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Finance Committee 09 March 2016

09 Mar 2016 · S4 · Finance Committee

Item of business

Prevention

Rachel Cackett (Royal College of Nursing Scotland) Watch on SPTV

Thank you for the opportunity to open the discussion. I emphasise that it is our opinion that there is an awful lot of good practice around prevention. That was clear from the submissions from the other partners around the table, who gave their own examples. In terms of nursing and the nursing workforce, we have been doing some work over the past couple of years to highlight where nurses are starting to make significant inroads in the reduction of health inequalities in particular, and in dealing with prevention. We published a report just over a year ago that profiled a number of nurses across Scotland who were working in areas such as criminal justice, blood-borne viruses, mental ill health and homelessness. We looked at the impact that those nurses were having in preventing further ill health or negative outcomes for people in those areas. We came to a number of conclusions. One is that, quite often, those nurses were managing to do what they were doing because they were working slightly outside the system. They were willing to take risks. Dare I say, many of them were approaching retirement and, for that reason, perhaps felt more able to take risks than their younger colleagues did. They were doing fantastic work and we, as the Royal College of Nursing, were proud to showcase that. We have also done some work recently to look at prevention in remote and rural areas, for example at the ways in which nursing staff are working with older people who may find themselves particularly isolated because of where they live. Again, there are examples in our remote and rural health boards of nurses doing fantastic work with colleagues across health and social care, and often with agencies beyond health and social care, and using what they have available to them to make a step-change difference. We have been successful in securing 500 new health visitors, who are going through training. Reports, including the report to the committee from its adviser, have shown the need for that. There has been work, through the chief nursing officer’s review of health visiting, to extend the work that health visitors do, and there are now additional visits within the pathway. That early intervention is key in the universal package that is available to every family in Scotland as a core, embedded approach to how we stop long-term health conditions and inequalities arising from the very beginning. Those are just some examples. I think that our difficulty in Scotland is often how to scale those examples and to take the learning from particular projects and programmes and turn it into a far more sustained way of working. That is sometimes because, to briefly touch on your second question, how we define success in the public sector does not always work to our favour.

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Finance Committee 09 March 2016

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