Developing public health nursing: barriers perceived by community nurses

To understand the key issues for field nursing in developing their public health role within five primary care trusts (PCTs) in Merseyside, in the North West of England.

Qualitative study.

Fourteen school nurses and 30 health visitors participated in 11 focus groups consisting of others from their profession working within the same PCT, and 24 practitioners responded to a questionnaire.

The findings suggest that there are a number of shared obstacles that need to be overcome before the public health approach can be fully developed within community nursing. These include: the need for facilitation to deal with organisational change, lack of clarity around the public health role, inadequate administrative support, general practitioner attachment problems, poor interprofessional partnerships, competing priorities and resistance to change.

The development of public health nursing in England envisaged in current government policy will not occur in full unless the kind of issues identified in this study are adequately addressed. This will require participative, interprofessional approaches to redesigning services by all relevant public health practitioners.