Archive for June, 2018

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Thursday 21 June is the longest day of the year but it is important for another reason as it it’s also the date of Clean Air Day 2018. This special day, coordinated by Global Action Plan, is held each year to raise awareness about the harms of air pollution and to inform people of the simple things we can all do to tackle this silent killer on our streets.

The air we breathe is essential to life and air pollution affects us all – from before we are born until old age. Harmful pollutants including tiny particles and toxic gases cause a wide range of diseases which affect the heart, lungs, circulatory system, brain and other vital organs. In the UK, air pollution caused by the most harmful pollutants is estimated to cause approximately 40,000 early deaths each year. While air pollution is harmful to us all, people who are older, live in deprived areas, have pre-existing conditions or live near busy roads are at greater risk. This means that our poorest and most vulnerable communities are exposed to some of the worst outdoor and indoor air quality, worsening health inequalities.

Air pollution also has a major impact on ecosystems and biodiversity, it contributes to climate change and is damaging to our wider economy. A recent report estimated that pollution from cars and vans costs us £6 billion in health costs year – equivalent to £8000 for each car driven in central London. Whilst converting from diesel to petrol cars may be an option to reduce air pollution, it still increases carbon emissions. The best solution is therefore to travel by foot and by bicycle. If we as a society could swap just 1 in 4 of urban car journeys in urban areas for walking or cycling we could save £1.1 billion in health costs per year.

Therefore, why not use Clean Air Day to leave your car at home and try a different mode of transport – whether it’s walking, cycling, taking public transport, or test driving an electric vehicle. You can also play a role by getting involved in a wide range of events and activities around the country from nature walks to citizen science projects and much more. For more information about Clean Air Day 2018, to download free resources and get involved, visit the Clean Air Day website here.

Written by Dr Suzanne Bartington, Clinical Research Fellow at University of Birmingham and Honorary Specialty Registrar in Public Health at FPH.

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save the date_2018_145What will you do for Clean Air Day 2018? 21 June is the opportunity for public health professionals to bring the issue of air pollution to the attention of our colleagues and patients.What will you do for Clean Air Day 2018? 21 June is the opportunity for public health professionals to bring the issue of air pollution to the attention of our colleagues and patients.

Air pollution is the largest environmental health risk in the country, ranking alongside cancer, heart disease and obesity in the scale of its health impacts.  Air pollution affects us all at work, at home and out and about.  It causes heart and lung diseases, affects children’s lung development and shortens the life of at least 29,000 people every year.  As the Chief Medical Officer acknowledged earlier this year, we must start to address air pollution as disease prevention.  The role of the public health professional in this is crucial.

Although the majority (68%) of people in a recent nationwide survey were aware that their day-to-day activities can have a direct impact on air quality in their local environment, comparatively few were doing anything to protect their health from air pollution, such as cycling/walking a route previously driven (21%) or buying milder, fragrance-free or naturally-scented cleaning products for the home (11%).

Public health professionals have an opportunity to address this knowledge-action gap on Clean Air Day, and beyond, by:

  • Providing information on what people can do to reduce air pollution and protect themselves from it;
  • Encouraging pollution-busting behaviour

The Clean Air Day campaign has free, ready-to-use resources such as leaflets, posters, newsletter templates and social media memes, to make it as easy as possible for every healthcare organisation and professional to get involved with Clean Air Day. Here are some of the things you can do:

1. Incorporate air pollution advice into care pathways – print out leaflets and give to patients

2. Tell your colleagues:

  • Work with your communications team to share messaging
  • Encourage colleagues/visitors/patients to cycle/walk/use public transport on 21 June.  Reward those who do with a free breakfast or some other form of recognition.
  • Hold an event about air pollution on 21 June e.g. a stall in reception, talk at lunchtime

3. Work with local partners – include air quality in Joint Strategic Needs Assessments and Health and Wellbeing Strategies

4. Share messages about what you’re doing – use the hashtag #cleanairday @CleanAirDayUK

5. Use the free healthcare toolkit –  contains leaflet, posters, messaging, sample newsletter text etc. www.cleanairday.org.uk/healthcaretoolkit  

Clean Air Day is a chance for the whole country to come together and improve air quality through collective action.  And as public health professionals, it’s your chance to seize this opportunity on June 21 2018 to start the conversation with patients about air pollution – and clean up the air in and around our organisations.  For more information and download graphics to support Clean Air Day on social media, go to www.cleanairday.org.uk.

Written by Larissa Lockwood, Head of Health at Global Action Plan, coordinators of Clean Air Day.

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Steve SeniorThe FPH has asked me to write a blog about preparing for the Part A exam. The trouble is, I’m very aware of how much luck was involved in how well I did with the Part A. I was lucky to have an unreasonably supportive family, a great bunch of people to study with, lots of support from the North West School of Public Health, and a great team in the office. And although my daughter was born in September (prime revision months – how very inconsiderate of her) she slept marvelously, and in any case I was allowed to sleep in a different room. You might call these the social determinants of Part A success.

There was a lot of luck involved on the day too. Questions came up on things that happened to be among my favourite topics, things that I could link directly to work I’ve done in my placement in Tameside Council’s public health team, or things that I just happened to have looked at my notes on that morning.

But ‘be lucky’ isn’t really very useful advice. So below are some things that seemed to work for me (a study of n = 1).

  1. Don’t panic! It’s a tough exam with a fearsome reputation. I found studying for Part A really stressful. For a long time it seemed that I’d never get all this stuff into my head. It helped to keep things in perspective. For example, unlike University final exams, you can have several tries at Part A. And in the long term, no one is going to care what score you got.
  2. Start early. I found that the main challenge was the volume and breadth of material to get through. I started making notes around the beginning of September. This helps with getting through the material, and I also found it helped me feel more in control, which helped manage the stress.
  3. Get a study group. Taking turns to prepare and present sessions on topics is an effective way to learn. But the social support is probably more valuable still. Look after each other.
  4. Chunk it up. I made a big spreadsheet of the the curriculum with all the topics that I’d need to learn, colour coded by how confident I felt. This helped me to break the whole curriculum into manageable chunks, and focus my studies on the areas where I was least confident. Updating it as I went along gave me a sense of progress. Plus making the spreadsheet let me put off doing any actual studying for several hours.
  5. Test yourself. Testing yourself leads to better recall than staring at a text book or making notes. Better still, get someone else to test you. I am sorry to say that long car journeys became an opportunity for my wife to test me, and my four year old son probably knows more about Lewin’s theory of change management than is proper for someone his age.
  6. Do lots of past papers. I switched to mainly doing past papers about four weeks before the exam. I did each one in the time given in the exam, or a bit less. This helped me to focus my revision as the exam got closer, and helped get the timings right. The examiners’ comments are really important.
  7. If you can, link your answer to work you’ve done. This doesn’t need lots of detail, but a couple of sentences at the end of an answer showing that you’ve used that particular bit of knowledge in practice seems to go down well with the examiners.
  8. Don’t be scared to have an opinion. I was really quite rude about the Myers-Briggs Personality Type Inventory (or ‘astrology for business students’ as someone put it on Twitter), and I did fine on that question. If I were an examiner I think I’d quite appreciate someone saying something that isn’t straight from ‘Mastering Public Health’.
  9. Stockpile sleep before the exam. I found that I didn’t sleep the night before each day of the exam. Partly this was nerves. Partly it was poor choice of hotel. Partly it was someone, evidently having a great night out, singing ‘livin’ on a prayer’ outside my window at midnight.

I hope this advice is helpful. Either way, good luck!

Written by Steven Senior, a specialty registrar in public health based in Greater Manchester. He won the Michael O’Brien prize for the highest score in the January 2018 sitting of the Part A exam. You can follow him on Twitter.


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My name is Victoria and I am a public health registrar (ST3) in Yorkshire & the Humber. I am currently on an academic placement at the University of York, where I am doing qualitative research on palliative care needs and motor neurone disease, and also collaborating with the World Health Organisation on examining the cultural contexts of health.

This is a short blog for Phase 1 registrars with tips for preparing for the Part B exam. I sat Part B quite recently (December 2017) and was fortunate enough to pass first time – these are the things that I found useful during my preparation, so hopefully other registrars will find them helpful too!

Tip 1: Focus on communication skills, not knowledge

  • As the Faculty puts it – Part A is ‘know how’, and Part B is ‘show how’. Unlike Part A you don’t need to do months of learning from books beforehand; how you interact with the ‘actor’ is the most important part. Make sure you tune in to what’s important for them – even if you can’t directly address their questions make sure you acknowledge you understand what their concerns are.
  • Look at the question headings in the marking guide – make sure you know what the 5 key aspects of the marking criteria are (and note that they relate to communication skills, not external knowledge!)

Tip 2: Familiarise yourself with the OSPHE set up

  • The FPH website has useful guidance on exactly what happens on the day – make sure you read it in advance!
  • Mock exams are very useful – mine was arranged by our local Part B rep (another registrar) and had 6 stations, with a consultant and senior registrar at each. We got feedback at the end from the examiners about every station, and although I did mine 6 months before I actually sat the exam the feedback was very valuable.
  • The most important preparation I did was short practice sessions with colleagues, going through 1-2 scenarios each and getting feedback. I paired up with another registrar, who was working at health protection with me and also due to sit Part B, and arranged a session roughly once a week with a different consultant to go through a scenario each (using the FPH’s mock questions on the website). As well as being the candidate, it was also useful to role play the actor and examiner parts as this gave me more insight into what they were looking for! You also begin to appreciate how much you can say in 8 minutes (or 2-3 minutes if the question asks you to give a summary at the beginning), which helps pace the conversation better.

Tip 3: Practice writing notes in 8 minutes

  • 8 minutes is not long (particularly under exam pressure!) – the more used to the time constraint you are, the easier it is to concentrate on reading and making notes in the exam.
  • I had a structure for how to lay out my notes on a page so I remembered to write down important things like who I was talking to, key points to address etc.
    Although I mainly practiced using the mock questions available through the Faculty, you can practice on other things too e.g. reading a short journal article.

Tip 4: Practice tailoring your answer to a particular audience

  • Different people (e.g. finance director of a CCG, medical consultant, journalist) will have a different level of understanding about particular issues, and different priorities. You need to respond to their priorities as well as making sure you get your own key message across to them in a manner they can understand/relate to.

Overall, Part B is more similar to a standard day in the office than Part A, and so preparation should be less stressful. Many of these skills you will naturally practice every time you have a conversation – the extra work needed should just focus on fitting it into the specific 8-minute exam format!

Written by Victoria Turner, Specialty Registrar in Public Health and the winner of the 2018 McEwan Award for achieving the highest grade in the Part B exam. You can follow Victoria on Twitter.

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#futureofpublichealth: this is the first in a series of blogs that aims to champion the prevention delivered in NHS settings as part of the NHS at 70 celebrations and FPH’s public health funding campaign

Caroline Bovey BDA

“This week is the fifth annual British Dietetic Association (BDA) Dietitians Week, when the dietetic profession come together to spread the word about our work and profession. Our theme this year is “Dietitians Do Prevention”. All four nations in the UK have identified improving prevention and public health as a key component of the future NHS.

There is a growing drive for more resource in prevention and public health activities as a means to managing pressures on clinical and social care services, and increasing the sustainability of provision.

Public Health Dietetic practice is my own specialist area. For some time, it has felt as though this area has been somewhat on the fringe, seen as less complex and as somehow less critical than clinical work. But now, the role that public health practice is being seen as valuable in its own right. The skills that dietitians hold in negotiating complexity in practice and their skills as influencers are greatly needed.

Although we may not always use the same language to describe it, we know that all dietitians already “do prevention”. They employ Healthy Conversations in their day to day work, they embrace MECC (Making Every Contact Count) principles utilising brief advice and brief intervention methods, and that social media spaces offer great opportunities for dietitians to share public health messages and information. Indeed, we’re sharing plenty of examples and case studies on social media this week, and are pleased the Faculty of Public Health will be joining us to share these messages.

Prevention and public health are going to be priorities beyond Dietitians Week. I recently launched it as the Chairman’s Theme at BDA Live, the BDA’s bi-annual conference. “Go to Dietitians for Prevention” will focus the Associations attention on driving this agenda and gives us opportunities to influence stakeholders, politicians and the public in a variety of ways.

The theme will be multifaceted, with public facing elements such as our recent Twitter campaign with Diabetes UK and Beat Flu focusing on promoting free flu jabs for people with a very high BMI. We also have examples of grass roots actions by BDA members. The creation of the Twitter hash tags #WhatDietitansDo or #WhatRDsDo toward the end of last year had a reach of many hundreds of thousands and continues to be a powerful way of highlighting and sharing best practice amongst the profession. Of course, social media offers ideal forums for dietitians to engage in public health messaging – the mere act of talking about our work, including newly emerging and evolving practice, spreads our influence.

But social media campaigns won’t be enough on their own and we must think about how we are designing our services; does everything need to be done directly by dietitians for example, is a check that we should be asking frequently. Many health authorities now employ dietitians to help build capacity in others. Supporting knowledge and skills development in other health and social care professionals and volunteers is an ideal way to spread evidence-based nutrition messages and specifically targeting colleagues who have food, nutrition and hydration in their roles, gives us the chance to significantly increase the number of people with the right skills.

We also recognise the need to work with others to highlight the importance of prevention and public health and campaign for more support for this important area of healthcare. This is why we are pleased to be working more closely with the Faculty of Public Health in the coming years and supporting their own campaigns.

As the incoming Chairman of the BDA, I have spent the last twelve months undergoing a steep learning curve. As I have become more involved with the work of the Association I can better understand the breadth of challenges facing us and our profession. The challenges are not, of course, unique to Dietetics but that doesn’t mean that we should assume there is little that we can do.

The time is right for this theme! I’m very excited about Dietitians Week 2018 which will hopefully kick start a much greater recognition of the role of dietitians as “go to” professionals for prevention and public health.”

Written by Caroline Bovey RD BEM, Public Health Dietitian and BDA Chair-Elect.

Note from FPH: As we celebrate the NHS at 70, many in the health community are taking this moment to ask some big questions about the kind of future we envision for our health system and the level of funding support necessary to realise it. We believe that public health and prevention must be central in this national debate about the future of NHS funding and we’d like your support to help us make that case. If you’re an FPH member or work in the NHS delivering prevention, please consider joining our ‘sounding board’ of members and clinicians who are helping us develop policy on this issue. For more info, please email policy@fph.org.uk or click here.

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paul pic global running day

parkrun was a small idea with a small p that has grown into something I could never have imagined when I started the first parkrun in London’s Bushy Park in 2004. In fact, it was only ever intended to be a single event and for the first two years it was. I still find it hard to believe that it has captured the imagination of three million people around the world who have walked, run and volunteered at a parkrun event.

parkruns are free, timed, 5k events that are coordinated entirely by volunteers and take place in public areas of open space every Saturday morning. Each parkrun is held every week, in the same place, throughout the year, and most events finish near a local cafe for the all the important post-parkrun socialising.

A parkrun isn’t a race – it’s a timed 5k event for walkers, runners, volunteers or, if you’re not quite sure about the idea just yet, spectators as well! The best kept secret of parkrun is that it isn’t really about the running at all – it’s the people who you meet along the way.

Back in the beginning, I was a keen club runner with a long term injury who missed the social side that comes with being part of a running club. I wanted to do something to fill that void in my life, so I invited a group of my friends to run a 5k loop in our local park, which I would time and publish the results, and then we would go for a coffee afterwards in the park cafe. My friends could run, and I could see them – it sounded like a good idea to me!

There were less than 20 of us on that overcast morning in 2004 – 13 runners and five volunteers in fact. In early 2007 when our numbers had increased beyond 300, we started a second event at nearby Wimbledon Common. Far from splitting the numbers however, it created a whole new community. Before long there were volunteers in Leeds, Wales and Scotland who asked to replicate the idea in their communities, and in 2009 we expanded to Denmark, our first international territory. And the rest as they say is history.

Last weekend, more than 250,000 people at 1,500 locations across 20 countries took part in parkrun.

On the surface the parkrun concept is incredibly simple and the format hasn’t changed since that first morning – free, timed, weekly, 5k, for everyone who wants to take part. What has changed however is the way that we have evolved from attracting mainly club runners in the very beginning to people from all walks of life.

Over time we have gradually broken down many of the traditional barriers to taking part in in regular physical activity, and we’ve grown to a stage where we can proactively engage with the people who are the least likely to take part in physical activity and volunteering – and therefore potentially have the most to benefit from it.

Families can take part together, you can run with your dog on a short lead, walkers are supported by a volunteer Tail Walker, support groups for 10 different disabilities and long term health conditions have been established to facilitate involvement with parkrun, and participation is recognised rather than performance – milestone shirts for 50,100, 250 and 500 completed parkruns, and for volunteering 25 times, provide a significant incentive for many parkrunners.

There is still so much more that we need to do to change what it means, and looks like, to be physically active, but we are on the right track. I genuinely believe that parkrun can help to make the world a healthier and happier place, and we’ve only just begun…

Written by parkrun founder, Paul Sinton-Hewitt CBE. To find out more about parkrun and to locate your nearest event, click here.

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Stoke Speaks Out was recently the proud recipient of the Advancing Healthcare FPH and PHE award for contribution to Public Health for creating a whole systems approach to tackling speech and language delay across the City of Stoke on Trent.

Our Stoke Speaks Out initiative, based in Stoke-on-Trent and funded by Stoke Local Authority, was commended for the impact we are having on children’s communication development at population level. This is timely in light of the ‘Bercow 10 years on’ review looking at services for children with speech/language and communication needs.

‘Stoke Speaks Out’ is a city-wide, multi-agency approach ensuring children living in areas of high deprivation, receive the best start in life to develop early language and communication skills.

The project, which was started in 2004 and has now developed into a ‘strategy’, focuses on ‘Healthy Beginnings’ and is run by our small multi-agency team. I provide the leadership and am seconded from Staffordshire and Stoke on Trent Partnership Trust speech/language therapy department. The core specialist service understands the importance of engaging at Universal and targeted level to ensure the specialist part of the service reaches those who need it most. Our project includes a training programme for the ‘early years’ workforce that emphasises the importance of early attachment and positive parenting on children’s development. Our team is made up of speech and language therapists, communication champions, early years practitioners, reading champions and a project officer.

We are particularly proud of our innovative Early Communication Screen (ECS) tool to improve the school readiness of children from two to five. This is designed to be used by Early Years practitioners who are trained by SLTs in a one-off ECS session, as well as through ongoing support. The screen is designed to identify early language delay and measure children’s progress over time. As a result, practitioners can plan appropriate and targeted interventions.

Over 8,000 children have been screened to date, and taking just 5-10 minutes per child, this is a cost effective, efficient method of early identification which empowers practitioners to detect and support language issues early. We have, to date, trained more than 1,800 regional practitioners to use it.

At the beginning of our school readiness initiative in 2016 only 35% children were on track with their language development. Within 11 months we could quickly demonstrate the impact of our work with 54% children on track. Having a clear picture of the level and detail of need has been really valuable for targeting services and being able to monitor the impact of the work is crucial to future planning. As Stoke is an area of high social deprivation this links strongly to the Department for Education’s social mobility plan and offers a solution to improving children’s outcomes.

Winning the award has been a real boost to the team morale. The team are extremely proud and passionate about their work and are thrilled that this has been recognised nationally. This has led to national interest in our work and enabled us to support other AHPs (allied health professionals) in public health developments.

Written by Janet Cooper, clinical lead speech/language therapist at Staffordshire and Stoke on Trent Partnership Trust and lead for Stoke Speaks Out.


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