The Contribution of Allied Health Professionals to Public Health Evaluation Summary Report Marie Griffiths Public Health Network Cymru Coordinator March 2018
Introduction
Public Health Network Cymru based within Public Health Wales provides a range of support to practitioners and researchers across all sectors that influence any aspect of public health and health improvement in Wales. Amongst the services they provide is a seminar series that seeks to promote best practice based on existing and emerging evidence. The series covers a diverse range of topics and recent examples have included topics such as Behaviour Change and Addictive Behaviours and Healthy Minds for Future Generations: Promoting Dementia Risk Reduction. The topics are determined by the network members who vote on a list of approximately 12 topics that are circulated annually and Allied Health Professionals was within the top 4 voted for by members. The Network arranged a planning group to aid in the shaping and contribution of the seminar. This seminar took place on the 14 March 2018 and was hosted at the Brangwyn Hall, Swansea. The seminar was chaired by Judi Rhys, Non-Executive Director at Public Health Wales. Judi welcomed everyone to the event and spoke about her understanding of Allied Health Professionals and of her personal experiences with several services.
Overview of Presentation The day was opened by Dr Gill Richardson, Assistant Director of Policy, Research and International Development within Public Health Wales. Gill spoke about the role of Allied Health Professionals and how they are an important part of Public Health. This was followed by two presentations, Judith John – Welsh Therapy Advisory Committee and Linda Hindle – Allied Health Professions Lead, National Engagement Lead Police, Fire and Ambulance Services within Public Health England. Judith spoke about the recently published Strategic Framework for Allied Health Professions and how
across the range of their services and through their contacts with large numbers of the population, to make a valuable contribution to public health outcomes. Linda presented on the ‘Evidence and Impact of Allied Health Professions Contribution to Public Health’. Linda shared information on the role and successes of Allied Health Professions in England and what has contributed to those successes. Individual presentations are available by contacting publichealth.network@wales.nhs.uk or can be accessed on the Public Health Network Cymru website.
Parallel Sessions Three workshops were held during the afternoon: • Developing the Workforce: Huw Griffiths, Physiotherapist, Cardiff and Vale University Health Board and Jonathan Morgan, Physiotherapist, Aneurin Bevan University Health Board • Demonstrating Impact: David Hughes, Manager and Clinical Lead, Abertawe Bro Morgannwg University Health Board; Lisa Williams, Community Dietitian, Cardiff and Vale University Health Board; Angela Jones, Podiatrist, Cardiff and Vale University Health Board; Claire Butler, Speech and Language Therapist, Aneurin Bevan University Health Board and Sue Koziel, Speech and Language Therapist, Abertawe Bro Morgannwg University Health Board. • Health and Wellbeing Across the NHS: Mathew Tidball, Physiotherapy Lead Staff Health and Wellbeing, Abertawe Bro Morgannwg University Health Board; Rachel Turner, Occupational Therapy Lead, Abertawe Bro Morgannwg University Health Board; Alison Clarke, Assistant Director of Therapies and Health Science, Abertawe Bro Morgannwg University Health Board and Emma Holmes, Dietitian, Cardiff & Vale University Health Board
Evaluation Form 51 people registered via Eventbrite for the event and 43 attended on the day. The seminar was also live streamed via Twitter and a total of 84 people viewed the seminar. An evaluation form was given to all delegates at the end of the event and 19 forms were returned. An email was sent to all delegates following the event asking for the completion of evaluation forms but none were returned.
Quantitative Results The first question asks delegates whether or not they were members of Public Health Network Cymru. It is interesting to note that the majority of delegates were not members of the Network (63%). This may largely be due to the event flier being distributed amongst stakeholders recommended by the seminar planning group, however the Network had 17 new member registrations in 1 week following the seminar.
Are you a member of Public Health Network Cymru ?
Yes
37%
No 63% Another question on the evaluation form asks delegates to rank from one to five, (where one is not at all useful and five is very useful) how useful did you find the seminar. As can be seen the majority of people answered 4 or 5 (89.5%) to this question with 10.5% (2 people) providing the answer of 3. Following a closer look at the evaluation forms there was nothing to indicate why these 2 people gave the answer they did.
How useful did you find the event?
4
53%
5 (Very Useful)
37% 3 10%
Qualitative Results Further questions on the evaluation form looked for a qualitative response which is detailed below.
What was your main motivation for attending this event?
The majority of delegates attended the event to learn more about the AHP role and gain more knowledge of public health. Some also wanted to learn more about how they can incorporate public health into their role. I wanted to learn about the AHP role and how I can support / promote this in my work Find out more about AHP role in PH and how we can support it. Interest in how it can be implemented into my clinical practice in learning disabilities
Was there anything that was of notable interest?
A number of people mentioned Linda Hindle’s presentation on the work in England as being one of the highlights of the day. Other speakers were also mentioned including David Hughes and Ruth Crowder. Making Every Contact Count also received a lot of interest. Excellent, inspirational speakers - Linda Hindle and Ruth Crowder David Hughes' work! The various systems available to take MECC
How do you plan to utilise the learning gained at this event?
Many of the delegates said that they would share the information gained at the event with colleagues and would make more efforts to incorporate public health into their everyday work. Utilise some of tools on PHW website etc. E.g. Logic model. Embed public health into staff PADR, JD Incorporate public health agenda into inservice training and between SMT at VCC. Ensure MECC happening at Velindre. Network with colleagues so the right people are linked into the right forums for influencing AHP roles in Public Health.
What seminar / conference topics would you like to see delivered in the future? The topic areas that delegates said they would like to see covered in future events were varied. The Network wouldn’t be able to provide events on some of the topic areas stated as they are too specific but would be able to direct delegates to other more relevant organisations: • • • •
Using IT in Public Health Social Prescribing How different AHPs measure competency MECC
It is worth noting however that Nutrition and Early Years was suggested and this is an area that the Network is already investigating for a future seminar.
Other Comments Delegates had an opportunity to provide any further comments they had about the event. There were only 2 negative comments from the day and these were in relation to disruption during one of the speeches and a particular staff group not being mentioned as an AHP. This was due to the fact that Biomedical Scientists are not listed in the ‘Public Health Strategic Framework for Allied Health Professions’. Thank you for an inspiring day! Very interesting and enjoyable conference To make these seminars a regular event
One Word Participants were asked to give one word to sum up how they felt about the event. These words have been inputted into Wordle (www.wordle.net). Wordle generates word diagrams that give greater prominence to words that appear more frequently in the text. From this you can clearly see that informative, interesting and excellent were stated most frequently.
Further Information Further information and a short video of the day is available on the Public Health Network Cymru website or by contacting publichealth.network@wales.nhs.uk
Appendices Workshop Notes Developing the Workforce Who are the most useful people / organisations to help AHP’s in this area? • AHP’s • Collective professional body • Diverse group • Links between professional groups • Understanding each other’s position • Network • Knowing what is available • Public Health Network • Central point of contact • Creating professions community • Raise profile • Senior Management • Step change • Learning from exemplars • Including private sector • Ourselves • Profile – shouting – Learn from other organisations • Buy in – from everyone • HR – workforce • Commitment • Be useful • Citizens • Curriculum – across the community • People need to know where to go… • Public Health – link to the Action Plan
Barriers /Issues
Solutions
• Time capacity to put across message /time to spend with patients • Research big commitment • Understanding showing success • Modelling in workplace with colleagues/skills of the workforce, need to train and develop • Confidence of staff to have the conversations • Motivational interviewing – key skills staff need , ensuring all staff access it , new starters • NB pre registration training needs to pick up
• Need mechanism for sharing information on public health network cymru – who ? • Use our leaders – Chief Therapy Advisor , need a Lead Public Health AHP • Focus on Public health in pre registration training • Strategies – needs to be part of Health Education Improvement Wales and development of the AHP workforce • Link with professional bodies across the UK • Develop champions across AHPs and across HB’s
Demonstrating Impact What are the Strengths / weaknesses / opportunities/ threats for AHP’s in this area?
Strengths
Weaknesses
Opportunities
Threats
• • • •
Expertise Diverse Skills Knowing audience Using graduates
• Health & Wellbeing boards • Promote Selves
• • • • • • • • • • • • • • • • • •
Diversity of role Spread message / awareness/influence Parliamentary Review Collective knowledge base Collaboration / shared understanding Isolated in workplace Unique skill mix Thinking outside the box Public Health Dietician / Everybody’s role Role / purpose Wide range of opportunities / contacts Time with patient / client / staff member Threat – educating others & own staff Comfortable to have conversations Improved collaborations required Reducing Gaps Training/ appropriate skills Support
• We are human… • We don’t promote ourselves as a profession
• • • • • • •
Change financially Getting buy in Temperature Priority?? How to change perception Not knowing what’s recent… The message changing constantly
Barriers /Issues
Solutions
• Lack of service design and improvement methodology early on in training and career • Need to reinforce and embed early on • Use the current scoping exercise as a baseline to enable evaluation • MECC – how do you demonstrate actual impact? Or is it ‘The right thing to do’ • Access to information about own service but need more about other services and develop shared outcomes • Don’t have enough information about other services e.g. directory of services – is this DEWIS aim • It needs to be at the centre of what we do • Data appropriate outcomes – same for all AHPs • WCCIS potential for silo of information, this needs to develop a consistent approach with all AHPs • Gathering data issues finding appropriate tools data collectors ned to know • Not following people up to look at outcomes recording .use of the electronic record
• Referral forms available on line • Centralised up to date service directory • Social prescribing, consistent and collective approach • Mandate for PROMS for AHPs – led by Directors of Therapy and Health Sciences and Chief Therapy Adviser • Develop the same tools across all national groups across the whole pathways utilising national PROMS projects and patient experience - Aneurin Bevan example • ‘Clinical activation’ – need to believe in it and use the data, currently doing it but not recording it, need better IT systems to make it easy and usual practice • MECC needs to be more of a Health Board priority to embed across Professions e.g. immunisation services less confident initially or hadn’t thought about it but now doing it • Co productive approach, legally responsible • BHF house of care model • Use current evidence base – don’t re invent the wheel • Sharing – uni professional and multi professional • Patient self assessment /measuring, non validated tools – still valuable • Use NWIS support patients to be measuring • Culture – shift- the right thing to do – change culture of professionals •
Health and Wellbeing across the NHS Ways AHP’s can ‘Lead by Example’ Protecting their own health & wellbeing and that of their colleagues • • • • • • • • • • • • • • • • • •
Sensible Footwear/ preventing falls Regular Exercise Role Model Making Change Environment / Ergonomics Culture *change* Regular Breaks / Lunch Healthy Choices Removing Guilt Treating each other well Flexible working policies Empowering Caring Implementing values Senior Support Influencing action plans & change Everyone’s responsibilities Practice what I preach “role models”
• • • • • •
Education – upskill managers Change in culture – supported Relationships with managers – wellbeing support for managers – AHP’s link into stages Identifying own needs & others Including wellbeing as part of PADR/Job descriptions Having conversations regarding evidence that AHP’s can bring