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The West Midlands Public Health Community
Fellowship Scheme: an example of partnership working across the health landscape Dr Clare Walker and Dr Emma Hirons
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Public Health is Everyone’s Business
Public health is important – I would say that, wouldn’t I. But so do other people. PH is in Foundation Curriculum General Practice Curriculum NHS 5 year forward view Making Every Contact Count in the Standard NHS Contract Sustainable Transformation Plans Demography Look at this slide. Clinical care only has a 20% contribution to health outcomes. So perhaps we should flip the budget and give 80% of health funding to public health and give 20% to health care. @NHS_HealthEdEng
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And we’d spend it on these kind of things
And we’d spend it on these kind of things. But in the real world medical students and trainee specialists spend little of their time in the community where 80% of health and wellbeing is determined. The WMPHCFS seeks to open a window on this different side of healthcare. And this is how we do it in the West Midlands….
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WMPHCFS What is it? F2 doctors work as volunteers in community organizations on a public health related project over a four month period F2s are placed into project teams and matched with a PH StR to provide leadership and technical support Grew out of similar projects in Wessex and Team Up in London
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WMPHCFS Aims for F2s To gain a wider knowledge of how charitable and voluntary organisations provide services To gain a broader experience of health and wellbeing projects in a different environment To promote closer working with community organisations To have exposure to public health skills, knowledge and values
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WMPHCFS Role of Team Leader Team leaders are StRs in Public Health
Their role is to act as a technical resource as a project manager to keep the project on course to provide leadership to act as a public health role model @NHS_HealthEdEng
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WMPHCFS Role of F2 Differs according to your project. Each team member may have a different task. Be flexible and learn new skills Work 6-8 days on the project, but this may be split into half days or even blocks of 2-3 hours at a time. Be organised – negotiate time off for your project with your clinical supervisors as early as possible.
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Role of Community Organisation
WMPHCFS Role of Community Organisation Offer health and wellbeing projects to work on. Provide practical support and knowhow about the communities they work with. Are hosts, providing teams status as volunteers whilst they work with the organisations. Sponsors of the project and commissioners of the work. And now I’m going to handover to Emma who is was one of the F2s on the Scheme last year who will explain a little more about how the scheme works
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First Contact October 2015 Initial email from WMPHCFS
28th November 2015 Application form deadline 4th November 2015 Information evening 4th December 2015 Successful applicants informed
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Information evening Introduction & background to WMPHCFS
Meet charities & hear about projects Information on application process Information on expectations for scheme Introduction about how plan developed from Team Up etc. Mainly charities related to eye health. Short intro from each charity and then a brief synopsis of project. Not always fully formed plan at this stage. Info from organisers on how to apply – everyone who came to evening would be able to have a place, but also still open for application for anyone who couldn’t attend, but expressed interest. Info on what was expected of us – time spent on project (6-8 days), working in small groups, presentation at the end.
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Application Motivation & benefits = 400 words
Previous relevant experience = 400 words Top 3 community project preferences CV Word document – ed back with CV Short & easy to fill in
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Why apply? Medicine outside of hospital setting
Develop holistic approach Career plans Benefits of volunteering Medicine outside hospital setting – mainly GP experience, if any by this point in F2. Can develop skills that can be applied elsewhere in working life. Holistic approach esp important in GP, Psych, Palliative Care, Paeds (can argue for all specialties). Career plans – for anyone planning on going into GP or PH. For me – Occupational Medicine. Many people enjoy volunteering – often part of the concept of ‘wellness’, giving something back to community. Many will have had previous experience (personal – NH & adaptive rowing)
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Choosing a Project Beacon Vision Focus Birmingham
Accessible Information Standard Focus Birmingham Smoking & eye health in schools Sight Concern, Worcestershire Telephone befriending Beacon Vision: Needs assessment, literature review and recommendations around the new Accessible Information Standard. Charity supports people with visual impairment. Based near Wolverhampton & Stourbridge in West Midlands. Focus Birmingham: Design and delivery of an intervention for use in schools around smoking and eye health and evaluation of the intervention. Looking at continuing the relationship and further dissemination via academic route. Charity for sight loss & disability in Birmingham. Sight Concern, Worcestershire: Literature review, Interviews and business case to inform grant proposal for development of telephone befriending service. Charity supports people in Worcestershire with visual impairment.
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Choosing a Project RAWM 2nd Chance Group Midland Heart
Pre-qualification questionnaires 2nd Chance Group Sports Academy programme, HMP Oakwood Midland Heart Health information booklet for women’s shelter RAWM: Questionnaire survey, semi-structured interviews, desk based review on the requirements of Pre-Qualification Questionnaires and how that might relate to the ability of VCS to complete this stage of procurement for bidding for providing health and wellbeing services Support agency for voluntary & community sector in West Midlands 2nd Chance group: literature review of the place of sport in mental health and wellbeing of prisoners and comprehensive evaluation of the “Sports Academy” programme in HMP Oakwood Charity uses sport for rehabilitation of prisoners. Currently running a programme at HMP Oakwood in Staffordshire. Midland Heart: Worked with residents of women’s shelter to identify needs and produce a booklet to meet those needs containing relevant health information and local services. “Looking After Your Health and Well-being”. Providing hostels, housing & care across the UK plus advice services on benefits etc.
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Choosing a Project? Topic Task Location
Topic – mainly eye health. I chose Sight Concern Worcestershire due to relevance for OH – engaging people with visual impairment as volunteers. Volunteering is often a way back into work after ill health & is beneficial to our well being. 2nd choice was HMP Oakwood – also relevant to OH in sense of rehabilitation. Task – some may appeal more than others, eg. Creating teaching for school, creating a health info booklet. Others may be more interested in literature review, data analysis & stats etc. Location – scheme open to all West Midlands deaneries & charities also spread across West Midlands. I grew up in Worcester so helping with a local charity in my hometown was appealing. Also easy to drive down there & go regularly anyway. Others not so easy to get to (eg HMP Oakwood). Don’t have to spend much time actually at charity base if doing more analysis. Will look at this more in feedback section.
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Getting Started 14th December 2015 Induction morning January – April
Project work January 2016 Meeting with Sight Concern 20th April 2016 Presentation evening
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Induction Morning Meeting team Discussing project Creating plan F2
PH StR Charity Discussing project Creating plan Teams based on interest in project as much as possible. Ranging from 1- 4 F2s. Unfortunately not all charities able to be present. From my experience – charity not able to attend, limited info on project so limited ability to create ideas & plan. Need to align everyone’s understanding of the aim. Usually long term project, working for the charity on something they have started but don’t have the man power to complete. One team member thought the project was only 2 weeks long & wanted something quick to put on his CV.
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Project Work Meeting with Sight Concern Literature review Interviews
Volunteer Service users Investigating telephony options & costings Report & presentation Took a while to get going. Unable to meet charity until after Xmas. Needed Clare to get us going with a plan. Work then shared out.
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Other Opportunities Excellence in Public Health Conference
March 2016, Wolverhampton Academic Trainees Meeting, Warwick University March 2016 Joint Foundation Faculty Sharing Best Practice Event March 2017 Also had opportunities to present work during project Poster at PH conference Oral presentation at Warwick Univ Plus today Currently working on systematic r/v of telephone befriending based on work with Sight Concern. Also seen presentation at Foundation conference in Bristol 2015 from 2 FY2s who presented their version from Wessex Deanery.
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Feedback ‘Post it note’ exercise Focus groups Online questionnaires
Post it presentation evening What went well, what could have gone better, what would change for next time/top tips Focus groups Separate rooms for F2s, charities & PH SpRs Online questionnaire After presentation evening
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Evaluation: F2s 13/18 online responses After taking part in the scheme
Strongly disagree Dis- agree Neut-ral Agree Strong-ly agree I know more about how the voluntary sector works. 1 7 5 I know more about Public Health. 4 3 I would be interested in working with Public Health again. I would volunteer again. 13/18 online responses
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Evaluation: F2s cont. Induction generally useful
Not enough information on project 4-8 days work, mostly free time
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Evaluation: PH SpRs 4/6 online responses (1 SpR excluded)
Yes No Did you gain the leadership experience you expected? 4 Did you discuss your work on the scheme with your ES? 2 Did you access other support (eg HEE) Would you recommend the scheme to your peers? 3 1 4/6 online responses (1 SpR excluded) All agreed that mentor training prepared them adequately for the role
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Evaluation: Charities
Strongly positive Positive Neutral Negative Strongly negative How was your experience of working with the F2s? 2 How was your experience of working with the PH SpRs? 1 Overall how positive was your experience? 3 4/6 online responses
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Evaluation: Charities cont
All would recommend the scheme. All felt profile raised by the scheme. All felt expectations met by the scheme.
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What Went Well Teams Projects Other opportunities to present work
Well organised & good communication Enthusiastic Supportive supervisors Projects Interesting High quality work Helped charities to progress Other opportunities to present work
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What Could Have Gone Better
Project planning Brief from charity & attendance at induction Project selection Remote team working Geographical spread of team & project Secure lines for communication Single F2 in team F2 rotations & study leave PH StR input Project planning – more time for charities to plan projects & give more detailed brief to team. Also helps if can’t attend induction. Some projects difficult to manage (eg. Security issues for HMP Oakwood) so may need to be planned much further in advance or avoided. Remote team working – geographical spread of team members & project. Some FY2s suggested allocating team based on geograhpical location, but would limit choice. All F2s from central & northern schools. None applied from South. Team with single F2 felt experience would have been better with peers. Other F2 concerns – change rotation halfway through so new rota. Can’t plan work since rotas not out early enough. Suggested should coincide with start of rotation. Also concerns that can’t get study leave – needs to be formalised so not using annual leave & free time etc in future. Difficult to manage work since interviews during this period too. Some SpRs found it difficult to gauge how much to be directly involved with work. Difficult to deal with non-committal team members on virtual platform. Felt F2s needed to take more ownership of work.
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Cohort 2 Changes Whole timetable moved forwards
New recruitment strategy Awareness raising Relationship building with hospital foundation administrators Job Description for team leaders FAQs for F2s No induction evening @NHS_HealthEdEng #insertcampaignhashtag
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Cohort 2 Continued Peer support sessions for PH StRs
More than one F2 per team Tried a ST5 PH StR mentoring an experienced ST1 StR to run a project Working with the statutory sector as well as voluntary sector eg SEMH pathfinder
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Sustainability and development
Aim To find a sustainable model of working that is: as inclusive as possible Promotes participation by disciplines other than medicine Cost neutral or attracts funding And where risks to the scheme are reduced
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Threats This Scheme has no funding
Lead needs PH expertise to help organisations shape initial project ideas Lead role is time consuming No admin support Juggling numbers of F2s, StRs and projects If opened up to more disciplines more complex to administer
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Opportunities Doing good Enhance experience of F2s and StRs
Open up this experience to other disciplines eg. StRs leading subject specific groups mentored by PH StRs Multidisciplinary groups Improve visibility of PH across West Midlands Deliver the health improvement agenda
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Thanks to HEE West Midlands
Postgraduate School of Public Health Dr Ruth Goldstein, Consultant in Public Health Sally James, Public Health Workforce Specialist Dr Rob Cooper, Head of School Head of Foundation Schools Dr Andrew Whallett, West Midlands Central Dr Anthony Choules, West Midlands North Dr Michael Walzman, West Midlands South
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And thanks to HEE Wessex Team Up, London
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Thank you for listening
Dr Clare Walker, StR in Public Health and Honorary Research Fellow in Health Sciences, University of Warwick Dr Emma Hirons, GPST, Postgraduate School of General Practice, West Mildands E. W.
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