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Archive for the ‘Healthcare’ Category

Engaging all health and care professionals in the radical upgrade in prevention

Posted in Ageing, Healthcare, Lifestyles, Media and public health, Obesity, prevention, smoking, Uncategorized on January 31, 2018| Leave a Comment »

By Jamie Waterall, National Lead for Cardiovascular Disease Prevention and Associate Deputy Chief Nurse at Public Health England, and Honorary Associate Professor at the University of Nottingham

Over recent weeks, we’ve seen constant media reporting about the increased pressures our health and care system is experiencing.

There’s no disputing that the NHS is facing ever greater demands, often linked to our aging population and many more people living with long-term conditions such as heart disease, diabetes, dementia and certain cancers.

But it’s worrying that most of the news reports only focus on the need for more acute hospital beds and ambulances, rather than discussing the need for a radical upgrade in prevention to reduce demand on these services.

As public health professionals we know that there are no easy solutions to the pressure on our health and care system. These are complex problems, requiring a whole-systems response.

However, we also know that many of the health issues keeping our hospitals so busy are preventable. Having worked in acute medicine and cardiology for a number of years I witnessed the scores of patients I treated who were admitted to hospital with conditions that could have been delayed or avoided altogether.

And when working in the acute trust environment, I would have agreed that more beds and acute services was the answer to our problems. It was not until I was working in primary care as a nurse consultant that I became more aware of the need for an increased focus on prevention.

So I frequently ask myself; how can we better harness the skills of our trusted front-line professionals, ensuring we all get behind this radical upgrade.

Our research informs us that there’s real appetite to build more prevention into our daily practice, however it also shows us that there can be barriers and challenges.

Time and resource is of course an issue, but we’ve heard that some professionals can be apprehensive about talking to members of the public about their weight, for instance, or whether they smoke or keep active. We also know that there can be uncertainty about the availability of local lifestyle services to refer patients to.

With all this in mind, Public Health England has developed All Our Health, a framework which supports all health and care professions to get more involved in the upgrade in prevention. It provides tools and advice to support ‘health promoting practice’ with quick links to evidence and impact measures and top tips on what works.

Based on user research we’re making improvements to All Our Health as well as forging new links with universities and Health Education England, so we can build more prevention into the way we train our future professionals to practise in this different world with new expectations and opportunities.

We also hope All Our Health will help health and care professionals to engage with the local public health system, including getting involved in the development of prevention initiatives.

Surveys of the public constantly show that our frontline health staff are amongst the most trusted professionals in our communities. Just imagine the impact if our estimated two million health and care staff built more prevention into their practice. We could truly achieve the radical upgrade we so urgently need to see.

For further information and to read more about All Our Health, click here.

 

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Tackling health inequalities must involve addressing lesbian, gay, bisexual and trans inequalities

Posted in Healthcare, HIV, LGBT, Mental Health, SIG, tagged , , , , on July 7, 2017| Leave a Comment »

By Dr Justin Varney, National Lead for Adult Health and Wellbeing, Public Health England

Public Health England estimates that between 2-5% of the population identify as lesbian, gay, bisexual or other – comparable to many ethnic minority and faith populations. Despite legislative reform many LGBT people continue to experience discrimination, marginalisation and harassment.

  • 38 per cent of trans people have experienced physical intimidation and threats and 81 per cent have experienced silent harassment (e.g. being stared at/whispered about)
  • One in five (19 per cent) lesbian, gay and bi employees have experienced verbal bullying from colleagues, customers or service users because of their sexual orientation in the last five years
  • Almost 1 in 4 trans people are made to use an inappropriate toilet in the workplace, or none at all, in the early stages of transition. At work over 10% of trans people experienced being verbally abused and 6% were physically assaulted.

The impact of this discrimination on mental health is easy to understand, however the stark data on suicide and self-harm demonstrates the depth of the impact that this discrimination can have:

  • 52% of young LGBT people reported self-harm either recently or in the past compared to 25% of heterosexual non-trans young people and 44% of young LGBT people have considered suicide compared to 26% of heterosexual non-trans young people
  • Prescription for Change (2008) found that in the last year, 5% of lesbians and bisexual women say they have attempted to take their own life. This increases to 7% of bisexual women, 7% of black and minority ethnic women and 10% of lesbians and bisexual women with a disability
  • The Gay Men’s Health Survey (2013) found that in the last year, 3% of gay men have attempted to take their own life. This increases to 5% of black and minority ethnic men, 5% of bisexual men and 7% of gay and bisexual men with a disability. In the same period, 0.4% of all men attempted to take their own life
  • The Trans Mental Health Study (2012) found that 11% of trans people had thought about ending their lives at some point in the last year and 33% had attempted to take their life more than once in their lifetime, 3% attempting suicide more than 10 times.

The impacts aren’t limited to mental health, and the level of inequalities in lifestyle behaviours such as smoking and substance misuse will almost certainly play out in a great burden of chronic disease and premature mortality over the life course.

The evidence base of inequalities affecting LGBT populations continues to grow as we get better at incorporating sexual orientation and gender identity into the demographics of research and population surveys. Positively, as the NHS rolls out the sexual orientation monitoring information standard this year, this understanding will no doubt continue to grow.

As public health professionals we have a responsibility to advocate for the populations in our care, and this should include advocating for LGBT populations. Lesbian, gay, bisexual and trans communities are diverse, vibrant and varied and have many assets, although the LGBT community sector has faced fiscal challenges due to the economy there remain many small local LGBT organisations that are keen to work with public health teams to address these inequalities.  This is population who clearly need our professional expertise, advocacy and support to co-produce solutions for change and one where we could have a real impact.

So during this lesbian, gay, bisexual and trans Pride season please take up the opportunity to engage, empower and partner with your local LGBT community.

FPH is committed to improving the health and well-being of the LGBT population. If you would like to join us in our work please consider joining our Equality & Diversity Special Interest Group or our LGBT Health Special Interest Group. To express an interest in joining please email policy@fph.org.uk and we can help you get started!

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Putting research into action at the FPH conference

Posted in Academic, Children and young people, epidemiology, Healthcare, immunisation, PH Spending on March 15, 2017| Leave a Comment »

By Professor Aileen Clarke, President of the Society for Social Medicine

A highlight of this year’s UK Faculty of Public Health Conference in Telford is going to be the Society for Social Medicine’s (SSM’s) ‘Research in Action’ session.

The SSM will be hosting this research feast at the always fantastic and hugely enjoyable FPH conference. Last year this session had standing-room only and this year it will be bigger and better than ever – and hopefully will have more chairs!

In our ‘Research in Action’ session, we will be presenting the top-scoring abstracts from SSM’s own annual scientific conference with a variety of public health topics. Last year they ranged from obesity, to housing and health and active commuting. This year we’re including public health advocacy, youth mentoring and immunisation uptake.

You can also expect the presentations to cover a range of research methodologies from epidemiology, cost-effectiveness modelling, systematic reviews and mixed methods to qualitative research.

SSM’s purpose is “advancing knowledge for population health” and in this case we are hoping to advance knowledge by showcasing exemplar public health research. Our session at the FPH conference is an exciting opportunity to promote linkages and future collaborations between public health researchers and practitioners.

I hope I have been able to sell our session to you. Please do come along and get involved.

Please find more information about the FPH conference at Telford on 20-21 June here.

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What impact will Brexit have on public health and health services in the United Kingdom?

Posted in Academic, Ageing, Brexit, Europe, Global Health, Healthcare on March 6, 2017| Leave a Comment »

By Professor Azeem Majeed, Head of the Department of Primary Care and Public Health, Imperial College London

The departure of the UK from the European Union (EU) will have wide-ranging consequences for public health. The UK first became a member of the EU in 1973 and as a member of the EU for over 40 years, the UK has played a full part in European-wide public health initiatives. These have covered many areas, including food regulations, road safety, air pollution, tobacco control and chemical hazards.

Cross-national approaches to public health are essential when dealing with issues that do not stop at a country’s borders (eg. air pollution) and when dealing with large, multi-national corporations over which any single country will have only limited influence. Although EU public health initiatives have had important positive effects on health in the UK, there will be strong resistance from pro-Brexit politicians in participating in future programmes, as they generally view them as unnecessary interference in the UK’s internal affairs. The UK will also find that it is no longer able to lead such programmes or have much influence over their content, which will inevitably damage the leading role that the UK has played in public health globally.

The NHS will also find itself facing major challenges because of Brexit. With over one million employees and an annual spend of over £100 billion, the NHS is England’s largest employer. For many decades, the NHS has faced shortages in its clinical workforce and has relied heavily on overseas trained doctors, nurses and other health professionals to fill these gaps. This reliance on overseas-trained staff will not end in the foreseeable future. For example, although the Secretary of State for Health, Jeremy Hunt, has announced that the government will support the creation of an additional 1,500 medical student places in England’s medical schools, it will be more than 10 years before the first of these extra medical students complete their medical courses and their subsequent post-graduate medical training.

The recruitment of overseas-trained health professionals has been facilitated by EU-legislation on the mutual recognition of the training of health professionals. This means that health professionals trained in one EU country can work in another EU country without undergoing a period of additional training. For example a cardiologist or general practitioner trained in Germany would be eligible to take up a post in the NHS. Moving forward, it’s unclear that this cross-EU recognition of clinical training will continue. As inward migration to the UK looks to be the most politically contentious area in our post-Brexit future, we will need to take urgent action to ensure that the NHS has sufficient professional staff to provide health and social care for our increasingly ageing population.

The UK’s government will also have to address the issue of access to healthcare, both for EU nationals living in the UK and UK nationals living overseas in countries such as Spain. Currently, all these individuals are entitled to either free or low-cost healthcare. It’s unclear what will happen in the future, and this is particularly important for the UK nationals living overseas, many of whom are elderly and who will have a high level of need for healthcare. As the NHS has never been very effective in reclaiming the fees owed to it by overseas visitors to the UK, the UK may find itself substantially worse off financially when new arrangements for funding cross-national use of health services are put in place.

In conclusion, Brexit will have important impacts on public health and health services, with scope for wide-ranging adverse consequences for health in the UK. It’s therefore essential that public health professionals engage with government to ameliorate these risks and also gain public support in areas such as the benefits of participation in EU-wide public health programmes and the continued recruitment of health professionals from the EU.

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