Swimming Upstream: Inter-Professional Learning provides the key in tackling the spatial determinants of health Colin Thunhurst PhD Patricia Bond PhD Rachel Richards PhD

Outline West Midlands Health & Wellbeing Strategy Mapping the relationship with the Regional Spatial Strategy Inter-sectoral Action requires Inter- Professional Learning Opportunities for Inter-Professional Learning Beyond Learning to Action – organisational implications

Acknowledgements In this presentation we will be drawing upon work that we have undertaken for the DoH West Midlands on behalf of the West Midlands Teaching Public Health Network Thanks to Rowena Clayton (DoHWM), Ginder Narle (WMTPHN), Cathleen Manancourt (WMTPHN) and other colleagues in WMTPHN

West Midlands Teaching Public Health Network

Our Vision To increase the standard, range and availability of public health training in the West Midlands, in order to improve the health of the region’s population The National Lead on: Inter-professional learning (IPL) in public health Engaging partners Ethnic minority health

West Midlands Health and Wellbeing Strategy adopts an upstream model

Planning Transport and Health Housing and Health Environment and Health Economy Skills and Health Culture Leisure and Health Safer and Stronger Communities Health analysed through underlying determinants rather than ‘priority issues’

Mapping and Aligning Policies at the Respective Levels

WMH&WS Planning Transport & Health Housing & Health Environment & Health Economy Skills & Health Culture Leisure & Health Safer and Stronger Communities Health Inequalities Social Inclusion Demographic Change Mental Health WMRSS Urban RenaissanceRural Renaissance Diversifying and Modernising the Economy Modernising the Transport Infrastructure Communities for the Future Prosperity for All Quality of the Environment Accessibility Objectives of the West Midlands Regional Spatial Strategy (WMRSS) and the West Midlands Health & Well-being Strategy (WMH&WS)

WMH&WS Planning Transport & Health Housing & Health Environment & Health Economy Skills & Health Culture Leisure & Health Safer and Stronger Communities Health Inequalities Social Inclusion Demographic Change Mental Health WMRSS Urban RenaissanceRural Renaissance Diversifying and Modernising the Economy Modernising the Transport Infrastructure Communities for the Future Prosperity for All Quality of the Environment Accessibility Children Young People and Families Later Life + +/- Key: + indicates WMRSS supports objectives of WMH&WS - indicates WMRSS conflicts with objectives of WMH&WS +/- indicates WMRSS may either support or conflict with objectives of WMH&WS Mapping the Objectives of the West Midlands Regional Spatial Strategy (WMRSS) and the West Midlands Health & Well-being Strategy (WMH&WS) at the macro level Cross-cutting Themes Cross-cutting Themes ++/-

Children Young People and Families Later Life Key: + indicates WMRSS supports objectives of WMH&WS - indicates WMRSS conflicts with objectives of WMH&WS +/- indicates WMRSS may either support or conflict with objectives of WMH&WS Mapping the Objectives of the West Midlands Regional Spatial Strategy (WMRSS) and the West Midlands Health & Well-being Strategy (WMH&WS) at the micro level Cross-cutting Themes Cross-cutting Themes Planning Transport & Health Modernising the Transport Infrastructure WMH&WS Improved Accessibility Increased Social Inclusion More Active Transport Less Road Accidents Less Air Pollution/ Noise Improved Built and Natural Environment Enhanced Community Participation and Partnership Working Health Inequalities Social Inclusion Demographic Change Mental Health WMRSS T1: Developing Accessibility and Mobility T2: Reducing the Need to Travel T3: Walking and Cycling T4: Promoting Travel Awareness T5: Public Transport T6: Strategic Park & Ride T7: Car Parking Standards and Management T8: Demand Management T9: Management and Development of Transport Networks T10: Freight T11: Airports T12: Priorities for Investment Communities for the Future Prosperity for All Quality of the Environment Accessibility All

From Mapping to Shaping Inter-Professional Learning A full understanding of the inter-relationship requires a developed systems mapping exercise (in the manner of the Foresight Report) However, more important than achieving an ‘accurate’ representation is establishing a medium, through which public health practitioners and spatial planners institute and maintain regular dialogue Inter-professional Learning

The health dividend relies on seeing the big picture and the detail at the same time

“Devil in the detail”: The challenge Develop a fully shared purpose – Build mutual understanding – Appreciate the scope of each others areas of work Build mutual goals into core business plans A “regional” understanding

Vision: to strive beyond “the accepted” to “what might be possible ” The potential for new conceptual models of healthy urban planning New patterns of connection, collaboration and alignment New ways of sharing knowledge Communities of practice

What could help? Additional principles and pre-requisites need embedding in the system: 1.A commitment to seeing these regional strategies as a continuous process 2.A commitment to build relationships 3.A commitment to collective action as a holistic process that recognizes the many disciplinary and professional interests of the collective.

Inter-sectoral strategy development requires Inter-Professional Learning Interprofessional education has been defined as "occasions when two or more professions learn from and about each other to improve collaboration and the quality of care" (CAIPE 1997). Based on the principles of organizational and educational psychology it provides a pedagogic model to underpin service realignment and integration IPE is not about "dumbing down" disciplinary intervention; neither is it about multiskilling. Rather it is a process that offers continuity and facilitates ongoing trust among professionals

Opportunities: IPL A Common set of professional values relating to public sector governance A history of interdisciplinary working The shared goal of creating “sustainable communities”. No national overview of healthy urban planning skills A Shortage of competencies to support the sustainable community agenda (Egan Review, Association for Sustainable Communities) Absence of generic skills training Collaborative working, Project management, Public engagement.

Advancing Inter-professional Learning Tools exist to assess the health implications of planning applications Professional bodies are on board The professions have comparative CPD requirements The sustainable skills agenda could provide common IPL content Opportunities for IPL at prequalifying levels are scant

Inter-sectoral strategy development requires Inter-Professional Learning Translating IPL into practice is a complicated exercise, requiring: – models of service planning that allow for measurement of change, as a function of the collaborative (teamwork) experience. – Structures that facilitate IPE for collaborative practice – Stability and sustained action

Organisational Implications Moving out of our silos – Organisational Alignment – Institutional commitment – From supportive partnerships to active joint working Breaking down the barriers between statutory agencies and third sector organisations

Contacts Colin Thunhurst Patricia Bond Ginder Narle