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Community Nursing 
Research 
Professor Jean White 
Chief Nursing Officer/ 
Nurse Director NHS Wales
This 
presenta,on 
1. Core 
challenges 
for 
health 
services 
2. Core 
priori,es 
for 
services/government 
3. Relevant 
...
Popula,on 
challenges
Inequity
….. 
Social 
gradient 
persists 
rate per 100,000 population 
Avoidable, amenable & preventable mortality in Wales, 2001-2...
Shared 
Priori,es 
• Tackle 
popula,on 
demand; 
inequality; 
effects 
of 
poverty 
especially 
on 
early 
years 
• Preven...
Primary 
and 
Community 
Policy 
ac,vity 
• Se[ng 
the 
Direc,on 
– 
development 
of 
clusters 
• Addi,onal 
funding 
£3.5...
Professional 
ac,vity 
• Advanced 
prac,ce 
development; 
extended 
roles/skills 
• Acuity 
and 
dependency 
workforce 
to...
Prudent 
Healthcare 
Principles 
9 
Do no harm 
Minimum appropriate interven1on 
Only do what only you can do 
Promote equ...
Applying the principles 
Citizen 
o Recalibrating the relationship between the citizen and the state/the patient 
and the ...
Applying the principles 
Population Health 
o Public health education has succeeded in changing people’s attitudes and 
in...
The 
Caerphilly 
Study 
Substan,al 
reduc,ons 
in 
serious 
health 
condi,ons 
linked 
to 
healthy 
lifestyle 
behaviours:...
The 
role 
of 
legislaDon 
• Ac,ve 
Travel 
Act 
• Social 
Services 
and 
Wellbeing 
Act 
• Wellbeing 
and 
Future 
Genera...
Why 
Innova,on? 
We cannot solve our problems using the 
same thinking we used when we created 
them
R & D 
• Essential we create an 
evidence base for practice 
• Need to innovate to meet new 
demands 
• Economic benefits ...
Jean White - Community Nursing Research
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Jean White - Community Nursing Research

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A Showcase Conference for Community Nursing Research in Wales
“Small Improvements Make the Biggest Difference”
Wednesday 5th November 2014, Swalec, Cardiff

http://www.wspcr.ac.uk/cnrs-conference-2014.php

Publié dans : Santé & Médecine
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Jean White - Community Nursing Research

  1. 1. Community Nursing Research Professor Jean White Chief Nursing Officer/ Nurse Director NHS Wales
  2. 2. This presenta,on 1. Core challenges for health services 2. Core priori,es for services/government 3. Relevant Welsh Government policy ac,vity 4. Prudent healthcare 5. Innova,on
  3. 3. Popula,on challenges
  4. 4. Inequity
  5. 5. ….. Social gradient persists rate per 100,000 population Avoidable, amenable & preventable mortality in Wales, 2001-2012 (note: some avoidable deaths are classed as both preventable and amenable) 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 300 250 200 all avoidable 150 preventable 100 50 amenable 0 Source: Office for National Statistics They are s,ll too frequent ….. Es,mated that quarter of all deaths are avoidable. CMO 2012 report – equated to 7486 deaths in Wales. …and unfair
  6. 6. Shared Priori,es • Tackle popula,on demand; inequality; effects of poverty especially on early years • Preven,on; engagement with ci,zens; keeping people healthy and at home • Delivery of services; reputa,on • Listening and engaging with service users • Service configura,on; innova,on; new approaches to make a difference • Working across the NHS and across public services 6
  7. 7. Primary and Community Policy ac,vity • Se[ng the Direc,on – development of clusters • Addi,onal funding £3.5 million 2014/15 includes developing roles, targe,ng deprived areas; eye care; cardiovascular care • New Primary Care Delivery Plan – engagement exercise begins 6 Nov • Work on unscheduled care delivery – na,onal clinical lead 7
  8. 8. Professional ac,vity • Advanced prac,ce development; extended roles/skills • Acuity and dependency workforce tools • Early years work – Flying Start; healthy child programme implemented from April; smoking in pregnancy • Public health role for all nurses and midwives – being led by PHW & linked to WHO Health 2020 8
  9. 9. Prudent Healthcare Principles 9 Do no harm Minimum appropriate interven1on Only do what only you can do Promote equity Co-­‐produc1on
  10. 10. Applying the principles Citizen o Recalibrating the relationship between the citizen and the state/the patient and the service. o Using co-productive methods to help individuals take responsibility for creating the conditions for good health in their own lives. o Tackling health inequalities. “The NHS cannot afford to pay for life saving treatments in the future if giant swathes of us continue to make destructive lifestyle choices.” Western Mail editorial
  11. 11. Applying the principles Population Health o Public health education has succeeded in changing people’s attitudes and intentions, but not necessarily their actions. o A focus shift is required away from education to motivation. o Moving attention to changing the environments in which people live to enable them to turn good intentions into behaviour change. “And then let the doctors quit the centre stage To usher in the prophylactic age.” From ‘Superfluous Doctors’ – Prof. Archie Leman Cochrane
  12. 12. The Caerphilly Study Substan,al reduc,ons in serious health condi,ons linked to healthy lifestyle behaviours: – non smoking; – a low BMI; – regular exercise; – a plant based diet; and – alcohol consump,on within guidelines. By adhering to 4 or 5 of these healthy behaviours, there was a 73% reducDon in type 2 diabetes, 67% reducDon in vascular disease, 18% reducDon in cancer, and 64% reducDon in demenDa.
  13. 13. The role of legislaDon • Ac,ve Travel Act • Social Services and Wellbeing Act • Wellbeing and Future Genera,ons Bill • Public Health White Paper
  14. 14. Why Innova,on? We cannot solve our problems using the same thinking we used when we created them
  15. 15. R & D • Essential we create an evidence base for practice • Need to innovate to meet new demands • Economic benefits to Wales • Embed R&D in clinical roles • Need hubs of activity not individual projects • Over to you!

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