The contribution of nurse consultants in England to the public health leadership agenda.

Abstract

To examine the contribution of nurse consultants in relation to UK public health outcomes by contrasting the health and public health skills frameworks with a study of the role of nurse consultants. Nurse consultants are the most senior advanced nurse practitioners in the UK. They work clinically, lead, research, develop policy and disseminate knowledge. A synthesis of research and data from the UK professional skills frameworks with data from a mixed-methods study of the role of nurse consultants. Data collected from nurse consultants and stakeholders in England (n = 10) were analysed to identify issues impacting on the skills, competencies and effectiveness of advanced nurses. This was contrasted with the skills and career frameworks for public health and advanced healthcare practice. Nurse consultants use their clinical expertise to lead practice, facilitate change and monitor effectiveness. Within healthcare organisations, they contribute servicewide to the implementation of public health policy, service delivery and policy development, mirroring expected competencies and improved health outcomes. Two barriers were identified. First, that there was little time or will for nurse consultants to undertake research, precluding them from demonstrating their value. Second, that a lack of interprofessional understanding and support of their roles meant that their worth was often not appreciated by decision-makers. Nurse consultants lead and influence public health on many levels and need support to develop needs-led and evidence-based local, national and international public health practice and policy development. This research contributes to the global discussion currently being held about the nomenclature of advanced nurse practitioner roles, their scope and influence. The challenge for nurses to contribute meaningfully to public health structures at an advanced level is a concern for all nations seeking the common goal of addressing public health needs within their populations and suggests that further development of our understanding of the potential contribution of advanced nurses is needed.