P 07
Ymchwiliad i’r Adolygiad Blaenoriaethau ar gyfer y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon
Inquiry into the Priorities for the Health, Social Care and Sport Committee
Ymateb gan: UK Public Health Register
Response from: UK Public Health Register
23 August 2016
National Assembly for Wales – Priorities forthe Health, Social Care and Sport Committee – UKPHR’s response to the Committee’s consultation
Introduction
UK Public Health Register (UKPHR) welcomes the opportunity to contribute to the consultation on the priorities for the Health, Social Care and Sport Committee during the Fifth Assembly.
UKPHR urges the Committee to adopt an approach which draws together health and social and primary care and examines them through the prism of public health. The aim would be to “go upstream” and devise a preventive approach delivered not just by Wales’ core public health workforce but engaging the wider workforce, carers and communities also.
Background
UKPHR was set up as a result of a Tri-Partite public health community initiative, supported by the Department of Health and the Chief Medical Officer, Liam Donaldson in 2003. Today UKPHR’s register is accredited by the Professional Standards Authority and registers public health specialists, public health practitioners and public health specialty registrars.
Public health practice requires population based approaches to address wider determinants of health and health inequalities. By its very nature, public health practice requires multidisciplinary approaches and therefore a multidisciplinary workforce. UKPHR’s register brings together this diverse multidisciplinary workforce in one regulatory “home”.
Wales has always been committed to the success of UKPHR - the very first registrant, a public health specialist, was from Wales. The first public health practitioner we registered was from Wales. The first Specialty Registrar we registered was from Wales.
A preventive approach - public health practice
Wales has experienced a strong track record in improving and protecting the population’s health. However, people are generally living longer and this is resulting in new challenges facing the health and social and primary care systems. For example, £73m is the cost of obesity to the NHS in Wales, according to an academic study commissioned by the Welsh Assembly Government.
A shift in focus from tackling illness to prevention can lessen the otherwise predictable growth in the strain on health and social care budgets affecting both the NHS and local authorities. It is also the socially just course for Welsh society – tackling health inequalities and promoting not only longer lives but also healthier longer lives.
The strategic framework, Our Healthy Future re-committed the Welsh Government to improving people’s quality and length of life and ensuring that everyone has a fair chance to lead a health life.
Its vision includes:
· Providing children and young people a good start in life that supports their long-term health and wellbeing.
· Inspiring everyone to achieve a healthy and fulfilling working life.
· Providing older people the knowledge, skills or support to make informed choices about living independent and fulfilled lives.
· Improving the level of health of individuals experiencing greatest disadvantage to the levels found among the more advantaged.
· Supporting healthy sustainable communities – places where people want to live, work, play and flourish – are sought for all.
· Ensuring health and social services place greater emphasis on prevention and early intervention.*
· Health and wellbeing as a shared goal for all.*
· Public health policies and interventions that are based on good evidence and monitored. *
* Our emphasis.
Obesity has become more prevalent since the Welsh Health Survey started in 2003/4 and to date there has been no sign that this trend will be turned around without a radical upgrade in prevention and public health.
In holding the Welsh Government to account in relation to improving public health in general and reducing obesity levels in particular, UKPHR believes that the Committee should champion a public health approach which:
Ø Engages the wider workforce, carers and communities in a consistent, holistic preventive programme (demonstrating the strategy is joined up);
Ø Applies evidence and innovation in support of the programme (demonstrating determination to use all the right tools);
Ø Puts public sector organisations at the forefront of implementation including across health and social and primary care settings (demonstrating leadership and setting an example); and
Ø Invests in the skills, competence and commitment of Wales’ core public health workforce (demonstrating commitment to quality of services).
The Public Health Workforce
Creating a healthier, happier and fairer Wales for everyone[1], introduced the strategy for Public Health Wales (PHW) for 2015-18. One of the seven priorities outlined in the document is ‘Making sure our workforce is doing its best for you’. It has been identified that the public health workforce in Wales should be supported to ensure they achieve excellence in their respective roles and that the best possible workforce is recruited and retained.
It is important for public policy makers to recognise the central and vital role of the core public health workforce in the commissioning, co-ordinating and delivery of effective public health interventions and services.
Now more than ever, the public health workforce is required to work in diverse settings and bring to bear a range of complementary disciplines. The professional standards, competence and commitment of all who work in public health are vital components in ensuring that the public’s health is protected, improved and cared for.
The role of the senior leadership group is particularly demanding: demonstrating by example the multidisciplinary skills and knowledge of the public health workforce, advocating for public health and working with partner organisations to make every contact count in the delivery of holistic and consistent public health interventions.
UKPHR registration is an assurance of competence of the public health specialists who comprise this senior leadership group. Registration is open to those completing the Speciality Training Programme, those who are GMC-registered or GDC-listed as specialists in public health and those who achieve registration by way of retrospective portfolio assessment.
UKPHR also registers public health practitioners. Achievement of practitioner registration gives public health employers assurance that this registered front line workforce is competent to work autonomously (equivalent to Level 5 and above in the Public Health Skills & Knowledge Framework). However UKPHR practitioner registration is currently not included as a desirable criteria in all job descriptions and person specifications. This should change if employers, policy makers and the public are to be assured that public health practitioners, comprising the overwhelming majority of the core public health workforce, are competent to practice and possess knowledge and skills that are fit for purpose.
In many respects, UKPHR’s practitioner registrants are also leaders. They have roles in managing other public staff, in public engagement and working collaboratively with others.
Arising out of PHW’s experience of practitioner registration, the Professional and Organisational Development Team at PHW has developed a means of recognising advanced practice in public health. This is aimed towards those in the practitioner workforce who have developed additional skills and knowledge and taken on additional responsibilities, including roles in management of public health services and partnerships.
We are grateful to our colleagues in PHW for setting up this pilot which we believe has the potential to improve a distinctive public health career ladder and contribute in future to a making careers in public health all the more attractive to talented people seeking careers which will be challenging and satisfying.
UKPHR recognises the importance of ensuring that registrants who establish their competence in public health practice at the time when they achieve registration thereafter maintain and enhance their skills, knowledge and competence. We provide for this by applying mandatory standards for continuing professional development (CPD) and revalidation.
Registration of the public health workforce is increasingly bringing greater appreciation and visibility of this valuable workforce. It is also of interest to the wider workforce – people who may be delivering public health interventions but do not see their current jobs as “public health” – providing an encouragement to consider a career more directly in public health.
In conclusion
UKPHR wishes the Committee well in its work and hopes that a more comprehensive strategy and implementation plan for a preventive and public health approach in Wales will be something the Committee will work for.
UKPHR urges the Committee to recognise the crucial contribution which the core public health workforce already makes to improve the public’s health and wellbeing and reduce health inequalities in Wales. With greater attention and investment, this workforce can be even more effective and impactful and help the Committee to achieve more ambitious goals in health and social and primary care.
Registration by UKPHR offers assurance to employers, policy makers and the public of the competence of this key core workforce.
UKPHR would suggest that promotion of registration of this workforce by public policy makers and public health employers fits with the objectives both of the Committee and also Public Health Wales.
Evaluations[2] and leadership perspectives[3] on practitioner registration in PHW to date reinforce the view that participating in the process of public health practitioner registration positions PHW all the better to be able to plan and implement public health measures.
Contact
Please address all enquiries about this communication to:
David Kidney, Executive Director, UKPHR,
18c Mclaren Building, 46, Priory Queensway, BIRMINGHAM B4 7LR
Tel. 0121 296 4370 d.kidney@ukphr.org