1. The West Midlands Public Health Community
Fellowship Scheme: an example of partnership
working across the health landscape
Dr Clare Walker and Dr Emma Hirons

2. 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

3. 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….

4. 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

5. 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

6. 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

7. 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.

8. 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

9. 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

10. 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.

11. 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

12. 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)

13. 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.

14. 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.

15. 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.

16. Getting Started 14th December 2015 Induction morning January – April
Project work
January 2016
Meeting with Sight Concern
20th April 2016
Presentation evening

17. 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.

18. 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.

19. 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.

20. 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

21. 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

22. Evaluation: F2s cont. Induction generally useful
Not enough information on project
4-8 days work, mostly free time

23. 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

24. 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

25. Evaluation: Charities cont
All would recommend the scheme.
All felt profile raised by the scheme.
All felt expectations met by the scheme.

26. 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

27. 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.

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. And thanks to
HEE Wessex
Team Up, London

35. 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.