Public health nurses face shift to councils

20 July 2010 | By Amy Taylor

The majority of public health nurses and some health visitors could be transferred to local authority control under the white paper’s proposals.

The government said it would transfer the existing health improvement functions of primary care trusts to local authorities when PCTs are abolished in 2013. As a result, the majority of public health nurses may be transferred to local authority employment.

Nursing Times has learnt that care services minister Paul Burstow met last week with a group of PCT chief executives who hold dual roles on their local councils to discuss the plans.

Tony Hunter, chief executive of North East Lincolnshire Council, which took on 60 public health staff and 130 children’s health employees from the NHS in April as part of local integration plans, said the council had ensured public health staff were able to maintain their specialist knowledge when they transferred.

“Our public health staff were naturally very concerned that their professional specialisms would not be dissipated by going into large council teams.”

He had also reassured nurses that the transfer would not have any negative effect on their careers if they wanted to move back into the NHS.

The local authority had been careful not to destroy public health staff’s internal networks with other professionals and that successful management arrangements were retained, he added.

Health visitors working in Sure Start children’s centres, who are currently employed by PCTs and seconded out to the service, could also become council employees as a result of the proposed changes

Anne Longfield, chief executive of the charity 4Children, which runs a number of children’s centres, said bringing health visitors into local authorities could present cultural difficulties.

She said: “It would be very challenging for the local authority. The health service has its own particular culture, such as its own way of measuring things and its own language, and I don’t think it [making health visitors council employees] would instantly deliver better joint working.”

Lead professional officer for the health sector at the union Unite, Obi Amadi, warned that such transfers could be a “culture shock” to staff transferring to new management but it had already worked well in some places.

She added: “Staff terms and conditions will need to stay the same and their training and development can’t be ignored.”

Who is affected?

The parts of the nursing workforce most affected by government plans to abolish primary care trusts and strategic health authorities:

PCTs employ 82,310 registered nurses and midwives, of whom 314 are nurse consultants, 763 are modern matrons, 1,643 are community matrons, 2,523 are managers, 521 are midwives, 10,538 are health visitors, 9,742 are district nurses and 1,560 are school nurses.
SHAs also employ 22 nurses in management posts

Source: NHS Information Centre (September 2009)

Readers' comments (3)

Natalie Jewell | 20-Jul-2010 1:23 am
I think this could work very well as long as nurses don't find themselves isolated. Nurses are professionals in their own right and their Code of Conduct is very different from anything councils and education have. They will need support and nurses will need to be employed at all levels, not just on the coal face, in order that nurses have somewhere to turn for clinical expertise and support.

I work in schools and with social workers, it's not so bad because I have the support of nursing colleagues back at my office but one of the major problems I have is other disciplines' lack of understanding of my role. My concern is the support would disappear.
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Anonymous | 21-Jul-2010 10:19 am
Starts off well but as someone who is emoloyed by the NHS working in a social services team I already know how isolating it is, We have very little contact with the trust, in fact most of the trust are unaware that we even exist. computer systems are different so we do not receive any info via the intranet, this has been an issue for many years and when questioned is being looked at, training non exhistant, we are supposedly managed by social services who have no understanding of our roles and have there own agenda. all in all a rubbishy deal for nurses and clients
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Deirdre Budd | 22-Jul-2010 9:05 am
When I started my Health Visiting career we were employed by local councils. Then we were moved to become part of the Local Health Authority. Our conditions of service were poorer under the local health authority, but our links with other health professionals improved. In view of the current financial problems, local councils are cutting back, I doubt that we would benefit from this. How many local councils could afford a Public Health nursing service.
There is little new under the sun. I have real concerns that the NHS is being dismantled by the back door. Successive governments have tinkered with service provision. Within the NHS some seem to think that the roles of Health Visitors and Social Workers are interchangable. They are not now, they never were.

Moving Public Health Nursing and Health Visiting services back to Council care may well result in swapping roles to cut costs.

In too many areas of health, people who have good intentions and appropriate training for their chosen specialisation, are being expected to "act into" areas in which they lack both training and experience. This does not bode well for anyone, it appears to be an attempt to reduce service costs but takes no account of cost to the patient, or the cost in stress levels, for staff who do their best to comply with new directives.
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