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Archive for the ‘Public Health Training’ Category

By Brendan Mason FFPH, Chair of the FPH Education Committee

The Faculty of Public Health (FPH) is exploring the potential of credentialing, as a means of making careers in public health more flexible and strengthening governance. The General Medical Council (GMC) defines credentialing as: “a process which provides formal accreditation of competences (which include knowledge, skills and performance) in a defined area of practice, at a level that provides confidence that the individual is fit to practise in that area…”

The work is overseen by FPH’s Education Standing Committee. In 2017 a task and finish group, under the able leadership of David Chappel, was set up to explore the background to credentialing and how it might benefit public health. Credentialing has also been raised as a potentially important development by Fit for the Future, The Shape of Training report, Health of the Public 2040, and Facing the Facts.

FPH, supported by Public Health England, held a workshop on 8 February 2018 to bring together interested parties to discuss what the benefits of developing public health credentials might be and what we need to do next to develop them. Thirty-eight individuals attended the workshop.

There was widespread discussion both in small groups and plenary about both ‘post completion of speciality training credentials’ in fields such as health protection as well as a ‘public health credential’ for groups outside the core workforce doing public health work. FPH has a potential role as a ‘credentialing body’ which develops and awards a credential.

I have a number of personal reflections on what I heard on the day. The small groups all independently came up with a very consistent common message on credentialing after completion of speciality training. Speciality training is part of a process of lifelong learning, and mechanisms that already exist, such as continuing professional development and revalidation appraisal, are sufficient to ensure appropriate development in a consultant post. The curriculum is facilitative and its implementation in the delivery of training should prepare specialists for appointment to their first consultant posts. Consultants will then develop their professional knowledge and skills throughout their subsequent career.

A second common theme from participants was questioning the need for a specialist-level credential that covered part of the curriculum. For me these concerns were consistent with the FPH position that all specialists should demonstrate competence across the whole of the current curriculum at the point of specialist registration. There is a danger that such credentials would simply reinvent ‘defined specialists’.

The development of the wider public health workforce was seen as an important objective. The question for me that arose from these discussions was the form of this development: should it be a ‘regulated credential’, a ‘credential’ or some form of ‘certificate’ in public health.

Credentialing is a complex area. Credentials could take many forms and are a proposed solution for many real and perceived problems. Credentials may not always be the most effective or efficient way to address these problems. When a credential is an appropriate solution its development and implementation will require a partnership between a number of organisations. A credentialing body, such as FPH is necessary but not sufficient. A credential will need to be commissioned (funded) and the necessary training delivered by an educational provider.

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By Renu Bindra FFPH, Consultant in Communicable Disease Control, Public Health England @RenuBindra

The Selection Centre: the night before

Hurriedly pack suitcase to get to the selection centre by 4pm. Two dull hours on the motorway enlivened by an aeroplane that looks like it’s about to land on top of the car – the selection centre is in Loughborough and very close to East Midlands airport. Gets me every year. This year – and for the third year running – I’m marking the written exercise. All candidates are assessed by written test, group exercise and six (!) panel interviews. As a bonus (sarcasm intended), written selectors have to sit the test themselves a few days before selection, and Sunday afternoon is when we meet to compare answers and iron out any niggles (questions have already been peer-reviewed). Very relieved to find that I got all the answers right – the exercise requires good basic mathematical skills so I would have been mortified to have screwed up! The exercise also assesses qualitative analytical skills which are harder to mark – thankfully, a rigorous and well-tested framework helps us structure our marking. We finish by 5.30 – a quick change of clothes and I hit the hotel gym – only to find it closes at 6. Manage 20 minutes on the treadmill which I choose to run on an incline (ouch) in vague preparation for the Yorkshire 3 Peaks later this spring.

The Selection Centre: Day One

Quick breakfast where I meet Liz – public health consultant and fellow selector from the Highlands and Islands. I wonder if she’s had the longest journey to get here? Talk about our relative working environments; I thought some of my work journeys were long but hers definitely win! Head over to the morning briefing where we go over the selection process from start (application) to finish (offers issued in March). All candidates are assessed at every station against a range of skills: organisation and planning, conceptual thinking and problem-solving, communication skills, learning and professional development.

Walk past a nervous-looking gaggle of candidates about to go into the panel rooms. I’d love to stop and say something nice, but reassure myself they are being escorted round by a team of lovely and calming public health registrars who have experienced the process themselves.

Meet up with my fellow selectors where we get into our allocated pairs and go through the running order. As with all of public health we’re a diverse bunch working in defence public health, community provider organisations, academia, local authority and Public Health England. At around 10am the first batch of scripts arrive and we get stuck in. It takes a while to get into a good rhythm but we eventually get the hang of it and within an hour we’ve cleared the first batch. All scripts are double marked and at the end of each batch we work with our partners to compare scores. Where there is marked deviation (very rare) we work through the marking schedule to see if we can moderate our answers, referring to the lead if we get stuck.

Top tips for the written exercise from today’s selectors:

  • Stay calm and read the question carefully
  • Make sure you answer all questions – allocate your time!
  • If you mainly use a computer at work, practice your handwriting – we can’t guess the answer if we can’t read it!
  • Try and structure your answer as clearly as possible, using all the space available.

Five cohorts marked today and then we are done! Time to treat myself to a longer session in the gym followed by a dip in the pool, before we repeat the whole process again tomorrow. Good luck to all candidates!

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By Sarah Payne

I have the privilege to be a Health Education England (HEE) academic fellow this year, taking up my fellowship just as summer was throwing us an extra few weeks of warm weather to take forward into the Autumn. My first weeks were a blur of getting my feet under the table in my new home, the Nuffield Department of Primary Care Health Sciences at Oxford University, meeting new colleagues and setting out my plan for the year ahead. I was then straight off to a week-long intensive course to learn the art of changing people’s behaviours – courtesy of Susan Michie and colleagues at the University College London Centre for Behaviour Change. And what a week it was! Not only was it a great course but it was a great way to kick off my fellowship year, providing lots of inspiration and a ‘to-do list’ as long as my arm to get stuck into when I returned to the office.

Developing a suitable research project and securing research funding for it was one of the aims of my HEE academic fellowship, so I was thrilled when I found out I had been successful in securing an award, from the British Heart Foundation, to fund my proposed research project – investigating ways to help people with high blood pressure reduce their salt intake. Cue a short but wild celebration – short because the funding was contingent on having ethics approval for all elements of the research in place before the award would be given. So, duly inspired from my behaviour change course and brimming with enthusiasm to delve into the literature to understand more about the target behaviour I hoped to change and effective behaviour-change techniques to do so, and to spend some quality time developing a behaviourally informed intervention… I was faced with ETHICS FORMS! Hmmm….not so inspiring, though of course a critical part of the process.

Thankfully, the HEE fellowship provides a perfect bridge to support the development phase of my work, allowing me to prepare detailed research protocols and all the associated documents that support an ethics application for my proposed research and to begin some of the training in research skills needed to carry out the research. As well as fulfilling the immediate requirement to secure my longer term PhD funding, the process of preparing ethics applications has forced me to consider the finer details of my research and really think through how I will deliver it. I’ve had great support from my supervisors and my department – including the opportunity to gather valuable statistics feedback from the regular department Stats Coven!

So, a slightly different focus for my first six months than I had planned, but it has so far been a fulfilling and interesting time, as well as suitably productive. I’ve attended a couple of other short courses, both of which have helped to keep my ‘inspiration and enthusiasm’ barometer high. I’ve attended various department seminars and workshops and had an opportunity to meet and network with other PhD students. Naturally, I’ve also learnt the ins and outs of the various ethics processes and undertaken some training in research integrity and good clinical practice!

So onward and upwards. I have submitted my ethics applications and I’m in the midst of the lengthy process of amendments and waiting… and waiting… Perhaps I will use some of this time to explore that behaviour change literature-base I’ve been waiting to get to. Maybe there are even the beginnings of a systematic review in sight…

Sarah Payne is a Health Education England Academic Fellow

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By Mark Weiss, FPH Policy Officer

As the Health and Social Care Bill makes its journey through the Committee Stage at the House of Lords, FPH continues to actively engage with members, key stakeholders, parliamentarians, as well as through its representation on strategic working groups and supported by its wider media work.

Committed to ensuring the Bill will provide the structures and safeguards necessary to protect and improve the health and wellbeing of the people of England, FPH is working hard to ensure a strong and viable public health workforce is maintained and strengthened for the future; and a rigorous framework for the statutory registration and regulation of all public health specialists to protect the public is established. 

As we continue to press hard for amendments to the Bill, at the forefront of our minds the risks to the public posed by the Bill – E.Coli, SARS, pandemic flu, Buncefield, heatwaves, flooding, immunisation and screening – loom large. To meet this challenge, with Lord Patel taking a lead on FPH’s amendments, we maintain a focus on statutory regulation; the role, qualifications and accountability of directors of public health; the organisation independent of Public Health England; public health expertise in the new NHS Commissioning Board; employment conditions for public health professionals at parity with the NHS.

Over the past few months, FPH has developed and implemented a firm lobbying strategy. We have written to all MPs and peers taking part in the Health Bill readings in both the House of Commons and Lords, setting out a clear case for our amendments to the Bill. We have the support of a broad range of peers from across all political parties – and have regular meetings with peers to discuss the possible impacts of the Bill in the context of public health.

We are also working with other health and public health organisations through our chairing of the PHMCC task group, and actively engaging with local government colleagues – including producing a joint statement with the Local Government Group. We also have representatives on key strategic groups, including the Public Health England Group (feeding into the development of the PHE Outcomes Framework) and the Workforce Advisory Group and have taken an active involvement in the NHS Future Forum Process with a submission recently sent in for the Second stage. FPH also maintains close working relationships with other faculties, Royal Colleges and stakeholders to share information and horizon-scan.

Informing our position, three member surveys have been conducted to ensure that we are engaging our members in a full and meaningful dialogue. At present we are in the process of analysing the results of our latest survey of members’ views of the Health Bill, with a full analysis to follow shortly. In addition, FPH works closely with its Local Board Members to encourage their active engagement with local MPs and relevant stakeholders.

Our lobbying work around the Bill has been supported by our wider media work, delivering news articles including a recent response to the Health Select Committee 12th Report on Public Health appearing in the Guardian (a copy at this link); and letter to the Times outlining our key concerns with the Bill. In turn our monthly bulletin continues to keep all of our 3,500 members abreast of the latest developments.

For all the latest news on our work on the reforms visit www.fph.org.uk

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By Matthew Day, Public Health Registrar, NHS Wakefield District

When I started my public health training I had a three day local induction to get to know colleagues and learn from a range of speakers in public health from around the Yorkshire and Humber region. I found it useful as it provided inspiring insights and top tips on how things work in the specialty, as well as the time to connect with new colleagues. But while different deaneries strive to bring local trainees together through induction programmes and local events, how would it work nationally?

The idea of developing a ‘corporate identity’ for public health trainees was floated at the recent Public Health Futures event, organised by Sir Muir Gray and the Informing Healthier Choices team. Despite sounding like management speak, the fundamental point is a good one. While we all fight different public health battles at local, regional, and national levels, a better networked public health workforce developed through years of training would only be of benefit.

Sir Muir described his vision of the CMO welcoming all the new trainees personally. I can imagine the event: a handshake and pat on the back each, the CMO maybe throwing in a visionary comment about future public health challenges:

Trainee 1: “Er…hello Sir….

CMO: “Welcome to our specialty, son. Go forth and reduce inequalities…”

And then at the induction dinner that evening:

Trainee 1: “What did he give you?”

Trainee 2: “Coronary heart disease.”

Trainee 1: “You think that’s hard, I got inequalities…”

Jokes aside, rather than a pie in the sky idea, the underlying concept of a ‘national public health bootcamp’ for the new 2010 trainees has some merit.  Trainees 1 and 2 would stay in touch, collaborating, sharing and not duplicating important work on their interrelated subjects. In fact, this vision was already being taken forward after the event in the shape of the new national trainees’ website.

With Sir Liam Donaldson’s video message, and his imminent departure from Westminster, there was also a strong sense of the public health baton being passed on to us. Indeed, the baton we inherit bears the labels of a mix of hefty issues: obesity, alcohol (particularly minimum pricing), sustainability and health inequalities. In a show of hands vote, the majority of trainees in the room voted health inequalities as the single most important issue for our generation.

But very often public health is also about getting the right messages across to an audience, and doing it well. At the event, Sir Muir Gray quipped that “public health is about ‘performance,” and with his keynote speech Sir Michael Marmot gave a master class in how to engage with an audience. Indeed, in the shadow of a forthcoming election where spin-doctors are drawing battle-lines between ‘substance’ and ‘performance’, the message I took from the day as a whole is that we in public health must be experts, world leaders even, at both. We must deliver top-notch quality science and evidence base for our work and continually improve how we communicate that science and evidence base to an audience, be it the public, policy makers or the health sector.

National networking amongst trainees is certainly needed to help develop these skills so perhaps the sooner we’ll be pulling up those boots the better.

  • See the slides from the Public Health Future’s ‘Killer Slide’ competition with some brilliant examples of robust evidence base and great communication skills coming together

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