National Workforce Development Plan for Public Health in Wales
Author: Claire Barley, Head of Professional and Organisational Development
Date: March 2011 / Version: 0a
Publication/ Distribution:
· Public (Internet)
Review Date: Friday 13 May 2011
Purpose and Summary of Document:
The National Workforce Development Plan for Public Health in Wales was commissioned by the Welsh Assembly Government as an action from Our Health Future. The Head of Professional and Organisational Development for Public Health Wales lead the work supported by the National Workforce Development Group for Public Health in Wales. The aim was to develop a training plan for public health in Wales considering all levels and all sectors, partners, stakeholders etc. A number of individuals and teams across the public health system were interviewed and contributed to the information gathering stage and helped to shape the aims and objectives of the plan.
The document in its current format was structured following a workshop with members of the National Workforce Development Group for Public Health in Wales and incorporates both recommendations for the approach to national workforce development and “the plan” which details actions, i.e. the training plan element.
Work Plan reference:
Contents
1 Introduction 3
1.1 Strategic Framework 3
1.1.1 Our Healthy Future 3
2 Current Situation 4
2.1 Wider workforce 4
2.2 Practitioner Level 4
2.3 Specialist Level 4
2.4 Personal / Professional Development and Continuing Professional Development 4
2.5 Regulation and Registration of the Workforce Contributing to Public Health in Wales 5
2.5.1 Wider Workforce 6
2.5.2 Public Health Practitioner 7
2.5.3 Public Health Specialist Level 7
2.5.4 Current situation summary: 11
3 Conclusions from national dialogue 13
3.1 The Time is Right 13
3.2 Demand 13
3.3 Co-ordinated response 13
3.4 Representation at UK level 13
3.5 Europe 14
3.6 Coordinated Approach 14
3.7 Advising Welsh assembly Government 14
3.8 Leadership Role 14
3.9 Wider Workforce 15
3.10 Local Government 15
Local government 15
3.11 Health Boards 15
The Health Boards 15
3.12 Other Public Bodies 15
Other public bodies 15
3.13 Wider Workforce 16
3.14 The time is right 16
4 Aims and Objectives of the Plan 17
4.1 Objectives 17
4.2 Approach 18
4.3 Identifying Opportunities 18
4.4 Establishing Shared Priorities 19
4.5 Implementation, Monitoring and Evaluation 19
5 Recommendations 20
6 The Plan – years 2011-2014 23
7 References 28
7.1 Report of the Chief Medical Officer's Project to Strengthen the Public Health Function http://www.dh.gov.uk/en/PublicationsandStatistics/Publications/PublicationsPolicyandGuidance/DH_4062358 29
7.2 Websites 30
7.3 Public Health Wales Documentation 31
8 APPENDIX 1 - Public Health 33
8.1 What is Public Health? 33
8.1.1 Three key domains of public health practice: 34
8.1.2 The nine key areas for public health practice: 34
9 APPENDIX 2 36
9.1 The public health role of Health Boards in Wales 36
10 APPENDIX 3 38
10.1 Work of the Professional and Organisational Development Team of Public Health Wales 38
11 APPENDIX 4 39
11.1 Extending / Widening Participation 39
12 APPENDIX 5 40
12.1 National Occupational Standards (NOS) 40
13 APPENDIX 6 42
13.1 Public Health Skills and Career Framework 42
14 APPENDIX 7 45
14.1 Specialist information 45
14.2 Success of Wales’ top up support scheme 45
15 APPENDIX 8 47
15.1 What Wales already has in place 47
16 APPENDIX 9 49
16.1 Examples of public health practice from the Third Sector 49
16.1.1 Mentro Allan and the TARRAGAN project 49
16.1.2 Breast Cancer Care Cymru and breast health promotion. 50
16.1.3 The Train the Trainer: Breast Health Promotion Programme 50
16.1.4 Swansea Council for Voluntary Service (SCVS) and the local Health, Social Care and Wellbeing (HSCWB) Facilitator 51
16.2 Examples 51
16.2.1 NHS Direct Health and Well Being Directory 51
16.2.2 Geographically Targeted Work 51
16.2.3 Healthy City 51
16.2.4 Mencap Cymu Health Checks Video Clips project 52
16.2.5 Health and Wellbeing Community Development Officer, Ethnic Minorities Communities First Team 53
17 APPENDIX 10 54
17.1 Individuals interviewed during the evidence gathering stage 54
17.2 Public Health Wales National Workforce Development Group for Public Health: 55
18 APPENDIX 11 56
18.1 Recommendations for Public Health Wales 56
19 Appendix 12 59
19.1 Screening Division Workforce Development 59
19.1.1 BTW Radiography Pathway 59
19.1.2 Assistant practitioners 59
19.1.3 Biopsy takers 59
19.2 NBHSW Screener Pathway 60
19.3 Bowel Screening Wales Specialist Screening Practitioner 60
19.4 Cervical Screening Wales 60
19.5 Future developments 61
Date: March 2011 / Version:0a / Page: 4 of 53Public Health Wales / General document template
1 Introduction
Among the actions of Our Health Future is the development of a public health training plan. This document provides the strategic framework to support the plan (detailed page 21) together with a series of recommendations and actions to support national workforce development for public health in Wales.
Delivering a Five-Year Service, Workforce and Financial Strategic Framework for NHS Wales states that, “a cohesive, motivated and professional workforce” is required to realise the improvement needed to improve the health of the people of Wales. Coupled with the development of a new Public Health Institute the workforce development plan for Wales will build a common foundation of knowledge and skills across the key players contributing to this agenda. This document aims to set out the action necessary to develop a workforce able to deliver what is required for public health across Wales.
This plan was developed following an extensive consultation with individuals across the public health system in Wales, the work has been supported by the National Workforce Development Group for Public Health in Wales (formerly the Wales Centre for Health Workforce Development Group).
1.1 Strategic Framework
1.1.1 Our Healthy Future
This National Workforce Development Plan for Public Health in Wales has been developed to support and underpin the delivery of Our Healthy Future, and the ongoing development of the unified Public Health system in Wales.
A competent workforce is essential to delivering the Welsh Assembly Governments’ commitments and aspirations, leading to effective delivery of public health services in Wales. Recognising, valuing and supporting the whole of the public health workforce across health services, local government, the third/voluntary sector, academia, Welsh Assembly Government and other public services to deliver effectively and efficiently, is key to maximising impact and cost effectiveness.
2 Current Situation
There is a vast array of individuals, professions and organisations that contribute to public health, working at different levels across the workforce. The acknowledged levels are detailed below (further information is available from the Public Health On-line Resources for Careers, Skills and Training - PHORCaST website (http://www.phorcast.org.uk ):
2.1 Wider workforce
This group includes those who have a role in health improvement, protecting health and reducing inequalities but who would not necessarily regard or immediately identify themselves as part of the public health / health and wellbeing workforce. Such individuals may be highly recognised and highly financially rewarded. Alternatively, they may be unpaid volunteers seeking to make a difference in their communities.
2.2 Practitioner Level
Practitioners spend the major part or all of their time in public health practice. They increasingly work in multi-professional teams and include people that work with groups and communities as well as with individuals. There are also those who use their research, information, or public health promoting skills working in specific public health fields. They have knowledge and in-depth skills for their particular areas of practice and are a valued and a vital part of the workforce. Not all individuals who work at this level would necessarily identify themselves as “public health practitioners” as they may be aligned to other professional bodies (additional information below).
2.3 Specialist Level
This includes consultants and specialists who work at a strategic or senior management level or at a senior level of scientific expertise such as in public health statistics. At this level, an ability to manage change, lead public health programmes and work across organisational boundaries is crucial as are technical skills for example in epidemiology, health promotion or healthcare evaluation.
2.4 Personal / Professional Development and Continuing Professional Development
Individuals aligned to or members of professional / regulatory bodies will usually have specific requirements in relation to continuing professional development. Very often (and where regulation / registration is a requirement to maintain the right to practice) individuals will be involved in processes called re-validation (see section 2.5.3) – proving that their competence is up to date and that the individual is fit to practice. In cases where revalidation is essential, individuals have a strong driver to participate in appropriate learning and development.
All individuals should be actively encouraged to continually develop themselves professionally, to ensure they are up to date on their knowledge and that the application of their skills is appropriate. However, where there are no statutory requirements to demonstrate this, the motivation for development is reliant on the individual and / or the employing body. This is more challenging for the wider public health workforce where public health may not be the main focus of the role and the employer has limited recourses to support the said personal and professional development.
This plan is aimed at addressing such issues by providing and signposting opportunities for individuals, professions and organisations to engage and participate in a wider variety of opportunities aimed at supporting public health workforce development across Wales.
2.5 Regulation and Registration of the Workforce Contributing to Public Health in Wales
Review of the Regulation of Public Health Professionals 2010
In early 2010, Sir Liam Donaldson, (the then Chief Medical Officer for England) and the Devolved Administrations commissioned a review of regulation of public health professions in the UK. The views expressed throughout the review “provided some clear messages,” including strong support for a system of statutory regulation and a desire to avoid the requirement for multiple registration with different regulators. The recommendations of this review (November 2010) have been considered alongside the recommendations of this plan, although a final position on the status of the review’s recommendations is not yet available.
In support of all individuals and organisations across those roles which do or could contribute to public health the UK Public Health Skills and Career Framework has been established(The following is taken directly from the Framework: (http://www.phru.nhs.uk/Doc_Links/PHSkills&CareerFramework_Launchdoc_April08.pdf)
The Public Health Skills and Career Framework is a tool for describing the skills and knowledge needed across all groups, domains and levels of the public health workforce. It was developed in response to the strong expressed need for a mechanism that facilitates collaboration and coherence across this diverse workforce, in order to maximise its collective contribution and underpin the influence of public health in the UK. The Public Health Skills and Career Framework provides this by helping to ensure rigour and consistency in skills, competence and knowledge at all levels, regardless of professional background, and by enabling flexible public health career progression. Some barriers such as varying Terms and Conditions, pension rights etc remain as restrictions to free movement across the public health workforce.
The framework is for any individual who practises or participates in public health, and any organisation that employs people in public health roles or roles with a public health aspect to them. This will include local authorities, the NHS, the voluntary sector and the private sector. The framework is designed as a tool for individuals at any stage of their career to identify a pathway for skills and career progression, vertically or horizontally.
2.5.1 Wider Workforce
There are many professions, organisations, individuals etc. which go to make up “the wider workforce”. A well recognised part of the wider workforce is the voluntary and third sectors which contribute significantly in Wales to public health delivery, although formal recognition of this activity is often limited, or at least, not well understood.
Existing public health provision by the third sector stems from various drivers:
· Within many individual third sector groups and organisations, the provision of health information and awareness services has been identified as essential within their own strategic aims and objectives and is carried out as part of their core service activity
· Driven from strategic priorities set out in public health policy (Our Healthy Future, local level Health, Social Care and Wellbeing Strategies, Children and Young People Strategies) funding has been allocated to some third sector organisations by the statutory sector or charitable grant providers such as the Big Lottery, to undertake public health initiatives and appropriate actions
· County Voluntary Councils and Health Social Care and Wellbeing Facilitators work with the local voluntary sector and their community to support local implementation of Health Challenge Wales and Change4Life initiatives.
· The third sector often works closely in communities with marginalised and minority groups, which means it has an essential role to play in reducing and eradicating health inequalities and health inequities to ensure effective delivery and support for public health action and initiatives across communities in Wales.
Examples of a number of public health activities recently carried out within the third sector have been reproduced at appendix 9. The examples demonstrate some of the types of third sector activity contributing significantly to the wider public health workforce.
The third sector has neither an allocated, specific Sector Skills Council nor access to dedicated resources for the provision of learning and development to support public health capacity building (workforce development). Multi-professional learning opportunities and working collaboratively across all sectors will bring the benefits of increased sharing and appreciation of skills and knowledge, strategic working and greater local and national impact. With the more efficient use of workforce development resources and funding for public health development, there would be demonstrable improvements to quality and effectiveness across all sectors contributing to public health.
Regulation and registration of this part of the public health workforce (apart from those individuals trained in a particular profession (e.g. nursing)) is not universally recognised or available. Workforce development or individual learning and development is at best ad hoc and there are therefore new opportunities to integrate and encompass the wider workforce into the proposed actions of this plan.