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

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.

4

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

5

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

6

1

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.

12 3 4

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

7

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

9

1

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.

12 3 4

Levels of workforce and intervention in Public Health

10

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

12

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

13

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

14

15

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.

16

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?

17

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

18

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?

19

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

20

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?

21

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

22

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.

23

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

24

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

25

In conclusion:

26

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

27

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

28

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 teamPublicHealthEngagement@dh.gsi.gov.uk

Contact the DH Public Health Development UnitPublicHealthDevelopmentUnit@dh.gsi.gov.uk

Workforce consultation (until July 2012)www.consultations.dh.gov.uk

ADDITIONAL SLIDES

• WORKFORCE• DETAILS OF FUNCTIONS OF PHE

29

30

PHE’s organisational design

National Office (incl. hubs and supported by

national centres)

Units

Specialist distributed networks

Factsheet: PHE’s organisational design

31

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

32

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

33

Accountability and

governance structure for Public Health

England

34

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