Public health nurses have welcomed the government’s prevention agenda, including “bold action” on obesity, tobacco, vaccines and children’s mental health, but have warned a clear delivery plan is needed to make the ambitions a reality.
The 10 Year Health Plan was published this week by the Department of Health and Social Care (DHSC), setting out a wide range of measures to reform the NHS.
“Prevention cannot happen without investment in school and public health nursing, rebuilding and strengthening the workforce”
Susie Scales
The document focused on achieving the government’s three planned shifts for the health service, including moving the approach to care from sickness to prevention.
Nursing Times has broken down some of the key commitments and how public health nurses have responded.
Obesity and nutrition
One of the major pledges to feature in the prevention chapter of the health plan is to end the obesity in England.
It comes as around one in five children leave primary school with obesity – rising to 30% among those living in the most deprived parts of the country.
The government, therefore, promised to fulfill its manifesto commitments by restricting junk food advertising targeted at children, banning the sale of high high-caffeine energy drinks to under-16-year-olds and giving council powers to block new fast-food outlets near schools.
To support some of the poorest families, the plan pledged to restore the value of the Healthy Start scheme, which provides a nutritional safety net for pregnant people and families with children under four who are living in poverty.
It follows calls earlier this year by nurses to expand the eligibility criteria for the Healthy Start scheme, branding the current threshold “restrictive” and warning that children are going without the nutrition they need.
Similarly, the plan reiterated the government’s intention to expand free school meals, so that all children with a parent in receipt of Universal Credit will be eligible for free school meals from September 2026.
Child mental health
Meanwhile, the document set out targeted prevention measures for children and young people’s mental health.
It noted that around half of mental health conditions develop before the age of 18 and that fast access to mental health support was “critical”.
The government said it would work with education providers to better identify and meet children’s mental health needs.
As part of this, it will continue to roll out mental health support teams in schools and colleagues, to reach full national coverage by 2029-30.
Health practitioners, including some school nurses, will be included in the child protection teams to be legislated through the Children’s Wellbeing and Schools Bill.
The plan has also committed to tackling long waits for children and young people’s mental health services.
It said it would recruit 8,500 mental health staff focused on reducing these long waits, but did not specify if nurses would be included.
Vaccination and immunisation
Also set out in the 10 Year Health Plan were commitments around vaccinations.
It said it would increase uptake of human papillomavirus (HPV) vaccinations among young people who have left school, to support its aim to eliminate cervical cancer by 2040.
Similarly, it said it would harness progress being made in developing cancer vaccinations.
The government has committed to delivering 10,000 cancer vaccines to patients in clinical trials in the next five years – to be scaled up when new vaccines are shown to be effective.
Tobacco and alcohol
The drive by ministers to create a smoke-free country for the next generation was illustrated in the prevention agenda in the plan.
It follows ambitious legislative proposals last year, set out in the Tobacco and Vapes Bill, which aim to clampdown on smoking and vaping and eventually phase them out.
The 10-year plan promised to deliver on the legislation – currently at the reporting stage in the House of Commons – which would mean that children turning 16 this year (or younger) can never legally be sold tobacco.
Similarly, the document said it will tackle harmful alcohol consumption by introducing new standards for alcohol labelling, including a mandatory requirement for drinks to display consistent nutritional information and health warning messages.
More on smoking and vaping cessation
Reactions to public health ambitions
Public health nurses have responded positively to the proposals, but said workforce will be key to delivery.
Alison Morton, chief executive of the Institute of Health Visiting (iHV), told Nursing Times she welcomed the government’s plans and that they included “bold ambitions and a renewed commitment to give every child the best start in life”.
She said: “It is hard to disagree with many of the headline messages contained in today’s plan which are aspirational, promising better health care for patients and better working conditions for staff.
“Health visitors are ready and willing to support the government to deliver this plan,” she said.
“We want it to be a success, as we have long called for an end to the ‘tick box’ culture in healthcare and a greater focus on personalised care, professional autonomy and integrated working across healthcare to improve support for families.”
Ms Morton said it was clear that delivering the ambitious plan would require “sustained investment over the next 10 years”.
She added: “We now need the government to set out its plan for delivery, the workforce needed to turn it into reality, and to end the years of uncertainty that has undermined the confidence of so many brilliant people who work in the NHS.”
Meanwhile, Susie Scales, professional officer at the School and Public Health Nurses Association, told Nursing Times that the organisation would take some time to review the plan and understand what it means for the workforce.
She said: “It is positive to read the government’s commitment to raise the healthiest generation of children ever, recognising the need to reduce health inequalities and improve health outcomes.
“The focus on prevention is reassuring, with plans to reduce obesity, smoking and vaping and alcohol consumption and improve mental health and dental health and increase the uptake of vaccinations.”
Importantly, Ms Scales noted that the plan made reference to this year’s boost to the public health grant, which the government said could be used to fund essential public health nursing services, including family nurses, health visitors and school nurses.
She added: “Prevention cannot happen without investment in school and public health nursing, rebuilding and strengthening the workforce.
“We will eagerly await the publication of the revised workforce plan and the detail of the delivery plan and will be ready to work with the DHSC and NHS England to move from treatment to prevention, supporting children and young people in the communities that they live.”
Also responding, chief executive of the Queen’s Institute of Community Nursing, Steph Lawrence, said: “To ensure we can truly focus on prevention, we have to invest in services to ensure this happens.
“Instead, we have seen year on year budget cuts for public health services such as health visiting, school nursing and sexual health services. Prevention cannot happen without strong, robust public health nursing services.
“The QICN is ready and willing to work with the DHSC and NHS England to provide a strong community nursing voice and help find the solutions, to ensure we can truly deliver more care closer to home.”
