Tag Archives: Public health

 NHS Long Term Plan

What does this mean for libraries?

Increases in demand from students, such as nursing students on placement in NHS organisations, and increases in medical student numbers will have an impact on the workload of LKS, and may require the introduction of new services to support them, such as having access to good WiFi or lockers, and more collaboration with university library services.

A move towards more Integrated Care Systems, and potentially more collaborative working under the auspices of Sustainability and Transformation Partnerships (STPs) could have implications for LKS that have SLAs with only some local organisations, and more work may need to be done to encourage organisations that currently don’t contribute to LKS to do so, so that all staff in an area have equitable funded access.

LKS are ideally placed to help get better value for the NHS and get the most out of the investment in it by making the evidence base accessible and encouraging its use and application. It could be a good opportunity to promote time saving services such as current awareness and mediated evidence searches. LKS can also support innovation and change through encouraging and supporting knowledge management.

There may be a need to help NHS staff become more familiar with digital systems, particularly to help retain staff that are less confident with IT. While some areas are more difficult for LKS to provide training in (such as patient records) there may be areas that we can help with, such as helping staff become familiar with mobile devices and the use of apps.

With the focus on preventing illness, LKS will have a role to play in supporting the provision of good-quality health information for patient and carers.

Katie Nicholas of Health Education England has prepared a useful summary of references to evidence, knowledge, innovation and Topol in the NHS Long Term Plan.

Source: NHS England

Link to main document

Date of publication: January 2019

Summary of driver:

This is the first stage in planning for the next ten years of the NHS in England. Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) will have until the autumn to say how they are going to implement the plan locally.

It is said to be ambitious but realistic.

There are three main areas of health and care this plan aims to tackle:

  1. Making sure everyone gets the best start in life

This includes taking further action on childhood obesity, increasing funding for children and young people’s mental health, reducing stillbirths and mother and child deaths during birth by 50% and delivering the best treatments available for children with cancer, including CAR-T and proton beam therapy.

  1. Delivering world-class care for major health problems (both physical and mental)

This includes preventing 150,000 heart attacks, strokes and dementia cases, spending at least £2.3bn more a year on mental health care, delivering community-based physical and mental care for 370,000 people with severe mental illness a year by 2023/24, and saving 55,000 more lives a year by diagnosing more cancers early.

  1. Supporting people to age well

This includes increasing funding for primary and community care by at least £4.5bn, bringing together different professionals to coordinate care better, developing more rapid community response teams to prevent unnecessary hospital spells, and speed up discharges home and upgrading NHS staff support to people living in care homes.

The planned means to do this include:

  1. Doing things differently

This includes encouraging more collaboration between GPs, their teams and community services, as ‘primary care networks’, to increase the services they can provide jointly, and increase the focus on NHS organisations working with their local partners, as ‘Integrated Care Systems’, to plan and deliver services which meet the needs of their communities.

  1. Preventing illness and tackling health inequalities

This will include action on helping people stop smoking, overcome drinking problems and avoid Type 2 diabetes.

  1. Backing our workforce

There are planned thousands more clinical placements for undergraduate nurses, hundreds more medical school places, and more routes into the NHS such as apprenticeships. There will also be work to improve staff retention.

  1. Making better use of data and digital technology

Among other plans, there will be a new NHS App, better access to digital tools and patient records for staff.

  1. Getting the most out of taxpayers’ investment in the NHS

Identifying ways to reduce duplication in how clinical services are delivered, and make better use of the NHS’ combined buying power to get commonly-used products for cheaper, and reduce spend on administration.

Drug strategy 2017

A Policy Briefing aimed at healthcare professionals is available for LKS staff to share in their own organisations. This has been produced and shared by the JET Library, Mid Cheshire Hospitals NHS Foundation Trust. Please feel free to reproduce it (with acknowledgement to JET Library) for your own purposes.

Impact on library policy/practice: 

The strategy will progress with an eye on emerging evidence, to understand current challenge on a global scale. Library teams can help organisations to monitor the evidence, providing current awareness or horizon scanning services for emerging trends and innovative practice. Library services could provide evidence outlining global issues, or provide evidence for local initiatives and commissioning of services.

Source: Home Office

Link to main document

Publication format: PDF

Date of publication: July 2017

Summary of driver: The strategy aims to reduce illicit and other harmful drug use, and increase the rate of individuals recovering from their dependence. Integral to the strategy is partnership working to tackle drug misuse and the harm caused at local, national and international levels. The government will work with partners in education, health, safeguarding, criminal justice, housing and employment to provide a joined up approach to commissioning services which enable people to live free from drugs. The government will also work with global partners to restrict supply and lead global actions to prevent drugs harms.

Key features of driver:

Current situation:

  • Social and economic cost estimated at £10.7bn p.a.; £6bn linked to people stealing to buy drugs
  • 2015-16 ca. 2.7m people reported using illegal drugs
  • Fewer drug users are coming into treatment and reduced number of under 25s being treated for opiate addiction
  • More adults are leaving treatment successfully than in 2009-10, but wide variation between the best- and worst-performing local authorities
  • The number of deaths increased by 10.3% in 2015, deaths involving heroin more than doubled between 2012 and 2015

The strategy has four key themes:

  • Reducing demand for drugs –preventing the onset of drug use through targeting the most vulnerable members of society, e.g. young people, NEET, offenders, families, women at risk of violence/abuse, sex workers, homeless, veterans, older people.
  • Restricting the supply of drugs – working in partnership and changing approach to tackle changes in criminal activity. Using new technologies and innovative data collection methods.
  • Building recovery – providing treatments for the range of needs, adopting a joined up approach to commissioning services which enable individuals to lives a life free from drugs.
  • Global action – take a leading international role to adopt new evidence to prevent drug harms.

The approach will be grounded in the evidence base, monitoring global practice to inform the approach. The strategy was based on a recent evidence review published by Public Health England. Whilst the strategy is focused on drugs, there will be a joined up approach with action on alcohol.

Primary audience: Public health and Commissioners. Also those working in Education, Health, Safeguarding, Criminal justice, Housing and employment.

Date last updated: September 2017

Due for review: September 2018

Group member responsible: TP


Focus on: Public Health and Prevention: Has the Quality of Services Changed Over Recent Years?

Source: QualityWatch (a partnership between Nuffield Trust and The Health Foundation)

Link to main document

Publication format: PDF

Date of publication: April 2016

Summary of driver

This research looks at whether the quality of public health services, and public health outcomes, have changed over the last few years, particularly in the light of the move to local authority provision of public health since the 2012 Health and Social Care Act.

20 public health indicators are examined, along with reflections from senior public health staff. Six indicators showed deterioration, while 10 showed improvements although in five of those, progress may have slowed.

It was felt that there were opportunities for integration across local authority services to improve services, for example working with leisure services to encourage participation in sport. However, there was also some fragmentation, and loss of referral routes in some areas.

Continued funding cuts are still a concern, despite prevention and public health being a key part of the Five Year Forward View.

Key features of driver

Both quantitative and qualitative research approaches are used to provide an independent overview of public health quality and outcome. However, the short period of time since public health moved into local authorities in 2013 means it may not be long enough for funding and organisational changes to have had their full impact.

Primary audience

Public health staff, commissioners, Health and Wellbeing boards

Impact on library policy/practice

One of the main opportunities identified in the report was greater integration across local authority functions in support of public health goals. This may lead to a discussion about what constitutes the public health workforce, and whether library services that are commissioned to provide a service to public health may need to extend their offering to the ‘wider’ public health workforce, for example housing professionals, trading standards, and leisure centre staff, as these and many other employees can have an impact on public health outcomes.

Whilst an embedded librarian role, such as that used in Warrington (where there is a dedicated  Public Health & Commissioning Librarian) is an ideal, funding cuts to public health of 3.9% per year over the next five years as proposed in the 2015 spending review make this more difficult for local authorities to fund, and hence for library services to provide.

However, with prevention and public health being a key part of the Five Year Forward View, library services may decide, justifiably, to push to raise their visibility among public health staff, and try provide a range of key services to them (for example, literature searching and current awareness, as identified in the Warrington case study) even where funding for library services from local authorities does not follow. The Sustainability and Transformation Plans that are due to be published in 2016 may also provide a further driver for this. However, care needs to be taken that this does not disadvantage organisations that continue to pay for library services, or provide a disincentive to fund them.

Date last updated: July 2016

Due for review: July 2017

Group member responsible: JC

Due north report: PHE response

Title of driver: This collection of documents outlined Public Health England Response to: Due North: The Report of the Inquiry on health equity for the north 

Source: Public Health England

Link to main document 

Publication format: Web page which lists a collection of relevant pdfs

Date of publication: Latest report published in July 2015

Summary of driver: These documents describe the actions Public Health England (PHE) is taking to improve health equity and outlines their plans to address the issues highlighted in Due North: The Report of the Inquiry on health equity for the north .

Key features of driver: The July 2015 document discusses the following key areas and provides examples of best practice for each:

Economic development and living conditions

  • Leading evidence-informed debate on living standards and health inequalities
  • Supporting local partnerships working for economic growth
  • Promoting health at work
  • Working with the housing sector

Early childhood as a critical period

  • Promoting healthy development in early childhood
  • Giving every child the best start in life is a priority

Devolution: having the power to make a difference at the right spatial scale

  • Sharing power and resources and securing community engagement on the
    determinants of health

The vital role of the health sector

  • Strengthening the role of the health sector in promoting health equity

Primary audience: Public Health Staff

Impact on library policy/practice: Library teams supporting public health staff could incorporate these themes into current awareness services.

Date last updated: 19th February 2016

Due for review: 19th February 2017

Group member responsible: Tracey Pratchett

Due North: The report of the Inquiry on Health Equity for the North

Source: Report prepared by the Inquiry Panel on Health Equity for the North of England

Link to main document 

Publication format: pdf

Date of publication: September 2014

Summary of driver: This inquiry was commissioned by Public Health England in February 2014, to examine Health Inequalities affecting the North of England. It was led by an independent Review Panel of academics, policy makers and practitioners from the North of England. It  is part of ‘Health Equity North’  created to address health inequalities. It intends to make recommendations to address the social inequalities in health in the North of England compared to the rest of the country.

Key features of driver: The document is split into a number of chapters which cover:

  1. Principles and processes of the Inquiry
  2. Current policy context
  3. Evidence
  4. Making the following recommendations:
  • Tackle poverty and economic equality
  • Promote healthy development in early childhood
  • Increase the influence of the public in allocation of health resources
  • Strengthen the role of the health sector in promoting health equity

Primary audience: Public Health Teams

Impact on library policy/practice: Provide evidence and current awareness services linked to the 4 recommendations

Date last updated: 19th February 2016

Due for review: 19th February 2016

Group member responsible: Tracey Pratchett

Local action on health inequalities: evidence papers

Title of driver: Local action on health inequalities: evidence papers

Source: Commissioned by Public Health England and prepared by UCL Institute of Health Equity (IHE)

Link to main document 

Publication format: Webpage with links to eight individual evidence reviews and 14 briefing papers

Date of publication: September 2014

Summary of driver: The evidence reviews provide evidence for interventions on social issues that lead to poor health, as well as practical advice in dealing with these issues, and local examples.

Action to reduce health inequalities is central to the work of Public Health England, and health inequalities are a longstanding challenge. Local authority public health teams wanted evidence to support implementation of practical action on health inequalities

The topics covered relate to some of the policy objectives in the Marmot Review and are intended to provide a useful local focus for action.

Key features of driver: The evidence reviews provide useful background information on public health issues, including the impact on measures such as life expectancy, morbidity, or impact on hospital admissions. They also provide case studies of actual interventions, areas where further research is required, and an extensive reference list.

Primary audience: Local authority staff, particularly public health teams and health and wellbeing boards

Impact on library policy/practice: No direct impacts identified

Date last updated: March 2015

Due for review: March 2016

Group member responsible: JC

A Framework for Personalised Care and Population Health for Nurses, Midwives, Health Visitors and Allied Health Professionals

Source: Public Health England and Department of Health

Link to main document

Publication format: PDF

Date of publication: 4th July 2014

Summary of driver: The framework forms parts of the public health contribution of nurses and midwives: guidance. It has been developed with practitioners and leaders as a resource to support nurses, midwives, health visitors and allied health professionals’ in the delivery of their public health role. The framework will facilitate their access to the best evidence and is a tool to support practice on a number of levels. It can also assist clinical leaders, managers and commissioners to develop services which use the knowledge and skills of healthcare practitioners to deliver the best health outcomes for the populations they serve. This document recognises that at this point in time, health promoting practice is essential to meet the health challenges in society and is related the Public Health Outcomes Framework and the Compassion in Practice.

Key features of driver:

  • Six key areas of population health activity are listed; Improving the wider determinants of health, health improvement- making every contact help, health protection, healthcare public health, supporting health wellbeing and independence and Lifecourse.
  • Each section has an ‘aim’ which is linked to the relevant indicators in the Public Health Outcomes Framework (http://www.phoutcomes.info/) which can be used to measure impact/outcomes in that particular activity area.
  • Framework will support practice on a number of levels and provide staff with a tool that will help support them in the delivery of the population elements of their role. All staff will gain something from this framework ranging from using the framework to develop services for the local healthcare population to using it to develop local commissioning.
  • Framework supports and shapes health promoting practice and embeds personalised care across all ages and communities
  • Public Health Intervention Wheel (adapted from the Minnesota Department of Health in 2001) demonstrates the use of public health practice at three levels- individual, community and population. It defines the scope of public health nursing practice by the type of intervention.

Primary audience: Nurses, midwives, health visitors and allied health professionals, professional managers (local and regional)/commissioners/researchers and those in other education based roles.

Impact on library policy/practice:

  • Opportunity to ensure that healthcare staff have the relevant up to date evidence via methods such as current awareness bulletins and targeted information delivery (Kings Fund/WHO).
  • Opportunity to develop new outreach links and services to staff in the community.
  • Ensuring that access to the documents/links mentioned is available and signposting access. The framework is an interactive document so users should be able to access the information at the point of need. LKS staff can ensure that access to the links and documents is available.

Date last updated: July 2014
Due for review: July 2015
Group member responsible: LK

Tackling health inequalities: the case for investment in the wider public health workforce

Title of driver: Tackling health inequalities: the case for investment in the wider public health workforce

Source: Royal Society for Public Health (RSPH)

Link to main document

Publication format: PDF

Date of publication: June 2014

Summary of driver: A proposal to engage professionals working outside the public health sector, to harness their skills and motivation in order to positively impact public health in their communities. The report argues that through the promotion of healthy behaviour and encouragement of healthier lifestyles, health inequalities within local communities can be addressed which could in turn help to reduce the national incidence of lifestyle-related disease and safeguard resources in the NHS.

Key features of driver:

  • The report highlights the pressures that are placed on the welfare system, the economy and social justice, with a cost to the NHS alone of around £5.5 billion (Frontier Economics. Estimating the Costs of Health Inequalities: A Report Prepared for the Marmot Review. London: Frontier Economics Ltd, 2010);
  • The ‘wider public health workforce’ is discussed and defined as: any organisation or individual, who is not a professionally qualified public health specialist, but has the ability or opportunity to positively impact public health;
  • 5 health initiatives are discussed and their effectiveness assessed in the context of: health outcomes, social benefits  and financial costs, benefits and sustainability) in tackling health inequality and encouraging healthier lifestyles: (1) health trainer service (funded community-based), (2) health champions initiative (community volunteers), (3) Making Every Contact Count’ (health promotion within organisations), the role of non-health professionals and (4) the creation of ‘healthy settings’ (schools and universities);
  • The report comments that each stakeholder group (trainers, champions and clients) report a wide range of benefits that extend beyond simple improvements to physical health – improved mental well being, increased social interaction, higher levels of community cohesion and improved career prospects;
  • Barriers to achieving change are described with 2 areas of particular concern being: the ability of the workforce to integrate with ‘hard-to-reach’ groups and the need for greater research  particularly into the extent to which behaviour change is sustained and the cost-effectiveness of programmes.

Primary audience: Local Government Authorities

Impact on library policy/practice:

  • Opportunity to work collaboratively with colleagues in Public Health England to raise awareness of the wider public health workforce initiatives and communicate this to healthcare staff in primary and secondary care, for them to promote to patients and families;
  • Opportunity to liaise with colleagues in public libraries to offer an evidence-base (literature, displays, talks) for their library users; showing how positive health outcomes and improved quality of life can be achieved by small changes in lifestyle e.g. better diet, regular exercise, engaging in community recreation and health education schemes;
  • Commitment by library and knowledge service managers and resource librarians to incorporate a selection of health promotion and ‘healthier living’ resources into library stock and promote widely within our NHS organisations;
  • Support Health Education England events in our regions e.g. Health Education Week to raise awareness of healthier lifestyle choices which can have a positive impact on the health and wellbeing of our local communities; families, friends and neighbours.

Date last updated: September 2014

Due for review: September 2015

Group member responsible: ME

Knowledge strategy: Harnessing the power of information to improve the public’s health

Title of driver: Knowledge Strategy: Harnessing the power of information to improve the public’s health

Source: Public Health England

Link to main document: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/248820/PHE_Knowledge_strategy_October_2013.pdf

Publication format: PDF. Other formats available on request; email james.freed@phe.gov.uk

Date of publication: October 2013

Summary of driver:

The document is a response from whole public health system under PHE, to the Department of Health information strategy, The Power of Information: Putting all of us in control of the health and care information we need.
The PHE strategy outlines the strategic approach that the public health system will take around information and knowledge, in order to improve and protect public health and reduce inequalities. It is an illustration of how PHE will meet the knowledge and information requirements of public health practitioners across the public health system via a framework to support change across the public health system resulting in PHE becoming ‘an information-led knowledge-driven organisation’.

Key features of driver: Eight priorities for public health knowledge were identified by PHE which in turn led to the creation of 12 commitments which will be used to support business planning cycles over the next five years. Those eight priorities are:
Understand and meet the needs of users, particularly local government and local NHS
Assess priorities for the support, conduct and translation of public health research
Work with others to build and manage linked datasets that are safe and available for use
Bridge the current gap in translation of knowledge into action
Build and develop health intelligence networks
Extend the use of surveillance to inform health responses
Connect people to share experience
Develop a web portal to report and provide access and evidence
Each of the eight priorities has an example of the priority in practice and the metrics used to evaluate it.
This document is to be used by PHE as a tool to inform of immediate needs and to close the gaps where the way forward is less clear.

The 12 commitments
Support openness and innovation
Provide the tools to let public health professionals do their jobs
Understand and meet public health requirements for knowledge
Develop a strategy for research
Make data more useful and more accessible
Work with others efficiently
Work with knowledge and data safely and securely
Ensure everything we do has a positive impact and provides value for money
Develop cross-system networks to share intelligence and expertise
PHE to deliver the national health surveillance strategy for England
Share and learn from experience
Development of a digital strategy

Primary audience: Public health workers/local authorities/other stakeholders

Impact on library policy/practice: With the push towards evidence based practice this highlights the possibility of targeting the public health workforce with detailed current awareness bulletins if not doing so already. Some public health organisations might not have specialised library information professionals available to them-so there is an opportunity here for other NHS LKS staff to close the gap. There is the possibility of collating more general public health current awareness information for other health organisations-to alert them to changes/drivers in public health. Priority 4- Bridge the current gap in the transition of knowledge into action- is more or less what we do every day as PHE move to develop a
‘minimum standard’ of knowledge services and the skills required to deliver them.
The knowledge services required include evidence synthesis, mediated literature searching and filtering, information skills training and training in knowledge management tools. Involvement in journals clubs is listed in priority 7 (connecting people to share experience).

Date last updated: June 2014 (Consultation responses published)

Due for review:

Group member responsible: LK

DH Wellbeing and health policy

Source: Department of Health

Link to main document https://www.gov.uk/government/publications/wellbeing-and-health-policy

Publication format: PDF

Date of publication: 6th February 2014

Summary of driver: Evidence on why wellbeing matters to health throughout someone’s life, and what policy makers can do about it

Key features of driver: Important findings are that wellbeing:

•adds years to life and improves recovery from illness
•is associated with positive health behaviours in adults and childrens
•is associated with broader positive results
•influences the wellbeing and mental health of those close to us
•affects how staff and health care providers work with implications for decisions for patient care practises and services, and treatment decisions and costs
•affects decisions about local services
•may ultimately reduce the healthcare burden

Primary audience: All NHS Trust staff

Impact on library policy/practice: Publicise and display material in relation to wellbeing and health for staff. Signposting to relevant support services within workplace.

Date last updated: 6th March 2014

Due for review: 1 year

Group member responsible: LK