Public health nurses urged to be ‘bold’ and lead change

School and public health nurses are “perfectly positioned” to shape, lead and deliver on policies to improve the nation's health, England’s deputy chief public health nurse has said.

Professor Jamie Waterall, who holds the leadership role at the government's Office for Health Improvement and Disparities, has called for greater investment in the public health nursing workforce to tackle health inequalities and improve outcomes for the population.

Professor Jamie Waterall, who holds the leadership role at the government's Office for Health Improvement and Disparities, has called for greater investment in the public health nursing workforce to tackle health inequalities and improve outcomes for the population.

"I certainly would like to see an establishment of a clear workforce plan for the specialist public health workforce"

Jamie Waterall

In his keynote address, Professor Waterall noted that school and public health nurses and the populations they serve had been faced with “huge uncertainty and adversity” in recent years due to events such as the Covid-19 pandemic, the cost-of-living crisis and conflict in other countries.

However, he argued that these challenges should also be used to “seek opportunity” to improve public health outcomes in the future.

Professor Waterall said: “We need to be bold, we need to be brave.

"We need to be able to challenge at all levels, whether that's to government policy, through to our own professional practice and education, and into the services that are being delivered.

“But there is opportunity, and I strongly believe it's in these times of adversity and challenge, we really can make a difference.”

Public health nursing professions should reflect on whether they are using their “collective leadership” to challenge nursing policy, education and practice, argued Professor Waterall.

He said: “As professions working across the life course, we’re integrated within our communities.

“And school nursing [and] the wider public health family are no better example [of] the way that we work across communities [and] across life courses.”

Jamie Waterall

“I think we're perfectly positioned to shape, to lead and deliver on policy and service and practice development, which will result in people living more independent, healthier lives, for longer.”

However, Professor Waterall noted that putting a “sharp focus” on addressing health inequalities was central to making positive change in public health.

He highlighted how recent data had shown that those living in the most deprived parts of the country were not only living fewer years, but they were “living less years in good health”.

For example, he said that children living in the most deprived areas were more than twice as likely than those in the least deprived to be obese, which put them at greater risk of developing cardiovascular disease.

“These are real challenges that we need to consider professionally and societally,” he said.

Separately, Professor Waterall noted that the chief nursing officer for England, Dame Ruth May, announced last year that she would be launching a new professional strategy for all nurses, midwives and nursing associates.

The strategy, which is expected to come out later this year, will set out ambitions for the professions over the next three to five years.

It has been developed in the context of other key strategic documents, including the recently published NHS Long Term Workforce Plan.

Professor Waterall used his keynote address to share some of the findings from a working group that was conducted to “strongly shape the CNO strategy”.

He said one of the key issues that was raised was around developing a specialist public health workforce for the future.

He added: “I'm hoping that there will be a strong commitment in [the strategy] saying that we need to ensure that we’ve got the specialist public health workforce to meet the population need and to start to respond to some of the challenges that we've seen.

“And with that, I certainly would like to see an establishment of a clear workforce plan for the specialist public health workforce.”

This call follows commitments outlined in the NHS workforce plan around increasing health visitor and school nursing numbers.

The plan pledged to expand health visiting training places by 74%, and almost double the number of school nurse training places, by 2031-32.

While Professor Waterall welcomed these announcements, he said they needed to “go much further”.

He said: “We need to make sure that there's adequate funding within the system to ensure that we can recruit and retain and develop the specialist public health workforce.

“And I hope this new strategy will enable us to very clearly set out much-needed workforce plans and that we can then hold parts of the system accountable for delivering against that.”