The Information Needs of the Frontline Public Health Workforce

1. The Information Needs of the Frontline Public Health Workforce Jill Rutland 2010

2. My Background • Public Health Library • Service to Public Health Professionals • Need to reach out to ‘frontline’ staff • Interested to know more • Use results to inform library and knowledge service

3. Policy Background • Choosing Health (2004) • Wanless Report (2004) Securing health for the whole population • Our health, our care, our say: a new direction for community services (2006); Darzi 2008 • PHRU (2008) Public Health Skills and Career Framework (for Practitioners) • Individual professional areas – have own guidance with regard to promoting public health

4. Research • Literature search • Qualitative – explorative • Phenomenological approach – describe everyday experience to achieve understanding • In-depth semi-structured interviews • Representatives of 8 professional groups • Ethical review • Taped, transcribed interviews • Analysis of data – categories – themes – tables – colours • Needs, barriers, where needs met

5. Results • Children’s Centre Manager • Lack of time, lack of knowledge about access to health libraries, need for local resources, named contact, current awareness, course support • “if we are informed, we can try to do something about them. By encouraging parents to undertake some exercises or pram pushing, or working with children regarding obesity, we are contributing to the much wider public health agenda”

6. Community development worker • Lack of support from employers, lack of information from above, need for training in finding info. Lack of time, lack of awareness if what is available. • “it is quite difficult for me to identify what I’m missing and for my line managers because their background isn’t community development either”

7. Community Midwife • Lack of IT. Need training in literature searching, named contact, current awareness, local website • “something like that would be really good because it’s difficult for me to get hold of figures like that when I go to meetings”

8. District Nurse • Local information, national targets and policies, access to relevant library, training, targeted current awareness, lack of managerial support and communication of information • “the targets that the government set, how they impact on what we are doing, they are all of interest...we would hope that our managers would be cascading it down to us, but it doesn’t happen”

9. Health Visitor • Lack of IT, lack of management support, lack of cascading information, lack of time, lack of training • “I feel I have to put on GMTV or pick up the Daily Mail to find out what I need to know today” • “they are missing an absolute treat because health visitors are very well placed...we are actually there, with the community, people are letting us into their house when they don’t have to...we could deliver so much of the public health agenda, but there is no regard for us. I feel we are bottom of the pile”

10. Pharmacist • Need training in effective use of internet, knowledge of what is available, targeted current awareness, “too much information” • “a lot of pharmacists don’t even have an email address. One of our issues is that we can’t email them information, for example, when we do projects or there are things we are trying to promote”

11. Practice Nurse • Lack of time, lack of IT, lack of email – difficult to contact. Need training, current awareness, local information, named library contact, literature search service. • Since primary care more target driven, decline in opportunity to practice primary prevention • “I don’t have time to delve into anything which doesn’t have implications for my work, but anything that does would be helpful”

12. School nurse • Lack of time, very broad role, lack of awareness of what is available, lack of training (P/T 25 hrs pw- 7 primary, 2 senior, 2 special, 1 private) • “there’s just not the time. You’d love to take a subject on board and really go into it because if you can back it up with research it holds more weight...you carry on doing the same thing, and I know we shouldn’t do that, we should look at new ways, but a lot of it is the time and the funding”

13. Conclusion: Main Information Needs • To be met by the library service: current awareness (targeted), local website, training, literature searching service, more promotion and outreach to aid awareness of what is available, named contact, outreach librarian, patient information • To be met by management: IT provision, CPD, more time, more communication, more funding

14. Implications • Further research needed: • Interview more representatives • Questionnaire based on themes discovered by qualitative approach – lead to quantitative research • Aim to meet information needs through library and knowledge service developments – broaden mailing lists, offer training more widely, promote service more widely, develop Observatory website to reach these groups

15. And finally.... • Common theme emerged – frontline staff doing less public health work than previously – crowded out by other demands. • Children and adults receiving far less screening and fewer health checks – lack of primary prevention • E.g school nurse no longer give medicals to children starting school • HVs concentrate on disadvantaged families • Practice Nurse – no time to carry out well-man and well-woman clinics and pick up early signs of diseases • Most interviewees felt overworked, fire-fighting, rather than engaging in preventative work – a worrying trend

16. Post script • Now we have ‘Equity and excellence: liberating the NHS’ (July 2010) • How will this affect • Public health organisation? • Frontline staff? • Libraries? • ??????