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Preventive services not covered by NHS cash boost also need funding, warn nursing groups

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Nursing organisations have urged the government not to forget about key health and care services, such as health visiting and sexual health, that will not benefit from the recent announcement of a funding boost for the NHS.

While extra funding for the health service has been welcomed, organisations like the Institute of Health Visiting (IHV) said it was “totally illogical” not to also invest in services that can prevent ill health in the first place.

“It’s totally illogical not to invest more into prevention”

Cheryll Adams

IHV executive director Cheryll Adams said: “All the evidence suggests that the government needs to invest in the whole patient pathway to drive real efficiencies in healthcare.

“This includes investment in upfront prevention, especially in the very early years,” she told Nursing Times.

Health visiting, schools nursing and other public health services, now commissioned by local authorities, have been subject to swingeing cuts as the result of reductions in public health allocations to councils.

Ms Adams said health visitors had been forced to move away from helping all children to supporting those in most need.

“Recent disinvestment in health visiting in many areas of the country means that health visitors are being driven from their traditional preventive role to a safeguarding one,” she said.

“They may catch children before they fall ‘over the cliff edge’, but they won’t be able to stop them from needing to be rescued by the NHS or social care with all the attendant costs. It’s totally illogical not to invest more into prevention,” she warned.

“This lack of vision is nonsensical, conflicting and very poorly thought out policy”

Sharon White

Sharon White, chief executive of the School and Public Health Nurses Association (SAPHNA), said there was clear evidence that money spent on public health paid dividends. One recent research review suggested that every £1 spent on public health in the UK could save an average of £14.

“SAPHNA welcome the recently announced investment into NHS services. However, we are concerned that this will not apply to many health visiting, school nursing and other public and community health services, now outside the NHS,” said Ms White.

“This lack of vision is nonsensical, conflicting and very poorly thought out policy which, once again, ignores opportunities to reduce the demand on NHS services through early help and intervention,” she said.

Concern over the balance of funding comes as the influential think-tank the King’s Fund has published a report showing NHS finance chiefs want to see new money going to services outside hospitals, including social care and community health.

Dr Crystal Oldman, chief executive of the Queen’s Nursing Institute, said it was important to realise that lack of funding in areas like public health services had a knock-on effect on the NHS.

“It is important to recognise that health and social care work together as an ‘ecosystem’”

Crystal Oldman

There were were already concerns that recently announced NHS pay rises would hit nursing services that no longer fell under the health service umbrella, she noted.

“Nurses working in services that are outside of commissioned NHS services, such as general practice nursing, health visiting, school nursing, and in care home nursing are concerned that the rise in NHS salaries over the next three years will deplete workforce numbers even further in these nurse-led community service areas,” she said.

“It is important to recognise that health and social care work together as an ‘ecosystem’ and a lack of funding in one area will have an impact on services in another,” said Dr Oldman. “Nurses and other professionals need to feel equally valued, regardless of the way their service is commissioned.”

Capital funding and workforce training also fall outside the NHS funding announcement outlined in a flagship speech by Theresa May last Monday.

As part of the speech, she said more detail on social care and public health spending would be included in the next government spending review.

“We also know we need to improve social care and continue to support prevention and public health, both for the benefits they bring in themselves and to relieve pressure on NHS care,” Ms May said.

“So we will come forward with proposals to put social care on a more sustainable footing. And we will set out budgets for both social care and public health as part of the forthcoming spending review,” she said.

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