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Workforce in the New Public Health System
Leaders’ Networking Event9th May 2012
Yvonne DoyleDirector of Public Health, NHS South of England
Chair, Workforce Strategy Group Public Health England Transition Team
Challenges and Opportunities
• Unresolved health challenges from the good times
• New health challenges for the most vulnerable from the bad times
• Opportunities to act differently and to address neglected problems
An effective public health system
• Accounts for the changing nature, assets and strengths of the population – is vigilant for new health threats
• Ensures economic development creates health and well being
• Advocates wise use of environmental resources
• Promotes individual and community well being
• Helps people limit behaviours damaging to their health.
• Secures equitable access to good quality health and social care, with prevention incorporated into all contacts.
• Systematically works to reduce health inequalities and embeds health and well being in all policies.
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The new approach - what will be different?
Economic and social return on
investment
Holistic high quality prevention
services
Health in all policies
Health Protection/Resilience
Integrated service delivery
Public Health communicationsLocal people
Sustainable communities
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Features of contemporary public health practice
Population based
Emphasises personal and collective responsibility for health, its protection and disease prevention
Recognises the key role of the state, linked to a concern for the underlying socioeconomic and wider determinants of health,
as well as of disease
Works on an inter-disciplinary basis
Builds partnerships with all those who contribute to the health of the population.
Enables equality in access to public health as a career at all levels
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Levels of workforce intervention for public health‘Slice’ of the workforce for
the function
Community engagement and public action
Professional input, partial and episodic actions for public health, Remit usually not labelled as public health
Professional input, Identified as public healthpractitioner actions
Specialist leadership for the key areas ofpublic healthservice and academic practice
Note: Levels 2-4 can operate within one professional group.
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Levels of workforce and intervention in Public Health
Examples of roles in levels 3&4
LEVEL 4Consultant in PHDPHSpecialist RegistrarConsultants in health protectionProfessor of PHConsultant in dental PHConsultant PH microbiologistInfectious disease consultantCommunicable disease consultantMedical toxicologists
LEVEL 3Environmental specialistsHealth promotion practitionersHealth visitorsSchool nursesOccupational nursesDrugs and alcohol liaison nursesSexual health nursesHealth intelligence and information analystsRadiation protection specialists
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Specialist public health skills
Knowledge-*Population*Evidence
*Background professional
Able to take an overview
Advocacy
Social Entrepreneurship
Analytical
Adaptive Leadership
Transformation
Recruitment
Practice
Leadership
Outstanding leadershipApril 20, 202320 April 2023
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Levels of workforce intervention for public health‘Slice’ of the workforce for
the function
Community engagement and public action
Professional input, partial and episodic actions for public health, Remit usually not labelled as public health
Professional input, Identified as public healthpractitioner actions
Specialist leadership for the key areas ofpublic healthservice and academic practice
Note: Levels 2-4 can operate within one professional group.
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Levels of workforce and intervention in Public Health
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How different is the new public health system?
The public health workforce operating with new relationships from 2013
This diagram shows elements of the new commissioning and policy systems
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The NHS’s role in public health
• The provision of health services and ensuring fair access to those services will contribute to improving health and reducing inequalities.
• The NHS will also continue to commission specific public health services and will seek to maximise the impact of the NHS, making every clinical contact count.
• PHE will have a close working relationship with the NHS Commissioning Board.
National Institute for Health Research
NIHR School for Public Health ResearchAimTo increase the evidence base for effective public health practice by:•conducting research to increase the volume and quality of applied public health research and evidence, including evaluations; and•creating an environment where first class applied public health research, focused on the needs of the public, can thrive
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National Institute for Health Research
NIHR School for Public Health ResearchApproach•Comprises leading academic centres of applied public health research•Designed to build closer relations between researchers and practitioners across Public Health England and Local Authorities•Will place an emphasis on what works practically and can be applied across the while of England•Funding up to £5m per annum•Launched on 18th April 2012
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A Public Health Workforce Strategy
• White Paper Healthy Lives Healthy People gave commitment to develop a PH workforce strategy for consultation
• Working Group includes members from the FPH, BMA, LGA, DCLG, RCN, the Deaneries, HPA as well as officials from DH.
• A consultation document has been published. Seeks views towards a definitive strategy which will be prepared later in 2012.
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Purpose and vision
• Public health is everyone’s business – we need to make further step change in order to solve major health challenges
• How can the wide range of skills available – from specialist to community development enable this next phase of health improvement and protection?
• What roles could be played by workforces that can improve health – some of whom are not in NHS?
• How can people help their own communities and their own health?
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Chpt 1: Purpose of the consultation
– To set out proposals that will support and develop a highly qualified, motivated workforce that will be employed in a range of settings including LAs, the NHS, PHE;
– To identify opportunities to develop and embed public health into the wider workforce from healthcare practitioners, clinicians, housing officers – making every contact count.
– Not about HR issues, these are dealt with through HR Concordat, HR Frameworks and LA guidance
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Chpt 2: The current public health workforce
– Who are they and where are they located?
– What are they called and do we agree what the terms mean?
– Where will they be in future?
– How much do we need to know about the PH workforces in future ?
– How do we get that information?
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Chpt 3: Workforce challenges and opportunities
– Values of the public health workforces
– International literature
– Equity and equality
– Future public health challenges
– Achieving a good transition
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Chpt 4: Wider workforces and local communities
– How will we make every contact count?
– What contribution will the wider local government and key NHS workforces* make to public health in future?
*Such as health visitors and school nurses
– Where are there current and new opportunities for developing communities?
– What is the contribution of the PH practitioner workforces?
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Chpt 5: Getting it right for the public health specialist workforce
- Competencies for specialist public health
- Recruitment to specialist training
- Education and training, HEE, LETBs
- Health protection
- CPD
- Leadership
- Academic public health and PH information and intelligence
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What issues has the work to date identified
• The importance of a coherent approach to the public health workforce of the future – viewing public health as a whole system in which various components of the workforce contribute their ‘unique’ components
• The difficulty of knowing who is in the public health workforce and where they are operating
• The ambition of those who represent lay interests to be more involved in determining their ‘own’ public health – building on good work that is in hand
• The importance of planning the education and training components in future and working in national and local partnerships towards this
• The need of certain key workforces for career planning.
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Further work is needed
• Relationship between public health specialists, practitioners and the wider workforce;
• Development of our leaders in public health for new environments
• Can we support employers to plan workforces of central importance in the future public health system?
• PHE – how will it provide professional leadership to those working in LAs, NHS and elsewhere?
• Key relationships throughout the public health system
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Taking forward work on the consultant/practitioner interface. Policy messages.
• The practitioner workforce is important for building capacity in public health now and particularly in future
• They comprise an important element of teams led by specialists and an essential component of pathways in public health
• These pathways are not always well defined and therefore ‘the baton’ can fall before it is passed on from consultant to practitioner
• Practitioner training programmes are worthy of further examination and extension
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In conclusion:
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Opportunities will present to:
-exploit relationships in new (local) settings to mobilise a wider workforce to tackle longstanding challenges
-build a robust evidence base to use in a number of practice locations
-make the most of co-location of skills in PHE to deliver excellence and high level professional support
-use the developments of the transition period to deliver more aligned national public health services
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Next steps
• Public Health England Transition Team will collate and analyse the responses received
• Will continue to work with stakeholders until the strategy is published
• The strategy will need to be regularly reviewed and updated to reflect developments and ensure that it remains fit for purpose
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Public health system updates
The new public health system factsheets are available athttp://healthandcare.dh.gov.uk/publichealth
Sign-up to our regular Transforming Public Health bulletinhttp://phbulletin.dh.gov.uk/
Contact the DH Public Health England transition [email protected]
Contact the DH Public Health Development [email protected]
Workforce consultation (until July 2012)www.consultations.dh.gov.uk
ADDITIONAL SLIDES
• WORKFORCE• DETAILS OF FUNCTIONS OF PHE
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PHE’s organisational design
National Office (incl. hubs and supported by
national centres)
Units
Specialist distributed networks
Factsheet: PHE’s organisational design
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Local authority commissioning responsibilities (1)
• Tobacco control & smoking cessation
•Alcohol and drug misuse
•Services for children 5-19
•National Child Measurement Programme*
•Obesity and weight management
•Local nutrition services
•Increasing physical activity
• NHS Health Checks*
•Public mental health services
•Dental public health services
•Injury prevention•Birth defect prevention
•Behavioural and lifestyle campaigns to prevent LTCs
•Local initiatives on workplace health
• Support and challenge of NHS services (imms and screening)
•Public health advice to NHS*
•Sexual health services*
•Seasonal mortality initiatives
•Local role in health protection incidents*
•Community safety •Social exclusion
* Indicates mandated services
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Expert partners worldwidePHE will work with partners to
identify, understand and develop approaches to tackle
health threats, foster innovation and draw on behavioural sciences
Devolved administrationsPHE will coordinate nationwide
action to tackle threats to health and enable effective
UK-wide emergency, resilience and response
arrangements
Local governmentPHE will support local authorities by providing
services, expertise, information and advice to
ensure action is taken on best available evidence
NHS Commissioning BoardPHE will provide advice and
service to support commissioning, support
delivery of service, and ensure prevention and health
promotion are systematically addressed
PHE will work in partnership
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Accountability and
governance structure for Public Health
England
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How do current public health workforces operate?
Click to edit Master title style
•Click to edit Master subtitle style
Workforce in the New Public Health System
Leaders’ Networking Event9th May 2012
Yvonne DoyleDirector of Public Health, NHS South of England
Chair, Workforce Strategy Group Public Health England Transition Team