1. APHO’s Technical Work Paul Fryers Deputy Director – East Midlands PHO Technical Advisor – APHO

2. Overview of APHO’s technical agenda  PHOs have responsibility for leading the development of public health intelligence resources and methodology  APHO’s role is to co-ordinate this work in order to make the most efficient use of a substantial national highly-skilled and experienced workforce  The technical work programme for PHOs is overseen by APHO Technical Group working with the APHO Technical Advisor to improve the strategic direction of this work  Looking ahead to identify priorities for methodological development  Building skills and capacity across the public health workforce  Increasing use of ‘best practice’ analytical methods  Providing robust and consistent data and information resources  Providing tools and toolkits to support public health analysts  Act as a central point of contact with other national organisations, e.g. Department of Health, Office for National Statistics, NHS Information Centre, etc.

3. APHO Groups APHO Exec Business & Comms Technical Group Website Steering Group HES Tech Group Health Profiles Team GIS Group Training Group? Lifestyles Group Content Management Group

4. APHO Technical Group  Bi-monthly meetings, with representation from  Each of the 12 UK and Ireland PHOs  Subgroups  Links with other APHO groups – Exec, Business & Comms, Website Steering Group and key external bodies, e.g. NHS Information Centre  Tech Group acts as an information sharing forum, support group and oversees national technical projects  Discusses data or methodological issues being tackled by PHOs  Ensures PHOs know what each other are working on  Presentations or updates from major APHO projects  Presentations from external organisations on relevant work  Co-ordinates and oversees a central programme of major reports and projects, both externally commissioned and core work  Co-ordinates training and capacity-building

5. Technical Briefings  Short briefings, giving guidance on key analytical methodological issues  Aimed at analysts, but intended to be accessible to interested health practitioners, to promote the use of ‘best practice’ public health intelligence  Briefings published on:  Sources of data on lifestyle risk factors in local populations  Statistical process control methods in public health intelligence  Commonly used public health statistics and their confidence intervals  Target setting in a multi-agency environment  Current and proposed briefings:  Social marketing segmentation  Measuring health inequalities  Using small area data  Prevalence modelling  Smoking prevalence data  Analysing trends and forecasting

6.  Web tools  Health inequalities intervention tool  Funnel plots for directly standardised rates and proportions  Disease prevalence models for CHD and COPD  Health inequalities toolkit  Lifestyle survey toolkit  On-line indicator search tool  Spreadsheet tools  Life expectancy calculator  Prevalence models for CHD, hypertension, stroke and COPD  Funnel plot tools for count data, rates (including directly standardised rates), proportions and indirectly standardised ratios (SMRs)  Standardisation and confidence interval methods Analytical tools and toolkits

7.  Analyses inequalities by:  Quantifying the current life expectancy gap at birth within local authority (LA) areas, and between ‘Spearhead’ LAs and England  Identifying the diseases contributing most to the life expectancy gap in each area  Models the extent to which the life expectancy gap can be reduced by increasing the provision of four high impact interventions:  smoking cessation  anti-hypertensive prescribing  statin prescribing  reducing infant mortality  Helps public health to ‘compete’ for resources by building the evidence base for public health interventions  http://www.lho.org.uk/NHII Health Inequalities Intervention Tool

8. Data resources  Health profiles  Provide comparative indicator sets for benchmarking of health outcomes and treatment patterns, to identify the needs of populations  Printed profiles for each local authority  On-line resource, updated more regularly  Basket of indicators  Alcohol profiles  Health Poverty Index

9. Other reports and publications  Indications reports  Regional and sub-regional summaries of public health issues  Lifestyle and its impact on health  Ethnicity and health  Child health  Sexual health  Mental health  Alcohol  Older people  Information briefings  Health Profiles  National Library for Public Health  Health Service Journal data briefings – many short topic-based reports  Several other ad-hoc reports

10. Summary  Strengths  Most analytical staff across the network are very enthusiastic about doing collaborative work: it builds their experience and gets the work they do to a larger audience  The very wide range of skills and experience across the network means that we have huge potential capacity and capability to do innovative and high-quality work  APHO has delivered  Weaknesses  For most staff, APHO work is still an extra to their day job. Regional PHOs are under huge pressure to deliver their local work programme: accountability is to the Regional NHS body  There is a very small pool of people who do most of the strategic APHO work  There is a sense that some PHOs contribute more than others, which undermines the principle of collaboration for mutual gain

11. Thank you paul.fryers@nhs.net