The bigger picture

June 9, 2016 in President's Blog by Andrew Furber

The job of a DPH can be so full on that it can be hard to create the space to think strategically, compare notes with colleagues and get a sense of the bigger picture. This is one of the opportunities ADPH events provide and one I certainly appreciated at our recent AGM and Policy Workshop.

It’s hard to have a public health policy discussion in these times without reference to finance, and our workshop was no exception. We heard from CIPFA of the forthcoming work with HM Treasury and others (including ADPH) on the development of a ‘prudential code’ for investments in prevention activity. If successful it could transform the way the public sector thinks about prevention (as the current code transformed capital investments). For years we have made the business case that public health interventions offer outstanding value for money. Whilst we’ve had some success I don’t think any of us could say we’ve seen the level of funding commensurate with the potential return on investment. It is time we went further and considered the bigger picture of how public sector finances operate and how we could influence that.

We also took some time to reflect on our quality improvement work. In England this is captured within our Sector Led Improvement programme. In other countries it takes different forms but with the same end – ensuring we continually improve our practice. Hearing how others do it is always an inspiration and we were presented with some fine examples. We also had our first virtual presentation at an ADPH event! Gill Richardson’s short video on the opportunities to improve the health of the public through the Well-being of Future Generations (Wales) Act was excellent. ADPH will be increasingly looking at how we can use technology to hear from members throughout the UK.

As someone who struggles for inspiration when writing my annual report, I always enjoy seeing how others go about it. Our Annual Report competition this year had a step change in the number of entries (thank you if you sent yours in). Congratulations to this year’s winners and all those shortlisted. Receiving a copy of your report even if you don’t want to be in the competition is really helpful for ADPH to understand your local priorities.

The final session of the day looked at housing (in its broadest sense) and health. It was terrific to hear from Neil Hamlet and Jim McManus on how progress was being made in Scotland and Hertfordshire respectively. Housing is fundamental to health in many respects, but it was the issue of multiple disadvantage that was the focus for our discussion. The evidence was summed up well by Julian Corner from Lankelly Chase based on their Hard Edges report. This seems to me to be a real opportunity for DsPH to make a difference as we see the bigger picture and are not limited to a single sector response.

Our AGM, which was my first as President, was heartening. We thanked those who were leaving the Board and Council for their service, and welcomed our new recruits. It is encouraging that there are still people who are prepared to step up to the plate and support our collective work in this way. It was also good to accept Janet Atherton as a new Honorary Member, the highest honour ADPH can bestow. Recommendations on membership expansion and subscriptions – vital issues for us but always difficult to judge correctly – were supported. It was especially welcome to hear from members that they felt this was precisely the time when we needed to work together through ADPH to advocate for the work of DsPH.

Jeanelle deGruchy did a brilliant job of chairing the Policy Workshop and Nicola Close and the ADPH staff team were exemplary in all the (largely unseen) preparation which was required to make the day such a success. Of the evaluation forms submitted 100% of respondents said the day was a good use of their time and that they have learnt something new. The session on housing and disadvantage was considered the most useful part of the day which inspired some of the members to look more closely at the issues related to housing and homelessness as well as how they link with devolution. Also the session on sharing best practice was considered useful by 96% of respondents many of whom decided to look further into the SLI and ways of developing it within networks. Other actions following from the discussions included watching the Cathy Come Home film, reviewing the Suicide Safer Communities Accreditation and checking on the numbers of health visitors and school nurses locally.

One of the downsides however, was the overall low number of DsPH attending which, we admit, was a missed opportunity for networking and discussion. Therefore, I wanted to ask you now to take a moment and mark your calendars for the following events coming up:

19th October – ADPH 160thAnniversary

8th November – ADPH Annual Conference

In summing up the day I was struck by three things. Firstly the overwhelming case for early intervention – multiple disadvantage often has very obvious, and preventable, origins. Secondly how DsPH are ideally placed to champion the place-based approaches required to resolve our most difficult issues, whether multiple disadvantage or public sector finances. And finally, the value of sharing good practice. ADPH often puts out requests for good practice but we don’t get much back. Partly this will be that DsPH are too busy to write it up, but perhaps we sometimes feel it is not good enough. Have no such fear – everyone loves a sharer. Only by hearing of such examples can ADPH really make the case for the impact DsPH are having locally. If you can think of ways in which ADPH can make such sharing easier please let me know.

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