Enabling Effective Delivery – A challenge
Tuesday 16 June 2009
Chair: Judy Jones, Deputy Director, Department of Health
Speakers: Yvonne Doyle, Regional Director of Public Health, NHS South East Coast , Richard Jarvis, Health Protection Agency , Gary Cook, Stockport NHS Trust
Judy Jones chaired this plenary, aimed at looking at challenges for public health from local, national and regional perspectives. She began by citing an expression she had heard over lunch: “surfing the edge of chaos”, which she felt was apt in describing the current state of public health. She went on to say that FPH members and government needed to predict the size of ripples and waves, and be ready to ‘surf’ when the time was right. Judy outlined the Department of Health’s (England) current important workstreams including the Secretary of State’s heath and wellbeing review, looking into matters such as the role of the state, and the effect of DH policy on leadership and workforce on public health delivery.
Speakers gave their personal reflections on the current and future challenges for public health.
Yvonne Doyle spoke of the big challenges for regional directors of public Health (RDPH) within the context of an economic downturn. For her, efforts need to be channeled into harnessing technologies to improve health, and for RDPH’s to provide leadership. Yvonne was passionate about the development of leadership skills at local, regional, national and international level arguing that knowledge was the core of public health training but that development of leadership came from attitude, ability to work with disparate organisations, good media and communication skills, and an aptitude for harnessing and valuing ‘stars’ of the workforce. These leadership qualities were crucial when addressing the demands of higher expectations, instant response, and lack of workforce capacity.
Gary Cook opened by describing his route to his current employment at an acute trust through analysis of clinical effectiveness, and research and development. The projects he has led on or coordinated have brought together radiologists, PCTs, GPs, physiotherapists and public health professionals to reduce unnecessary lumbar spine x-rays effectively and a similar diverse mix of specialists to analyse hip fracture incidences. For Gary, it is crucial for public health to ensure that the specialism is represented in these networks in order that unique skills can be ulitised. He described national challenges as being to reverse, or at least balance, the trend for top down approaches and to ensure public health is represented in clinically-driven projects and studies or the skills imported to other staff. Linking into commissioning bodies was also seen as vital.
Richard Jarvis spoke of the challenges for health promotion. He contextualized this within the overarching themes of governance of public health through revalidation, configuration, the role of change and professional identities. He felt that it was essential that public health is objectively comparable with other medical specialties and must also consider non-medical consultants in due course. He noted that a small incremental change to configuration improves efficiency but, conversely, a major change does harm and effects efficiency for three years. Therefore there is a task to persuade politicians and others that major reorganisation is not an effective strategy. Richard also felt it vital to celebrate the diversity of the profession of public health; not to only concentrate on the director of public health but to embrace the role of professionals like the health visitor as a vital element of the broader public health improvement picture.
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