Opinion

Changing direction

Viv Bennett CBE explains why Public Health England is adopting a healthy living approach, and how you can play a key role in spreading the word.

When Community Practitioner caught up with Public Health England’s (PHE) chief nurse Viv Bennett, it was the final day of the month-long #WeActiveChallenge – an interactive social media campaign that saw healthcare professionals competing with each other to be more active.

Viv has been working out in the gym, jogging and walking miles, and completing the 747 Fitbit challenge – climbing the equivalent of the height of a 747 jet in flight, or 4000 floors. Now, she jokes, she ‘needs a good rest’.

While it’s all about fun and friendly rivalry, the activity challenge addressed a serious issue – and a key priority for PHE to tackle over the next five to 10 years.

Physical inactivity is responsible for one in six UK deaths – the same as smoking – and up to 40% of many long-term conditions, ranging from type 2 diabetes to coronary heart disease and cancer (PHE, 2017).

Yet we are facing an inactivity epidemic – with the UK population around 20% less active than in 1961  and forecast to be 35% less active by 2030 if the trend continues (Ng and Popkin, 2012).

 

A new focus

‘We’ve always known how important [physical activity] was, but now we are articulating it far more,’ Viv says.

This new emphasis is part of an ongoing journey that has seen the focus of public health extend from ‘communicable disease to include lifestyle-related non-communicable disease’, explains Viv.

It is also about understanding the ‘wider determinants of health and health inequalities. Rather than thinking about care just as risk to the individual person, we work more with people and communities to help them get the best health.’

‘We are trying to look at the world in a different way – much more of a healthy living approach.’ This approach is now setting the agenda for PHE.

‘There are ever more problems with diet and physical activity fuelling the obesity epidemic,’ says Viv. ’We still have big problems with alcohol and other substance abuse, and we are much more aware of mental health and wellbeing.’

 

Let’s get physical 

PHE’s latest tool to tackle physical inactivity is an app called Active 10, designed to encourage at least 10 minutes’ brisk walking a day, as part of the ongoing One You campaign.

‘Evidence shows that the pace of walking matters,’ says Viv. ‘The message is that a brisk walk once a day, or even better three times a day, can really help you improve your health.

Viv suggests that health visitors can use the Active 10 app to help new mums with their physical and mental health. ‘While school nurses can link it to the mile-a-day school programme (thedailymile.co.uk),’ she says.

Community practitioners, says Viv, have a ‘huge role to play’ in the new healthy living approach. ‘We really value the role of frontline professionals in working with us to support these big campaigns.

‘Health visitors and school nurses are really familiar with the family and child health agenda – but might not be so familiar with the latest physical activity evidence as mentioned, and the new Tobacco Control Plan.

‘A particular focus of the latter is reducing smoking rates during pregnancy. Some women give up but start again with the pressures of the transition to motherhood. Health visitors can really engage with people and help keep them smoke free.’

But, with the transfer of public health budgets to local authorities reshaping services across the country, will the role of frontline professionals continue to be so important? 

‘PHE has been very clear that we absolutely value health visitors and school nurses as leaders in the field force in children’s public health,’ says Viv.

‘What is changing is the increase in focus on outcomes. I think, alongside that, there is a lot of interest in health economics. That’s somewhere public health is really seeking to up its game. We know some of the answers, but we have less evidence about whether who does what makes
a difference to the outcomes.

‘We are also trying to develop really robust case studies describing the transformed approach to care and demonstrating the impact that it has had. Health visitors and school nurses are trained in public health and individual health so are a very strong bridge between public health and primary care, and between children’s services and health services.’

She urges practitioners to ‘continue, as they have done, to embrace the changes’, and adds: ‘We are seeing some great examples of commissioners working with providers and professionals to think about how we transform services locally, to get the best integration and the best transition.

‘We live in a time of devolution to local authority areas – this is the political context within which we work. Those decisions have to be local.

‘At PHE we can continue to provide the evidence, the robust case studies, and keep the profile of the frontline public health field force high.

‘They themselves and their leaders can continue to showcase what they do so well.’


10.8%

The proportion of women in England that smoke during pregnancy. Health visitors can engage with people and help keep them smoke free

(Source: NHS Digital, 2017)


All about Viv

  • Qualified in 1979 and began her career as a nurse on a children’s ward in Oxford. 
  • Trained and worked as a health visitor while studying for a BA, then a master’s degree in health and social policy. 
  • Joined the Department of Health as deputy chief nursing officer in 2007, and was appointed director of nursing and the government’s principal adviser on public health nursing in 2012.
  • Is a visiting professor at King’s College London, and was honoured with a CBE for services to nursing in January 2016.
  • Her grandson turned one last month, when Viv also celebrated her 60th birthday.
  • She upped her step count during her month-long #WeActiveChallenge by being ‘really inefficient’ with the laundry – taking one item to the line at a time.

References

Ng SW, Popkin B. (2012) Time use and physical activity: a shift away from movement across the globe. Obesity Reviews 13(8): 659-80.

NHS Digital. (2017) Statistics on women’s smoking status at time of delivery, England: quarter 1, 2017-18. See: http://digital.nhs.uk/catalogue/PUB30070 (accessed 19 September 2017).

Public Health England. (2017) Physical activity: applying All Our Health. See: bit.ly/physical_ex (accessed 19 September 2017).

Picture credit | Shutterstock/iStock

 

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