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Life expectancy has gone down in my term of office. I am the first President of the UK Faculty of Public Health who has had to admit that, in 47 years.

Why beat about the bush? Austerity kills. We can now be clear that the – “un-‘natural experiment’”–austerity, has indeed made poor people poorer, made inequalities in health wider, and killed people.  Economic depression is a phenomenon, ‘austerity’ is a political policy. Austerity policies have killed large numbers of people in Britain who would otherwise still be with us.

Austerity kills. There has been a flood of reports in the last six months alone, and their links are buried in this blog – please do them the courtesy of clicking on them and bringing them back to life -they deserve and need it! On overall life expectancy, the Society of Actuaries reported in March that life expectancy had gone down on average by 6 months, Close on its heals, the Office of National Statistics reported widening inequalities in mortality for women, with women from poor areas dying years before women in rich areas.

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To quote ONS: ‘The gap in life expectancy between the richest and poorest areas of England and Wales has widened during the past decade. Women living in the most deprived parts of England lived an additional half a year less than women in the most affluent parts of the country in 2015 to 2017 compared with 2012 to 2014. The corresponding figure for men was four months. Men in the most deprived areas could expect to die 9.4 years earlier than counterparts in the richest places, while for women the figure was 7.4 years. “We’ve found a large fall in life expectancy at birth among women living in the most deprived areas in England,” said Ben Humberstone, deputy director for health analysis and life events at the ONS. “This has led to a significant widening in the inequality in life expectancy at birth in England. Wales mirrored this pattern, although significant changes were not detected,” he said.’

A review of recent trends in mortality in England, acknowledged that life expectancy has levelled off, and indeed decreased for women. They point to a range of factors which are contributing to this- not a single issue, but effects of drug-related deaths, infant deaths, deaths from flu? dementia, lower respiratory disease, a rise in strokes, and cardiovascular disease no longer going down as fast as it should be. However, between 2010-12 and 2014-16, life expectancy in the more deprived areas in England increased more slowly than in the least deprived areas. In addition, female life expectancy in the most deprived decile areas has decreased since 2010-12 and inequality in life expectancy has increased. Inequality in male life expectancy has fluctuated over time but increased since 2011-13.

This analysis indicates that whatever is causing the reduction in the rate of improvement, it is affecting the most deprived areas more than the least deprived areas, and that widening health inequalities has exacerbated the slowdown in improvement. There is also some recognition that social care cuts might be a factor.

In a damning editorial in the BMJ David Taylor-Robinson and colleagues described our child health unravelling.  The rise in infant deaths and the widening of inequalities between rich and poor is alarming and should be a wakeup call that not all is well in the public health world. Infant mortality is this most fundamental of public health measures and a marker for a new public health emergency. More babies dying should not happen in a rich country, but it is. Our infant death rate is now higher than Cuba’s. It cannot be attributed to worsening behaviours, or poorer treatment; the causes are upstream in the advance of child poverty and destitution and the worsening conditions and services in our poorer neighbourhoods.

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Nearly 200,000 more children live in poverty now than in 2010 & more than half are aged under 5. At a population level, fewer children are likely to get the best start in life & more are at risk of poor lifelong outcomes. Other manifestations of our neglect of young people’s health can be found in the Nuffield Trust report on international comparisons of adolescent health, and a warning from Britain’s head teachers, describing schools as the unofficial emergency service for the victims of Britain’s poverty, This is a crisis & must be urgently addressed.

Between 2004–05 and 2017–18, the share of those in headline poverty that are in working households grew by 10 percentage points (from 48% to 58%), and for severe poverty it grew by 26 percentage points. In May, ONS data showed ‘an astonishing difference in the risk of avoidable death between the rich and poor.

We are letting down the next generation. Leaving them potential victims of destitution, knife crime, modern slavery and homelessness. We owe our children more.

The politics of austerity is the politics of cruelty. On an average day in the UK, 3700 people are forced to visit a food bank, 5400 suffer domestic violence, 4750 sleep rough on the streets…There are daily stories of children being hungry in school and in school holidays. Food bank usage continues to rise.

Food charity cannot be the answer. We continue to ignore the root causes of poverty and suffering in favour of short-term charitable relief? Baby equipment banks are now springing up, catching up with food banks. Long recognised problems of fuel poverty are now joined by stories of period poverty. Universal credit changes will hit the poorest hardest. In my BMJ Editorial with Alex Bax, President of the Faculty of Homelessness and Inclusion, we described the escalating problem of homelessness and the health care crisis it is creating.

The word destitution has been brought back into use- conveying a sense of extreme and absolute poverty. 1.5 million people, including 365,000 children, were destitute in the UK at some point during 2017. They could not afford to buy the bare essentials that we all need to eat, stay warm and dry, and keep clean. There is no longer a welfare safety net- national and local government, and utilities, are the biggest creditors on the least able to pay. And people are being sent to prison for civil debt. 

UN Rapporteur, Professor Phillip Alston returned to the UK in May and compared British government policies to the era of the Victorian workhouse. 14m people live in poverty despite the UK being 5th richest economy in world; 40% of children in poverty within 2 years; millions in work dependent on charities, people joining gangs to avoid destitution and a shocking rise in food banks. And, in a reprise of 17th Century philosopher Thomas Hobbes famous quote, the UK’s poorest facing “nasty, brutish, solitary, and short” lives.

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What to do about it?

There is an owners club in reports on the ‘wider determinants of health’ and rightly, a clamour for health in all policies approach from our governments.

Poverty is bad for the nation’s health and also for its economic efficiency. Ten years after the Marmot report, it is completely clear that we have gone in exactly the opposite direction, in policies and in investments, that would have continued to reduce inequalities in health. Worse still, the national policies have gone completely in the opposite direction, wilfully creating more inequality. Following Acheson report recommendations in1998, health inequalities narrowed in the years to 2010, with real political will and local implementation of national policies. It is notable how much progress was made narrowing the gap between rich and poor areas on childhood mortality during the 2000s. The policies implemented were reinforced by Marmot in 2010. Early years support was a key and central recommendation of Acheson and Marmot. I attributed improvements in past pieces for FPH, to the ’Surestart Generation’ (a better name than ‘Millennials’?) There was a raft of evidence-based policies implemented from 1997: Surestart, Surestart-Plus services for teenage mothers, Surestart maternity grant, but also the minimum wage, working families tax credit, new deal for employment, Decent Homes Standard and a reduction in child poverty of half a million. And when we talk ‘millennials’- they are no longer smoking, drinking, having babies as teenagers- might that not also be a ’Surestart effect’? Ben Barr, Clare Bambra and colleagues  have now provided some evidence to back up this view, and so has the Institute of Fiscal Studies, in its evaluation of Surestart programmes.

Marmot also highlighted a need for tax policies reducing inequalities in income. The poor pay more proportionately, in tax than do the rich. Reform of tax systems and the overall national and local provisions for taxation need urgent review.  As major corporates and the super-rich avoid tax, the case for property, land and location taxes  become more compelling. Danny Dorling’s book ‘All that is solid’ describes the nightmare of UK housing policy and some of the remedies; buried in them, fair and proportionate property tax for high value properties.

England spends less on social care per person than Scotland and Wales, and the gap has widened since 2010/11. Today, England spends £310 compared to £445 in Scotland (43% more) and £414 in Wales (33% more). For many eminent public health authorities this is a driver of inequalities in health and the observed reductions in life expectancy.

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Cuts in local government budgets have fallen disproportionately on the poorest local authority areas. I share the view that we must redress the cut in social care- I would go as far as to say we should fully fund social care from taxation. We must also rebuild public health investment in local authorities in England and in all health systems. And there must be place in our comparatively wealthy country, for greater investment in an NSH – a National Service for Health.

Throughout my presidency I championed the Welsh Wellbeing of Future Generations Act. This visionary piece of legislation seeks to take political thinking beyond its usual ‘my term of office’ and ‘my back yard’ and offers Public Health Wales the chance to scrutinise all policies for their health and health inequalities impact. All health systems in every political administration need this provision.

Climate change is a health issue, and an inequalities issue, a cause and consequence of violence and conflict, and interconnected with environmental degradation, loss of biodiversity, creation of trafficking, refugees and slavery. I am pleased that FPH divested from fossil fuels investments last year. But our efforts have been given greater urgency. There has never been a greater need for public health expertise. We need to be resolved and stand together in the fight against darkness and destruction.

Written by Professor John Middleton,
Immediate Past President, United Kingdom Faculty of Public Health,
President, Association of Schools of Public Health in the European Region (ASPHER)
Honorary Professor, University of Wolverhampton,
Visiting Professor, University of Chester.

In 2017 I was in ST5 and getting ready for my first consultant interviews. This blog follows on from my earlier blog sharing my top tips gathered for Consultant job applications during the final stages of Public Health Specialty training.

After a great application, you will get your invitation to attend interview. Generally, those I was invited to attend contained details about the interview panel and format, e.g.  situational judgement/ psychometric test, role play with actors (memories of Part B!) or a presentation.

Research the interview panel through online searches, particularly if you are applying outside of your training zone and you don’t know them. Knowing that a Councillor on the panel has an interest in smoke free playgrounds and e-cigarettes is softer intelligence that can give you an edge over other candidates.

Real-life Consultant experiences

The biggest preparation that you can do for a job interview is consultant level on-the-job learning, shadowing and experiences in the year beforehand. You will collect examples and stories which you can use to answer interview questions. Use these real-life experiences to show that you are ready and capable to be a Consultant and hit the ground running.

Interview Questions

Use the library of interview questions you gathered earlier in the year from recently qualified Consultants. Think about themes from Job Descriptions and Person Specifications e.g. Leadership/ Change Management/ Commissioning/ Media/ Collaboration/ Continuing Professional Development or Learning Needs. Develop two to three examples using a simple answer framework (Situation Action Outcome Reflect).

Don’t forget the Part A and Part B frameworks from years gone by – you might get asked a technical question or a ‘how would you?’ question.

Look at some useful online resources too: –

https://www.healthcareers.nhs.uk/i-am/working-health/information-doctors/medical-specialty-training/consultant-interview

http://careers.bmj.com/careers/advice/Great_answers_to_tricky_consultant_interview_questions

Have a sensible question to ask of the panel at the end, but never ask a question that you could have found out in the recruitment pack or clarified beforehand (e.g. terms and conditions). You want to leave the panel with a positive impression as you exit the room.

Interview Presentation

Be prepared to deliver a presentation on the day – this might be sent out to you in advance or might be on the day. Either way, make sure you know and can talk about the organisation’s values, local & regional challenges and aspirations.

Consider the wider stakeholder context through websites, public health indicators and reports, plus any recent local press or social media. In one interview, knowing that there had been a recent avian flu outbreak meant that I had read up on outbreak responses and considered wider migrant worker health needs in my response.

Don’t be scared to ditch PowerPoint, unless you are specifically asked to provide one. I know some interviewees that have arrived with flash cards and props, making their point very effectively and memorably.

Clearly describe what you know about the role and organisation, what experience you have and what you can do for them.

Practice makes perfect!

Invest your time in interview preparation and presentation practice with buddies and Consultants to get feedback and ‘test’ examples. Set yourself interview questions when driving or making a cup of tea and talk out loud; it will help you refine your answers, being clear and succinct.  I tried recording myself; awkward I know, but this helps refine the waffling.

Unique Selling Point

You have worked hard training to become a Public Health Consultant, so what makes you special and stand out? What are you going to say about you? What is your ‘unique selling point’? Ask your colleagues and peers for informal feedback to boast your confidence and give ‘live’ examples for interview regarding personal qualities, leadership style and what makes you a good Consultant.

On the day

Arrive in good time, breathe, do your best and good luck!

Written by Hayley Mercer, Screening & Immunisation Lead – Public Health Consultant, Public Health England, North West

You can follow Hayley on Twitter

 

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I joined the Faculty of Public Health a year ago. I work across health and transport sectors but hadn’t ever joined a professional body before. Going to the Faculty of Public Health conference in Peebles in 2016 and 2018 broadened my interest in Public Health.

I joined FPH and attended an Introduction to Pubic Health event in London and then a training day in Manchester, led by Professor Gurch Randhawa from University of Bedfordshire on evaluation of joint interventions.

I was really enthused by the course run by FPH and liked the idea of inviting Professor Randhawa to Aberdeen and it was a very enjoyable experience working with FPH to arrange delivery of the course.

We had 25 attendees on the day and the event was held in the Beach Ballroom, a real Ballroom by the beach if you ever visit Aberdeen. The event took place on May 16 and the feedback has been extremely positive. Many of the attendees felt it should be re-run for the benefit of my Health & Transport Action Plan Steering Group members.

My advice to anyone thinking about joining the Faculty is to do so, it will certainly introduce you to new colleagues. Personally, I’ve found it helpful to belong to something collective as my role can be isolating at times.

I’ll end with thanking Nikol and Gurch for helping arrange the event and support my work around adding strategic value to partnership working across health and transport issues. I also thank CIVITAS PORTIS and Nestrans for funding the event, making it free for attendees.

Written by Andrew Stewart, Aberdeenshire Council (post jointly funded by NHS Grampian and Nestrans)

The publication of the Scottish Public Health Priorities2 in 2018 provides an opportunity to consider the future direction of public health as part of Public Health Reform1. How can oral and dental health contribute to the wider public health landscape? This is something that I along with the Consultants in Dental Public Health and Chief Administrative Dental Officers Group in Scotland have considered. In this blog post I want to share some of our key findings and messages.

The risk factors for oral diseases are the same as for other non-communicable diseases

If I mentioned poor diet, excess sugar intake, alcohol and tobacco use as risk factors for non-communicable diseases, what conditions immediately spring to mind? Type 2 Diabetes? Coronary Heart Disease? Cancer? Well in the mind of a dental professional those same risk factors might lead them to consider dental caries, periodontal disease and oral cancer. There is a high degree of overlap in the risk factors for oral disease and other non-communicable and chronic conditions which affect our population. Therefore we can use a common risk factor approach3 to ensure we have consistent messages and exert the greatest influence in our prevention activities.

Dentists are well placed to routinely see a “well” population

In a recent survey4, 73% of adults reported they had attended their dentist in the last year. Many of these patients will be attending for routine check-up appointments with no specific problems or symptoms. Therefore, the dentist might be the only healthcare professional a “well” patient sees for a while, why you ask is this important? Well, this provides a unique prevention opportunity, with dental professionals able to identify risk factors, such as smoking, alcohol intake or diet at an early opportunity and provide evidence based behaviour change advice and support such as referral to stop smoking services. As outlined in the Scottish Government’s Oral Health Improvement Plan5 there might also be the opportunity to explore the possibility of dental teams providing general health checks to aid the early detection of non-communicable diseases such as diabetes.

We have shown that investment in prevention pays

Childsmile the National Oral Health Improvement Programme for children in Scotland was first established in 2006. Every child in Scotland has the opportunity to benefit from Childsmile, from the toothbrushing packs and free flow drinking cups handed out by Health Visitors to all children and the universal supervised toothbrushing programme being offered in nursery schools. There is also targeted provision of fluoride varnish in priority nurseries and schools, and the extension of toothbrushing into some primary schools. Research6 has been able to demonstrate cost savings associated with spending on prevention activities. Within three years the nursery tooth brushing programme was shown to have recouped its annual expenditure through savings on actual and anticipated dental treatments. Indeed the programme was recently recognised by the EU Commission as an example of public health best practice7.

We still have a long way to go

Over the past 10 years, oral and dental health professionals, along with our varied range of collaborators have made huge improvements in the oral health of the Scottish population. We have high seen significant increases in the percentage of the population registered with a dental practice8 and have decreased the percentage of the Primary 1 child population suffering from dental disease by around 25%9.

However, we still have much left to do. By the start of primary school nearly a third (29%) of children will have dental decay at a level where treatment is required. We still see a huge inequity in the oral health of our population, with those living in areas of deprivation experiencing significantly poorer oral health as well as marginalised groups such as those experiencing homelessness.

Action can, and must be taken to harness existing momentum and build new and innovative actions to address the inequalities we see. Using a common risk factor approach, and recognising the clear cross cutting issues which affect dentistry, oral health and general health will be key. Action on oral health will result in improved health and wellbeing for our population. Indeed, we cannot strive to have good health for our population without improving oral health.

  1. https://publichealthreform.scot/
  2. https://www.gov.scot/publications/scotlands-public-health-priorities/
  3. https://www.ncbi.nlm.nih.gov/pubmed/11106011
  4. https://www.gov.scot/binaries/content/documents/govscot/publications/statistics/2018/09/scottish-health-survey-2017-volume-1-main-report/documents/scottish-health-survey-2017-main-report/scottish-health-survey-2017-main-report/govscot%3Adocument/00540654.pdf
  5. https://www.gov.scot/binaries/content/documents/govscot/publications/strategy-plan/2018/01/oral-health-improvement-plan/documents/00530479-pdf/00530479-pdf/govscot%3Adocument/00530479.pdf
  6. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0136211
  7. https://twitter.com/CDO_Scotland/status/1141375479309639680?s=19
  8. https://www.isdscotland.org/Health-Topics/Dental-Care/Publications/2019-01-22/2019-01-22-Dental-Report.pdf
  9. https://www.isdscotland.org/Health-Topics/Dental-Care/Publications/2018-10-23/2018-10-23-NDIP-Report.pdf

Written by Jacky Burns, Specialty Registrar in Dental Public Health NHS Fife. You can follow Jacky on Twitter.

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The Centre for Health and Development at the Staffordshire University and the Faculty of Public Health (FPH) held a hugely successful conference at the University on 26th June. Given the current political uncertainties and the mounting evidence of the public health impacts of austerity on life expectancy and infant mortality in particular, it was perhaps unsurprising that an event on ‘Economic, Environmental and Health Inequalities in a time of Austerity’ attracted over 100 registrations from a diverse range of public health professionals, including consultants, practitioners, academics, researchers, nurses, students and community workers.

These delegates were drawn from key public health and partner bodies including Public Health England, the National Instiute for Health and Care Excellence, Clinical Research Network, NHS, Universities, local authorities, the Illegal Money Lending Team, the Modern Slavery Network and the voluntary sector. This ensured lively, productive and, on occasions, inspirational discussion.

The speakers also reflected the diverse and inter-connected factors that impact on public health as well as representing the key bodies and levers for mitigating them. Keynote presentations from Professors Mark Gamsu, John Middleton and Chris Gidlow together with Dr Jacqui Ashdown set the scene for each session with evidence and experience-packed critiques of poverty, welfare, environment, food, economic development, debt, and housing.

The three workshop sessions were themed around living, moving and economic inequalities and provided delegates with expert detail on issues ranging from homelessness to county lines, mental health to obesity, loan sharking to the bedroom tax and all points between. Speakers drew on each other’s experiences and a particular highlight was a speaker going ‘off-piste’ to share his lived experience. Two of the speakers were recent MPH graduates and presented work from their dissertations with great assurance and to enthusiastic response. All three Q/A sessions were lively affairs and contributed to the learning gained. There is a rumour that one of our FPH Professors was completing his online CPD in real time! Presentations were complemented by displays from NIHR, a Big Local community project, North Staffs Financial Inclusion Group, PHE and the cream of the recent FPH #PublicHealthLooksLike photograph exhibition.

In short a powerful and productive public health day; much learned and much more to do.

Watch this space for news of next year’s event!

You can download the slides from the Conference here.

Professor Christopher Gidlow, Staffordshire University

Dr. Patrick Saunders, Visiting Professor of Public Health University of Staffordshire

It wasn’t that long ago in 2017 that I was approaching ST5 and worried about getting my first consultant post. Here are my top tips gathered for Consultant job applications during the final stages of Public Health Specialty training.

Think forward

  • In the last 12 months before the end of training, ask for lists of interview questions from recently qualified Consultants. Use these to undertake a personal SWOT (strengths, weaknesses, opportunities, threats) analysis, then develop an action plan linked to your personal development plan and work programme. One of my gaps was working with elected officials, therefore it was better to know this early and proactively seek out opportunities sooner rather than later.
  • Consider what training and courses there are available as you might need to book on early due to demand. I was lucky to attend a deanery funded course ‘preparing for interview’ with Anna Jackson but the FPH also run a similar course. This really helped with identifying what is my ‘unique selling point’ and frameworks for answering interview questions e.g. (Situation Action Outcome Reflect)
  • Look at what courses are available through the Deanery too. My Deanery provided a Consultant Careers Awareness Workshop, Leadership, Resilience and Educational Supervisor Accreditation. I was also able to access political awareness training through the local authority where I was based.
  • The most impact in my preparation in readiness for Consultant interviews and work life was through coaching and mentorship from new Consultants and a Director of Public Health (DPH). I choose a DPH coach who was quite different in ‘type’ to me.
  • Know about what is important to you in a future Consultant job – a career anchors assessment can help with this. At the time I was applying, I knew I needed a post that offered job satisfaction, stability, supported work-life balance (preferably no on-call) and with a main work base relatively close for school drop off and pick up.
  • Sign up to job alerts (NHS Jobs/FPH Jobs/BMJ Jobs/Jobs Indeed/ Public Health Jobs – Twitter), as knowing what types of jobs that have come up recently gives you a sense of what’s out there. Looking at job descriptions and person specifications also help you identify your gaps so you can work on these before you start applying for jobs.
  • Review and update your CV – it will then be fit for job enquiries. I found this HEENW Checklist useful and asked my Educational Supervisor to review my final draft. Identify your referees and make sure they are happy to be named on your CV or future job applications.

Job Enquiries

When you make that initial enquiry, you don’t know who might pick up the phone. On one of my first enquiries, I thought I would be booking a time slot for a future call but ended up directly speaking to the DPH for 30 minutes.

Think about what are you going to say about yourself and what questions you are going to ask. First impressions count, so even though it’s an enquiry, treat it like an ‘informal’ job interview.

It may sound obvious but before you even pick up the phone to enquire about a job make sure you have checked the following: –

  • Job Description and Person Specification
  • Organisational website and twitter
  • Organisation/DPH/Consultant Team through online searches
  • Local Public Health Outcomes Framework and public health annual report

Use your networks to find out more information about the team and location – Public Health is a small world!

Applications

In advance of ‘the job’ being advertised, start preparing your application: –

  • Ask your Consultant colleagues if they would be happy to share any previous applications they have made with you.
  • Prepare a generic application that can be flexed and adapted for different posts, organisations and job specifications.
  • Seek feedback from your coach, consultant and DPH. They all have experience and insight to offer.
  • Double check your referees are still happy and available to give you a reference and let them know that you have started applying for jobs. Reference requests can get lost in busy inboxes or junk mail folders.
  • Always make sure that any application matches the Job Description and Person Specification, plus use information gathered during your enquiry phone call and pre-visit. Make it easy for the recruiting team to ‘mark’ your application with clear layout and headings.
  • Don’t underestimate the time it takes to complete applications – formats vary considerably depending on the organisation and country.
  • It sounds obvious, but if known from the advert, protect the date of the interview in your diary. It’s hard to get an alternative date for an interview, so if you know there is a clash with another important event, let the recruiting team know in advance. If they really like your application, they may try and set another panel date.

Summary

Take control of the consultant job application process through your individual strategic plan.

The biggest preparation that you can do for a job applications and interviews is on-the-job learning, shadowing and experiences in the year before hand. In future weeks I will be sharing a blog on interview preparation.

Be confident as you have passed FPH exams and gained a wealth of experience through training – now is the time to get your first Consultant post! Good Luck!


Written by Hayley Mercer, Screening & Immunisation Lead – Public Health Consultant, Public Health England, North West

You can follow Hayley on Twitter

You may also find this bog from Kathryn Ingold on transitioning from Registrar to Consultant.

Community cardiopulmonary resuscitation (CPR) teaches people living in the local community the basic skills of delivering chest compressions and artificial breaths until lifesaving defibrillation can take place for people that have suffered a cardiac arrest (their heart has stopped beating). Many causes of cardiac arrest are reversible with the right treatment, but without CPR and early defibrillation people do not survive long enough to receive these treatments. On average only 10% of people who suffer a cardiac arrest outside a hospital setting will survive. This figure more than doubles when the victim receives community CPR(1).

History of CPR

We haven’t always had this valuable skill at our disposal. People have been trying to resuscitate victims of cardiac arrest since the 1500s, with varying levels of success. By the 1800s the accepted method of treating cardiac arrest became surgically opening the chest and massaging the heart by hand(2). The first publicised mention of CPR as we know it today appeared in Journal of American Medical Association in 1961, entitled ‘Closed Chest Cardiac Massage’. The revolutionary new technique was an alternative to the currently accepted technique of open heart massage(3).

Community CPR in the East Riding of Yorkshire

The East Riding of Yorkshire is a predominantly rural locality. Precious minutes can be lost before victims of cardiac arrest receive CPR, making community CPR even more important. The local council is offering free 1 hour drop-in sessions on CPR and defibrillation to their employees and the public, giving people the opportunity to feel more confident about what to do if someone close to them suffers a cardiac arrest be it family, a friend or someone on the street. The events are advertised using the council intranet and Facebook page and have been received very well. 100% of the feedback collected has been positive and all attendees reported improved confidence performing CPR and using a defibrillator. The council also took part in the British Heart Foundation’s ‘Restart a Heart’ day, raising awareness and training around 50 employees in CPR. There is a common misconception that you have to have a qualification to perform CPR on somebody. The truth is that is you have the knowledge, you can use it to try and save someone’s life.

Automated external defibrillators (AEDs) talk you through how to deliver an electric current to restore a person’s own heartbeat. There are over 100 publicly available AEDs in the East Riding of Yorkshire and Hull, a number the council and partners have worked hard to increase(4). When you call 999 the operator will direct you to the nearest AED if needed, and give you the code to open the safety box. AEDs are much less useful when CPR does not take place – something the council has recognised in its efforts.

The Yorkshire Ambulance Service are also working to address this issue with a successful community responder scheme. Community responders are normal people who are trained to provide initial lifesaving treatment and help to bridge the gap until paramedics arrive.

Community responders carry portable AEDs and are often able to reach the people who need them much faster.

Does it work?

chain of survival

The resus council recognises a Chain of Survival for Cardiac Arrest, which includes: early recognition of cardiac arrest and calling for help, early CPR to buy time and early defibrillation to restart the heart. When each link in this chain is strong, chances of survival can rise to over 50%(5), but if one part of the chain is delayed this percentage drops dramatically.

FAQs

‘Is it difficult to do?’

Research has shown that life-saving skills such as CPR can be taught successfully to children as young as 10 years old, whereas younger children aged 4 and above have been shown to be capable of calling for help and operating an AED correctly(1). In fact the Department of Education has plans to add CPR and first aid to the curriculum by 2020(6).

‘What if I hurt them, can I get sued?’

When a person has a cardiac arrest they are effectively dead. You cannot make the situation worse, but you may save their life. Sometimes you can crack a rib when giving CPR, but broken bones will heal and are a small price to pay for your life. No one in the UK has ever had legal action brought against them for trying to help someone by giving them CPR(5).

‘How can I get involved?’

The worldwide annual Restart a Heart Day courtesy of the British Heart Foundation takes place on the 16th of October. Why not raise awareness and join the millions of people all over the world learning CPR to keep each other safe. You can also look out for local BHF Heartstart schemes which run free 2 hour courses across the country. The easiest way to learn about CPR is via the British Heart Foundation website where you can browse their free information and videos.

References

  1. Plant. N, Taylor. K. (2013). How best to teach CPR to schoolchildren: A systematic review. Resuscitation. 84, 415-421
  2. CPR & First Aid Emergency Cardiovascular Care . (2019). History of CPR. Available: https://cpr.heart.org/AHAECC/CPRAndECC/AboutCPRFirstAid/HistoryofCPR/UCM_475751_History-of-CPR.jsp#10. Last accessed 25/4/19.
  3. CLOSED CHEST CARDIAC MASSAGE-P. Safar. Anesth. Analg. -Vol. 40:609 (Nov.-Dec.) 1961.
  4. OpenStreetMap. (2010-2019). Defibrillators in HU postcode area.Available: https://osm.mathmos.net/defib/progress/HU/#11/53.7516/-0.5493. Last accessed 9/7/1
  5. Resuscitation Council (UK). (2019). Frequently asked questions: CPR.Available: https://www.resus.org.uk/faqs/faqs-cpr/. Last accessed 10/5/19.
  6. Resuscitation Council (UK). (2019). CPR Education Campaign: CPR to be added to the school curriculum. Available: https://www.resus.org.uk/campaigns/cpr-education-campaign/. Last accessed 9/7/19.

 

Written by Isabella Price, FY2 Doctor in Public Health, East Riding of Yorkshire Council