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Archive for November, 2017

By Gill Rawlinson, Advanced Physiotherapy Practitioner, Salford Royal NHS Foundation Trust 

Earlier this year I was proud to win the Advancing Healthcare FPH and PHE Award for contributions to public health for our innovative service which embedded NHS health checks and diabetes checks within NHS physiotherapy services in Salford.

The project, which was funded by Salford CCG’s innovation fund, allowed us to take a more focussed approach on embedding health promotion principles with the aim of supporting our patients with musculoskeletal problems to make positive lifestyle changes.

Salford Royal NHS Foundation Trust provides physiotherapy services to some of the most deprived parts of England where health inequalities are large and health and lifestyle factors contribute greatly to ill health and premature mortality. From the initial project aims of creating a culture where patient’s health and lifestyle was central to their care, and where physiotherapists were encouraged to support behaviour change with individuals, the project quickly grew and partnerships developed with both public health at Salford City Council and the Salford National Diabetes Prevention Project (NDPP).

This allowed us to share our common goals and work collaboratively to deliver NHS health checks and diabetes check within routine physiotherapy appointments, the first service of its kind in England. This approach not only puts public health principles and prevention at the core of clinical assessment, but allows the opportunistic delivery of supportive interventions, such as motivational interviewing, at a time when patients are seeking help with a health problem and are often keen to make positive behaviour changes.

Helen Slee, Project Manager for the Salford NDPP, supported me to collect data which facilitated the identification of eligible patients and to collate a health profile of our patients. This data allows us to record our public health interventions and to evaluate our impact as a public health workforce. The project supports the Five Year Forward View NHS England strategy which challenges us all to put prevention at the heart of what we do and also illustrates the use of physiotherapists and wider Allied Health Professionals as an untapped public health workforce. Since the pilot project we have been supported by our Public Health team and Salford CCG to develop and scale up the project. We plan to evaluate the data further and publish the findings in the coming months.

Winning this award has allowed me opportunities to share and disseminate our project with many other organisations across the country.

It has also allowed me to meet many other people with a passion for public health who want to change things for the better, including leaders in AHP services and quality improvement. Most importantly it gave welcome appreciation and recognition to our many staff who embraced change and challenges to deliver an improved service, supporting our patients to live longer and healthier lives.
Why not think about entering for the award this year to share your great public health practice and celebrate your team’s successes? You never know where it may lead!

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By Dr Lesley Graham, Associate Specialist, Public Health for Alcohol, Drugs and Health in Justice, ISD, National Services Scotland, and Faculty of Public Health Representative, SHAAP. Dr Harpreet S Kohli, Retired DPH, Co-opted Member, SHAAP.

The UK Supreme Court has  unanimously ruled that the Scottish Government’s legislation on Minimum Unit Pricing is legal. This is a landmark moment for public health and the end of a long journey. However, it also marks the start of a new journey to implement MUP to reduce alcohol-related harm in Scotland. When implemented this will mean that no alcohol can be sold in Scotland for less than 50p per unit.

Although the Alcohol (Minimum Pricing) (Scotland) Act 2012 was passed 5 years ago by the Scottish Parliament without opposition, global alcohol producers headed by the Scottish Whisky Association took the Scottish Government to court. There followed a lengthy and costly battle (in terms of lives lost, time, and money) all the way to the European Court of Justice and back to the highest court in the UK. This victory has been a huge collaborative effort from many players with public health at the heart of it.

Just over 10 years ago, an alcohol advocacy group, Scottish Health Action on Alcohol Problems (SHAAP) was set up and we were the Faculty of Public Health representatives. SHAAP was established due to concerns about the epidemic levels of alcohol harm in Scotland being driven by increasingly cheap alcohol.

Our report, Price Policy and Public Health was the first public call for action to introduce a minimum price for alcohol. The incoming SNP Scottish Government took up that call. As well as targeting the Scottish Parliament, SHAAP reached out to build alliances at global levels. By 2010, WHO (World Health Organisation) were recommending MUP as a policy ‘Best Buy’.

The broad scope of the role of public health has allowed us to contribute in a variety of ways, including:

  • Production of routine national statistics
  • Policy development
  • Advocacy
  • Research
  • Evaluation of the implementation of MUP in terms of what alcohol-related harm means for health boards in Scotland such as service provision

Here are some of our reflections of that journey

First, the importance of a sound evidence base. Although MUP had never been tried and tested before, we had based the rationale on the evidence of the relationship between price, consumption and harm. The more price falls, consumption rises and so does harm. That sound evidence base proved its worth in the sometimes stormy debate that was to follow.

Second, we had ‘reframed’ the problem with a public health paradigm, if average population consumption would fall, so would harm. This helped move the narrative away from being the problem of a minority of individuals or one of anti-social behaviour.

Thirdly, those from the most disadvantaged backgrounds experienced greater levels of alcohol related harm, indeed, those inequalities were widening. It was a matter of social justice. We had champions, both political and public health who went out and campaigned hard and did not give up.  Other countries now are poised to follow Scotland’s lead.

Lastly, we think it is more than about alcohol policy. It shows that public health can trump private profit and the alcohol industry. A great moment indeed!

 

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The Chief Nursing Directorate at Public Health England (PHE) and the Florence Nightingale Foundation (FNF) are offering a bespoke scholarship a bespoke scholarship named after an inspirational public health nurse who sadly died in 2016.

The award is in memory of Nana Quawson, a dedicated school nurse and practice nurse who sadly passed away last year. Nana was passionate about improving the health and wellbeing of children and young people through evidence based public health interventions. She spent time with the Nursing Directorate in the Department of Health and Public Health England sharing her expertise, ideas and enhancing her public health leadership skills.

The FNF scholarship builds on Nana’s journey and aims to provide a fabulous opportunity for a public health nurse to enhance their leadership and become a strong leader with the skills and self-confidence to contribute positively and make a tangible difference to the outcomes for children, young people and families. As part of the scholarship we are delighted to also offer a work based placement within the Chief Nurse Directorate at PHE and work with the team on raising the profile of public health nursing, prevention and improving the health and wellbeing of children, young people and families.

This scholarship remembers the dedication, passion and drive of Nana Quawson (1972-2016), a valued colleague and school nurse. The scholarship provides the opportunity for other public health nurses to follow in Nana’s footsteps and make a difference to children, young people and families.

For further information please visit the FNF website. To find out more about our work at PHE please contact Wendy Nicholson or Penny Greenwood.

 

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