Partners in Care and Health (PCH) worked with 10 councils in the East Midlands Association of Directors of Public Health (ADPH) Network to improve partnership working and address common public health challenges. The Directors of Public Health and their teams completed the public health strengths and risks self-assessment tool in two stages. A range of new workstreams have now been launched; and the councils also report the support has had the added benefit of helping prepare for CQC inspections and appraisals.
The challenges and approach
The East Midlands Association of Directors of Public Health Network recruited a new regional coordinator just over a year ago to help boost improvement and partnership work – and getting support from PCH was seen as the ideal way to kick-start that process. Regional Lead Ania Hewis said:
“At a time when we were initiating our programme, the public health strengths and risks self-assessment tool provided a perfect opportunity to review where local public health teams were, what they identified as risks and to come together to understand common challenges and find ways to address them collectively with our partners.”
Normally councils will complete the full self-assessment covering seven separate domains. But in the East Midlands, they did it in stages and worked with PCH to tailor the support.
“We decided to focus initially on health protection and go through the results together. It was a priority to the directors and a way to dip our toe in. PCH were really supportive and flexible and we were able to focus our work on this before areas completed the rest of the assessment.”
Toolkits and vaccination buses
The directors of public health in the network were given one and a half months to complete the self-assessment domain relating to health protection and worked with UK Health Security Agency (UKHSA) colleagues to complete it.
A two-hour workshop was then organised for May 2023, facilitated by PCH, where either the directors or their health protection leads attended alongside UKHSA representatives.
Ania said: “All the directors had their individual results, but the collective results were presented at the workshop and we then went through the findings and discussed what actions needed to be taken.
“The facilitator ran it online very well. There was a sense, to start with, that we were turning to her for solutions, but she was very clear we had to find them ourselves. There were a number of areas of concern identified – the falling vaccination rate, the situation with tuberculosis (TB) and preparedness for a future pandemic.”
This work has resulted in greater collaboration - a TB conference has been hosted, good practice on measles outbreak management shared and increased health protection staff in one council as benchmarking against others showed it was under-resourced.
A health protection assessment toolkit to help councils identify their strengths and weaknesses was also developed and has subsequently been adopted by OHID for national rollout.
‘External input invaluable’
A second workshop was held with the directors of public health (DsPH). This time it lasted half-a-day, covering the remaining six domains within the public health strengths and risks self assessment. This identified two more priority areas – doing more to future-proof the workforce including better support to allow staff to progress in their careers and improving relationships with integrated care systems.
Ania said: “Neither are issues we can solve by ourselves, but we have lead DsPH for each priority area and that is allowing us to coordinate ourselves and try to influence the regional and national agendas.”
Feedback from the individual DsPH has also proved very positive with all agreeing it has helped identify areas for improvement and develop local action plans as well as improve partnership working. There have been other benefits too, including aiding preparation for CQC inspections and even being used as evidence for appraisals.
Nottingham City Director of Public Health Lucy Hubber said alongside using it to demonstrate her performance internally, it has helped make the case for public health to senior leaders and members.
“Having external input is invaluable. The peers are real experts in their field and they are from our world – they understand the wider picture which is something you don’t get if you just have management consultants come in.
“I think it has really helped improve the way we work together in particular – having that external support and guided conversations during the workshops really helps draw out the critical differences and areas of similarities and we have already started acting on that. “For example, we have just recently appointed a tobacco control coordinator for the East Midlands to focus on strategy and planning across the region. And this should be just the start.”