Charlotte McArdleThe chief nursing officers of England, Northern Ireland, Scotland and Wales said they were all facing the same problems of budget cuts and health inequalities in their address to the CPHVA conference [22 Oct].

Opening the address by each of the lead nurses, Ros Moore, chief nursing officer for Scotland said that the message from Scotland was one of progress and continuity, and that Scotland remains committed to the values of the NHS.

The biggest challenge facing Scotland was health and social care integration, although she was optimistic that this would be completed by 2015. However, she stressed that the “elephant in the room” was 2014’s referendum on independence, meaning Scotland was having to plan for both a ‘yes’ and a ‘no’ vote.

Charlotte McArdle (pictured), the chief nurse for Northern Ireland said, in her first address to the CPHVA, that the Northern Ireland public health strategy was nearly complete. Yet she warned that there was much that could be improved in the region relating to early intervention and prevention.

She said that as well as facing the challenges if budget cuts, Northern Ireland had its own particular challenges, including its largely rural population, high unemployment in young people (estimated at 23%) and high incidence of children living below the poverty line (20 per cent).

Professor Jean White, chief nurse for Wales also said geography and the rural nature of the principality posed challenges, yet they faced a much difficult challenge with their ageing population. Wales has the largest proportion of over 85s in the UK, she said. Other challenges included huge differences in life expectancy, and the ‘inverse care law’ – whereby those who need care most, such as Welsh miners, often have poorest access to support.

However, in terms of success, the Flying Start initiative was being doubled to ensure 36,000 children receive support by a health visitor and 165 new health visitors were in post.

The final presentation was made by Jane Cummings, the chief nursing officer for England. She too reiterated the challenges presented by austerity measures, yet said a further challenge faced in the country was the hugely complex NHS reforms taking place. “We are now working in a new world,” she said.