The October 2024 Budget will raise concerns among health visitors and school nurses about the effect on their services and the communities they serve. The King's Fund (2024) has provided a helpful summary of the potential impact on health and social care services.
The concern from all public health services has arisen because there was no reference to increasing the public health grant or the wider public health budgets. Given that ‘prevention’ is one of the three areas that the Darzi report highlighted for investment in the NHS, this could be viewed as an omission (Department of Health and Social Care [DHSC], 2024).
Lord Ara Darzi was tasked with undertaking a rapid review of the evidence to assist with diagnosing the major challenges for the NHS and identifying the priority areas for action. These are given in the report as: Community (from hospital care to community care), Digital (from analogue to digital) and Prevention (from sickness to prevention).
All three areas of priority will resonate with health visitors and school nurses. ‘Community’ because this is where people live their lives, where babies, children and young people experience health and illness, where health-related behaviours are learned and where there is the greatest potential for improving health and preventing illness.
As prevention was one of the three priorities, it does seem counter-intuitive that public health funding which supports preventive measures on a community-wide and an individual basis was not increased in the Budget. With more funding there would be the potential for direct investment into the workforce that focuses on the prevention of ill health from the antenatal period through to adulthood.
‘It seems counter-intuitive that public health funding which supports preventive measures on a community-wide and an individual basis was not increased in the Budget’
This includes, principally, health visitors, a profession whose four principles are the search for health needs, the stimulation of an awareness of health needs, the influence on policies affecting health and the facilitation of health-enhancing activities (Institute of Health Visiting, 2024).
The school nursing service would similarly be able to focus on prevention of ill health and promotion of good health in school-aged children, a potential that was clearly shown in the latest report by the School and Public Health Nurses Association (SAPHNA) (2024).
However, in terms of wider public health initiatives, some measures have been given additional funding, such as the renewal of increased taxes on tobacco and the introduction of a new tax on vaping products. In relation to the ‘sugar tax’, the Budget announcement included an increase to the soft drinks industry levy, as a continued incentive for manufacturers to reduce the sugar content of their drinks – an important policy to help reduce obesity and dental caries in young children.
The new Secretary of State for Health and Social Care, Wes Streeting, has launched a consultation on what is needed to ‘fix’ the NHS. Every citizen of the UK has an opportunity to complete the survey as an individual. There is also an opportunity to complete the survey as an organisation, which the QNI will be doing in the coming weeks.
Please do complete this and share with the families served, colleagues, friends and family: https://www.gov.uk/government/news/government-issues-rallying-cry-to-the-nation-to-help-fix-nhs.
Nurses and health visitors are excellent at knowing what needs to change in relation to public health measures to improve the health of the babies, children and young people they care for, and we must all be active in feeding this back to the government. We are almost 800 000 strong as a workforce and spending time with the communities we serve provides unique insight into the changes needed.
The QNI also strongly encourages nurses and health visitors to invite policy-makers to shadow them in practice. What is ordinary to the health professional is extraordinary to the lay person. Our shadowing experiences have seen directly related changes in policy, and we will continue to encourage this sharing and learning with politicians and their advisors.
Please do the same in your area – it could just be the shadowing visit that becomes the catalyst for the increased investment into public health funding that is so very much needed to enable the aspirations of the Darzi report on the NHS to become reality.