Miss Wendy Nicholson Mrs Penny Greenwood (UK)€¦ · Wendy Nicholson MBE, Deputy Chief Nurse –Children, Young People & Families and Deputy Head of WHO Collaborating Centre for

Miss Wendy Nicholson (UK)

Mrs Penny Greenwood (UK)

Universal health for all: a public health approach

Nurse Leadership and Evidencing Impact of

the Nursing contribution to improving

population health

Wendy Nicholson MBE, Deputy Chief Nurse –Children, Young People & Families and

Deputy Head of WHO Collaborating Centre for Public Health Nursing & Midwifery

RN, RSCN, RNt, MA, BSc, Dip Nursing FQNI, Scholar of FNF

Penny Greenwood -Associate Lead Nurse Children, Young People and Families and

World Health Organization Collaborating Centre Nurse Advisor, Public Health England

FFPH, UKPHR, RN, SCPHN, MSc, BSc, Dp Nursing, Queen’s Nurse

The 5th Commonwealth Nurses and Midwives Conference – 6 March 2020

Nurses: leading and delivering impactful health for all

• The United Nations ambition to provide

Universal Health Coverage by 2030 requires

a well-equipped workforce, with the skills and

knowledge to deliver at pace.

• Nurses, are the largest single workforce

delivering health care across the globe,

delivering in many different settings including

hospitals and within local communities.

• The face of nursing and midwifery is

changing; there is currently much more

emphasis on prevention, public health, self-

care, community empowerment and health

literacy.

• This not only provides an opportunity to

prevent illness and to optimise health and

wellbeing but will also reduce the burden on

health care systems.


Sustainable

Development Goals


Meeting the challenges & changes in population health

Understanding health as a foundation and an asset

• To meet the health challenges and changes in

population health, nursing will need to

continually evolve. Nurses are not averse to

change, however their significant contribution

is often underplayed.

• Their unique contribution, particularly within

the prevention arena, is impactful and there is

evidence to demonstrate the return on

investment.

• The evidence-base underpinning prevention

and public health nursing continues to grow,

with nurses using this both to strengthen care

delivery and contribute to the evidence base

by demonstrating impact.

The 5th Commonwealth Nurses and Midwives Conference – 6 March 2020The 5th Commonwealth Nurses and Midwives Conference – 6 March 20203

Current health challenges - Globally

10 Global health challenges:

1. Air pollution and climate change

2. Non-communicable diseases – diabetes, heart

disease and cancer

3. Global influenza pandemic

4. Fragile and vulnerable settings

5. Antimicrobial resistance

6. Ebola and other high-threat pathogens

7. Weak primary health care

8. Vaccine hesitancy

9. Dengue

10.HIV


Hertfordshire County Council’s adaptation of image from For debate: a new

wave in public health improvement

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62341-7/abstract

HealthCaring for the ‘Public’s Health’ - England

HEALTH

PROMOTING

PRACTICE (3P’s)

Preventing avoidable

disease

Protecting

health

Promoting wellbeing

resilience

“The future is not

something we enter. The

future is something we

create.”

Supporting healthy people and

healthy places now and in the

future

5

6 The 5th Commonwealth Nurses and Midwives Conference – 6 March 2020

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62341-7/abstract

Prevention and early intervention


Improved individual and population health, cost

control/sustainability of services and economic return

Nurses lead and

deliver many

programmes for

prevention and

early intervention

with good impact

and improved

outcomes

6

Public Health Nurses – Leading the way 0-5


• Leading local delivery – health visitors as

specialist public health nurses improving

outcomes from pregnancy to 5 years

• Supporting ‘fit for pregnancy’; reducing

smoking in pregnancy; early support for mental

health

• Improving outcomes for children (pre-school)

including speech and language acquisition and

school readiness


Public Health Nurses – Leading the way 5-19


• Leading local delivery – school nurses as specialist

public health nurses improving outcomes from 5-19

years

• Supporting school readiness; early support for

mental health; improving oral health and reducing

dental caries; childhood obesity and complex health

needs; delivering screening and immunisations

• Reducing risk taking behaviours – teenage

pregnancy, alcohol, smoking and drugs


Maximising impact – General Practice Nurses

• Maximising impact through the nursing

contribution to CVD, improving physical activity,

managing diabetes and delivering immunisations

and screening programmes

• General practice nurses leading prevention and

improving health and wellbeing at individual and

population level


Public health nurses – leading the way at

International level

• Nurses contributing to the evidence base by

demonstrating public health nursing in practice

• The evidence-base underpinning prevention and public

health nursing continues to grow, with nurses using this

both to strengthen care delivery and contribute to the

evidence base by demonstrating impact.

• Technical advisors are nurses, midwives and allied

health professionals working in public health having a

pivotal role in the health for all agenda nationally and

globally.

• Providing credible leadership, expert knowledge, and

sharing evidence-based practices with local, national

and international partners.

The 5th Commonwealth Nurses and Midwives Conference – 6 March 2020 1011 The 5th Commonwealth Nurses and Midwives Conference – 6 March 2020

Technical advisors – strengthening the

role of public health nurses

• Act as ambassadors for global public health,

bringing public health innovation to support

change in policy and delivery of health for all to

prevent illness and optimise health and wellbeing

whilst reducing inequalities.

• Embedding the public health philosophy of

prevention into the day-to-day practice of all

nurses and midwives

• Socialise the Sustainable Development Goals

through case studies and examples of practice the

public health nurse’s role demonstrating evidence

into practice

The 5th Commonwealth Nurses and Midwives Conference – 6 March 2020Prevent avoidable disease, Protect health, Promote wellbeing resilience 1112 The 5th Commonwealth Nurses and Midwives Conference – 6 March 2020

MOVING FROM

Topic based/illness based

services

Health as treatment and services

Care based on risk, ‘telling

and doing to’

Concerns about technology

Hierarchy/status

Invisibility of prevention in

nursing and midwifery PH roles

TO INCLUDE

Place based/healthy places

‘ASSETS’

Health in all policies/public services:

Prevention and Early Intervention

Care based on co-production

Leveraging technology

Distributed leadership exercising

influence

Nurses and midwives as highly

visible vital resources for health

What do we need to do? (1)


What do we need to do? (2)

Difficulty in starting & holding ‘hard

conversations’

Lack of confidence in own knowledge

compounded by lack of easy access to evidence

Concerns about own health choices and effect on

credibility/perceptions as ‘poor role models’

Views that health campaigns and professional

messages are often poorly coordinated making

local action more difficult

Perception that ‘value’ is not well articulated and

professionals are unable to measure impact

Time pressures


Overcome concerns from nurses & health and care professionals

13

Work with

regulator

Universities

Under Grad Ed

CPD

Develop

Leadership

Seek and use

policy

alignment

Marketing

Social media

Work locally, nationally

and globally

Develop

resources, tools

& metrics for

health

promoting

practice (3Ps)

Build into

public health,

primary and

community

care nursing

development

How do we do it?

WHO CC PH

Nursing And

Midwifery

Build ‘culture of

health’ in and

through nursing Make it real

and as easy as

possible!!

14 The 5th Commonwealth Nurses and Midwives Conference – 6 March 2020

What is my contribution to practice and policy

development?

What influence can I bring to upscale prevention,

protection and promotion for people and

communities?

What difference can I make through partnership

and developing collaborative plans?

How can I develop/extend skills and confidence

to influence and lead?

How can I support the All Our Health social

movement/best use AOH resources?


The ‘ask’ of Nurses – Influencing

Encourage nurses and midwives in reflection and individual

action, and ask ‘What can each of us do to influence local

policy and practice to promote prevention to improve

outcomes for patients, families and communities?’


The ‘ask’ of Nurses

‘USE YOUR INFLUENCE’ ‘VOICE’ ‘CREDIBILITY’

Influence is

the power to have an effect on people or things

and the power to shape policy

Having a confident leadership ‘voice’ is your key

to being a successful leader

Developing ‘voice and influence’ involves values

and credibility

Credibility is the quality of being trusted and

believed in. Credibility grows when you make

decisions based on values

Related to: validity, acceptability, tenability,

authoritativeness, impressiveness


Be role models for positive about

prevention

Understand the context and identify

opportunities

Understand the evidence and in particular

‘evidence into action’

Develop and extend knowledge and new

formal and informal approaches

Apply and help others to apply clinical

and professional knowledge for

prevention in everyday interactions

Understand effective change

management/improvement science in

developing nurses’ roles in health as an

asset as well as in care in sickness

The ‘ask’ of Nurses – Leadership


What is my contribution to practice and policy

development?

What influence can I bring to upscale prevention,

protection and promotion for people and

communities?

What difference can I make through partnership

and developing collaborative plans?

How can I develop/extend skills and confidence

to influence and lead?

How can I support the All Our Health social

movement/best use AOH resources?


The ‘ask’ of Nurses – Influencing

Encourage nurses and midwives in reflection and individual

action, and ask ‘What can each of us do to influence local

policy and practice to promote prevention to improve

outcomes for patients, families and communities?’


What would success look like?

Improved quality and outcomes and

reduced inequalities for individual people,

communities and populations

Improved visibility of scope of practice in

prevention, early intervention and in

supporting health literacy/self care

Improved measurement of interventions and

impact for upgrade in prevention and early

intervention

Sharing good practice & case studies

Best value from services for individuals,

communities and society


Resources for Health & Care Professionals

https://www.youtube.com/watch?v=5JtV8B_z7uo

Recent research PHE carried out to add to our knowledge about

HCPs views on the prevention agenda

‘Health and care professionals: Make prevention your healthy New Year’s resolution’

Motivational interviewing and health coaching, with links to useful resources

‘It’s good to talk: Making the most of our conversations’

Making referrals to lifestyle support services or trusted online resources

‘Health and care professionals: Your lifestyle referrals can create a force for change’

Prevnt avoidable disease, Protect health, Promote wellbeing resilienceThe 5th Commonwealth Nurses and Midwives Conference – 6 March 202020

[email protected]

Twitter:@greendwoodpj

Contact Information:


https://www.youtube.com/watch?v=5JtV8B_z7uo

https://publichealthmatters.blog.gov.uk/2018/01/08/health-and-care-professionals-make-prevention-your-healthy-new-years-resolution/

https://publichealthmatters.blog.gov.uk/2018/01/08/its-good-to-talk-making-the-most-of-our-conversations/

https://publichealthmatters.blog.gov.uk/2018/01/08/health-and-care-professionals-your-lifestyle-referrals-can-create-a-force-for-change/

mailto:[email protected]

Documents

Miss Wendy Nicholson Mrs Penny Greenwood (UK)€¦ · Wendy Nicholson MBE, Deputy Chief Nurse –Children, Young People & Families and Deputy Head of WHO Collaborating Centre for