Liverpool Community Health NHS Trust Training Location for Public Health Specialty Registrars 1
Foreword I believe that community health organisations and their workforce play a hugely important role in improving health in our communities. As an organisation, we offer a range of public health services from cradle to grave. We also have senior public health leadership providing advice on how we can maximise our impact on community health. I fully support registrars in public health who are placed with us and in the last year have seen the benefits that registrars can bring to our organisation, through the excellent work they have undertaken. I would really encourage you to consider LCH as a training location which I believe will further your career as a future leader in Public Health. Bernie Cuthel, Cheif Executive 2
Why choose Liverpool Community Health NHS Trust as a training location? Unique experience within an NHS community provider setting the new frontier of public health Lead key areas of work at a strategic level and develop innovative new projects Be based in a great city, in a state of the art building with good facilities in a small, friendly public health team 3
Introduction Working in a community trust has been a great opportunity, as it has provided a very different perspective to public health. It has built my knowledge and appreciation of the wide range of clinical services that are delivered out in communities, and the huge potential impact that preventative population healthcare brings. I have found it especially beneficial to understand the opportunities and innovative solutions that provider organisations can contribute towards tackling difficult public health challenges. This experience has given me greater insight into health care services, which I believe compliments and strengthens my public health commissioning skills. Ian Ashworth ST5 Liverpool Community Health (LCH) NHS Trust became an approved training location for specialty registrars in April 2013. Since then one senior registrar has been placed with us. Senior registrars in phase 3 of training are particularly encouraged to consider this as a placement. Rachael Gosling, Consultant in Public Health is employed by the Trust and is an accredited Educational Supervisor. 4
Liverpool Community Health LCH provides health services and care in the community and in people s homes. The overarching strategy of the organisation is to help people live longer, healthier lives and this is underpinned by three core strategic objectives: prevention, integration and growth. LCH provides services across North Mersey, but primarily in Liverpool and South Sefton, covering a population of approximately 600,000. Services are delivered from over 100 locations and frontline staff have contact with more than 2 million patients per year. In 2012, the Royal Society of Public Health awarded LCH its Health Promoting Organisation and Partnerships Award. Please visit the Liverpool Community Health website for further information http://www.liverpoolcommunityhealth.nhs.uk/ 5
The role of public health within a community provider Liverpool Community Health recognises the essential role it has to play in preventing poor health and reducing health inequalities in our communities. This is why prevention is a core strategic objective for the organisation. Our public health strategy has Board level support and has three key elements to it: preventing poor health through our contacts with our patients - making every contact a health promoting opportunity, improving our staff health and wellbeing, and being an organisation that recognises it can play a role in influencing the wider determinants of health. A small team is in place to implement the strategy and LCH also employs its own public health intelligence analyst. LCH also delivers a range of essential public health services, such as a smoking cessation service, the Liverpool health promotion team, community food workers, Sefton public health development nurses and an active ageing service. We also provide sexual health services, prison health services, community infection control and the pan-mersey TB services. Our child health practitioners are at the forefront of delivering immunisations to children and providing public health support and advice in our communities. The role of the Consultant in Public Health is multi-faceted and includes: providing strategic leadership on the implementation of the public health strategy providing expert public health advice and leadership to support the development of high quality equitable services within LCH within an ethical, evidence-based framework providing professional leadership and strategic direction to the development of Public Health services within the organisation. This includes the health improvement delivery team, public health development nurses, and immunisation and vaccinations team providing scrutiny across the organisation on tackling and reducing health inequalities, and promoting, leading and commissioning the use of research and evaluation to enhance the quality and effectiveness of services, interventions and programmes in community healthcare. 6
Opportunities for a public health specialty registrar based at LCH LCH can provide a placement for a specialty registrar at any stage of training. For a registrar at the beginning of training, it provides an excellent opportunity to develop an understanding of key public health services that are commissioned by local authorities, CCGs and NHS England Area teams. At this stage of training, there would be opportunities to be involved in service evaluations, write reports and briefing papers, undertake health needs assessments and health equity audits, shadow senior staff at meetings and develop an understanding of performance management processes. LCH is probably best suited to a more senior registrar who has passed both exams, is consolidating their core skills and is looking to develop specific interests to enhance their career opportunities. There are already a small number of Consultants in Public Health based in provider organisations and increasing interest amongst NHS providers in the important role that public health can play within the NHS - so gaining experience in this setting could be a beneficial career move. There are significant opportunities to develop key pieces of public health work in this evolving role. See the appendix for more detail on this. Did you know that there are a growing number of Public Health Consultants being employed directly by NHS Trusts? Birmingham Childrens Hospital, The Royal Free, Barts NHS Trust, Evelina Childrens Hospital, Lancashire Care NHS Trust and Liverpool Community Health NHS Trust have all recruited to Consultant posts in the last 2 years. Public Health England recently held a national meeting bringing together consultants and registrars working in these settings. 7
A Registrar s perspective I m Ian Ashworth, and started at LCH as an ST5 Registrar in August 2013 having previously passed both FPH examinations. As I was coming into my final year of training, it was a time of taking stock, reflection and thinking about actually where I wanted to focus my attentions given it was my final year of specialist training and I would be job hunting within 12 months! Given the public health transition, I was already fortunate to have experienced a variety of Primary Care Trust placements and had recently worked in public health within new a Local Authority setting. I wanted to add something different to my CV and experience, whilst also wanting to maximise the opportunities that the training scheme offers, but still not distance myself from the new public health landscape. Decision, decision, decisions... The opportunity to join LCH presented itself, and after meeting with Rachael Gosling, and Hannah Chellaswamy, it became apparent I could make a real impact, shaping the future role of Registrars in the organisation. Although the Public Health Strategy Team is small, LCH sees itself has a public health organisation, with over 3000 staff and over 60 services including Health Visitors, School Nurses, Dentists, District nurses, Podiatry, Dietetics, Walk in Centres, sexual health services, etc. all to a population of over 600,000. They also have commissioned Health Promotion Services such as smoking cessation, community food workers, walking and cycling programmes and falls prevention services. As I was quick to appreciate, there are many opportunities to work across all four domains of public health at LCH, and I was given the opportunity to lead on a number of key work areas. The best example of this would be the opportunity to use public health intelligence to help improve patient attendance at clinics. This allowed me direct access to Clinical Leads across the organisation, using internal data systems to develop patient profiles and provide evidence of the barriers that different patient groups may face when accessing LCH services. The work has enabled me to present to Service Transformation Boards, the Executive Team, develop successful business cases, work directly with clinical leads, present to a Joint CCG Performance Review and to the PHE national provider in public health network. 8
From a training point of view, there are multiple learning outcomes that can be easily achieved across each competency area. There are discrete projects of work as well as large scale work streams that Registrars can take the lead on working collaboratively with wider clinical leads, management, workforce and patients across the organisation. All have been friendly, welcoming and supportive, demonstrating their passion to provide the best care and experience for their patients. Working at LCH has given me a more rounded approach to public health, significantly increasing my knowledge of health care services and also developing my leadership skills. They provide specific services that I would be expected to commission within other public health roles. Having this unique insight into provider settings has given me greater confidence to commission this effectively and I would highly recommend that all registrars should experience working within a provider organisation like LCH. 9
Your Educational Supervisor I am Rachael Gosling and I will be your Educational Supervisor. My first degree was in International Development and I spent a few years working abroad before returning to the UK to work in the voluntary sector. I became interested in public health in the late nineties when I co-ordinated a Health Action Zone multi-agency programme improving access to services for young refugees and asylum seekers. I began my public health training in Cheshire and Merseyside in 2002 and have been in post at LCH since completing my training in 2011. I am passionate about reducing health inequalities, building public health capacity across the community workforce and developing the contribution of provider organisations to public health. As your educational supervisor, I will support and encourage you to ensure you are getting the most out of your placement and developing to your full potential. I will also expect high levels of self-sufficiency and initiative from registrars which will in turn maximise your leadership and development opportunities. Please contact me directly if you would like to discuss coming to Liverpool Community Health. 10
Working at LCH - Your base Liverpool Innovation Park is based off Edge Lane in Liverpool, approximately 2.5 miles from Liverpool City Centre. It is a 20 minute walk from local train stations. There is a café on site as well as a comfortable kitchen area to have lunch. Car parking is available at a fee of 10 a month. LCH at Liverpool Innovation Park operates an agile environment, where all staff are required to book a desk or a meeting space. You will of course be provided with your own laptop to enable you to operate efficiently in this environment. The environment is supported by a number of innovative working practices, including the use of the NHS Smart Card for access to the floor and printing; telephone extension mobility; high tech audio visual equipment and wi-fi throughout. For further information Liverpool Council s Joint Strategic Needs Assessment http://liverpool.gov.uk/council/strategies-plans-and-policies/adult-services-and-health/ joint-strategic-needs-assessment/ Sefton s Strategic Needs Assessment (SSNA) http://www.sefton.gov.uk/default.aspx?page=11805 11
Appendix Appendix: Examples of work that could be carried out in LCH against each of the 10 learning objectives LCH could offer projects and learning objectives across the 10 key areas of public health practices. Broad examples of the 9 key areas are presented in the table below, as it is expected that area 10 ethical management of self cuts across all 9. This list is not exhaustive and can be adapted according to the registrars training needs and interests. 12
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For further information, please contact: Rachael Gosling, Consultant in Public Health Rachael.gosling@liverpoolch.nhs.uk Tel: 0151 285 4666 14