I had an interview recently and I had a really difficult question posed to me ‘significant health inequalities exist in this area, what will you do to address this?’ As is often the way I’m still reflecting on the question and wondering what my role as a Children’s Nurse is in tackling the challenge of health inequalities?
The Royal College of Paediatrics and Child Health state ‘Nearly one in five children in the UK is living in poverty and inequality is blighting their lives, with those from the most deprived backgrounds experiencing much worse health compared with the most affluent.’ The State of child health reports and annual updates are worth dipping into https://www.rcpch.ac.uk/resources/state-child-health-2017-full-report The academic giants such as Sir Michael Marmot @MichaelMarmot have written extensively and authoritatively on this and I’d recommend this chapter for a helpful overview on child health and inequalities https://www.bma.org.uk/-/media/files/pdfs/working%20for%20change/improving%20health/child%20health/growingupinuk_may2013_chp3.pdf
At the @TheKingsFund this week Neil Churchill @neilgchurchill of NHS England @NHSEngland took us through the NHS long term plan (LTP) https://www.england.nhs.uk/long-term-plan/ and reinforced the commitment to spread best practice that’s happening to reduce health inequalities across the NHS, working collaboratively with the voluntary sector and other system partners importantly focusing on the unique needs of the person in front of us is a golden thread that runs throughout the LTP. Kevin Fenton @ProfKevinFenton provided the local authority perspective, reinforcing that deprivation drives inequalities and encouraged us all to collaborate on tackling these big challenges.
Which brings me back to my personal challenge so what I can do?
Can I help create more volunteering opportunities for local communities to engage actively with the NHS? We know the NHS is a big if not the biggest employer in local areas and we know that taking people out of poverty with a regular income transforms lives. Volunteering opens doors and increases aspirations. Having recently read Michelle Obama’s autobiography ‘Becoming’ (highly recommended) she talks about the impact of connecting with young people in schools and how it raises aspirations. Do follow @iwill_campaign for inspiration.
I can also engage with schools to promote careers in healthcare, Bev Matthews @bevMatthews_ and Ruth May @RMayNurseDir are doing a great job progressing this agenda. I can work with university colleagues, this week I got out on the wards to meet new foundation degree nurses who are on placement and I’ve also been interviewing potential new students too, it was great to be reminded of this short film by the RCN ‘I am a children’s nurse’ https://www.youtube.com/watch?v=O81ZY9wHhHw We’re also currently exploring ways to increase placement opportunities for students too so that we increase the volume and diversity of placements.
I can promote breast feeding, signpost families to smoking cessation advice, share information on accident prevention schemes, make sure my safeguarding training is up to date….
In my leadership role I can be an advocate, I can share narratives at health and well-being board meetings… but the health service on its own can’t tackle health inequalities a minimum income standard is needed for good health and well-being of children and many families such as those with disabled children or those from BAME are particularly vulnerable …
How would you have answered this question? Thoughts valued!
worth a read too!
from Jessie McCulloch via Facebook
Definitely linking up with other services which helps to identify and respond effectively to health inequalities. PHE have some guidance here:
and particularly about inequalities relating to ethnicity: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/730917/local_action_on_health_inequalities.pdf.
I’m a HV too, so advocating / influencing about health inequalities is definitely part of our role. The Institute of Health Visitors can be joined by non-HVs from other roles involving public health & they have a range of resources and evidence summaries, particularly about supporting families with particular needs (e.g travelling families, homelessness) – https://ihv.org.uk/for-health-visitors/resources/minority-groups/
20/2 Children & Poverty Article in Guardian