to promote”
Practice Nurse
 Lack of time, lack of IT, lack of email – difficult to
contact. Need training, current awareness, local
information, named library contact, literature search
 Since primary care more target driven, decline in
opportunity to practice primary prevention
 “I don’t have time to delve into anything which doesn’t
have implications for my work, but anything that does
would be helpful”
School nurse
 Lack of time, very broad role, lack of awareness of
what is available, lack of training (P/T 25 hrs pw- 7
primary, 2 senior, 2 special, 1 private)
 “there’s just not the time. You’d love to take a subject
on board and really go into it because if you can back it
up with research it holds more carry on
doing the same thing, and I know we shouldn’t do
that, we should look at new ways, but a lot of it is the
time and the funding”
Conclusion: Main Information
 To be met by the library service: current awareness
(targeted), local website, training, literature searching
service, more promotion and outreach to aid
awareness of what is available, named contact,
outreach librarian, patient information
 To be met by management: IT provision, CPD, more
time, more communication, more funding
 Further research needed:
Interview more representatives
2. Questionnaire based on themes discovered by
qualitative approach – lead to quantitative research
 Aim to meet information needs through library and
knowledge service developments – broaden mailing
lists, offer training more widely, promote service more
widely, develop Observatory website to reach these
And finally....
 Common theme emerged – frontline staff doing less public
health work than previously – crowded out by other
Children and adults receiving far less screening and fewer
health checks – lack of primary prevention
E.g school nurse no longer give medicals to children
starting school
HVs concentrate on disadvantaged families
Practice Nurse – no time to carry out well-man and wellwoman clinics and pick up early signs of diseases
Most interviewees felt overworked, fire-fighting, rather
than engaging in preventative work – a worrying trend
Post script
 Now we have ‘Equity and excellence: liberating the
NHS’ (July 2010)
 How will this affect
 Public health organisation?
 Frontline staff?
 Libraries?
 ??????