Building health promotion capacity through policy, training

1
Building health promotion capacity through
policy, training accreditation - International
direction and UK experiences

• Viv Speller
• 8th IUHPE European Conference on Health Promotion
• and Education
• Torino, September, 2008

2
Overview

• Shaping the Future of Health Promotion
  priorities for action (IUHPE / CCHPR, 2007)
• Galway Consensus Conference Statement (IUHPE,
  2008)
• UK Public Health Skills Career Framework
• UK Public Health Register
• England Health Trainers
• England Teaching Public Health Networks
• Childrens workforce development

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FORMARE UNA FORZA LAVORO COMPETENTE IN
PROMOZIONE DELLA SALUTE
E necessario raggiungere un consenso a livello
sopranazionale in merito al profilo base di
competenze per la promozione della salute, al
fine di meglio definire il campo dazione e di
fornire un orientamento comune per lo sviluppo di
curriculum formativi
Delineare il futuro della promozione della
salute le priorità per lazione
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The Galway Consensus Conference Statement
Toward domains of core competency for building
global capacity in health promotion
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Toward International Collaboration on
Competencies and Accreditation in Health
Promotion and Health Education The Galway
Consensus Conference
National University of Ireland, Galway 16 18
June 2008
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Intended audiences

• Practitioners, researchers academics in health
  promotion
• Policy and decision-makers in government NGOs,
  employers etc
• Relevant to all countries
• Health promotion occurs at many levels, is
  unique in the ways it can contribute to society,
  and is characterized by a unique set of
  competencies and skills that involve integrating
  interdisciplinary theories and approaches.

The Galway Consensus Conference Statement
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Core values and principles

• A social-ecological model of health taking into
  account the cultural, economic social
  determinants of health
• Commitment to equity, civil society social
  justice
• Respect for social diversity sensitivity
• Dedication to sustainable development
• Participatory approach to engaging population in
  identifying needs, setting priorities, planning,
  implementing and evaluating health promotion
  solutions

The Galway Consensus Conference Statement
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8 Domains of Core Competency

• Catalyzing change
• Leadership
• Assessment
• Planning
• Implementation
• Evaluation
• Advocacy
• Partnerships

The Galway Consensus Conference Statement
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Public Health Skills and Career Framework - UK
Multi disciplinary, multi-agency /
multi-professional April 2008 Public
Health Resource Unit (PHRU) and Skills for
Health
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Defined Area Health Improvement
... ...improving the health and well-being of
populations and reducing inequalities by using
health promotion, prevention and community
development approaches to influence the
life-style and socio-economic, physical and
cultural environment of populations, communities
and individuals.
Public Health Skills and Career Framework - UK
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Core Area - Assessing the evidence... Critical
assessment of the evidence relating to the
effectiveness and cost-effectiveness of health
and well-being and related interventions,
programmes services ...
Public Health Skills and Career Framework - UK
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Core Area Policy Strategy... Influencing the
development of policies for improving health and
well-being, implementing strategies to put
policies into effect and assessing their impact...
Public Health Skills and Career Framework - UK
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Core Area - Leadership Collaborative
Working... Leading and managing teams
individuals, building alliances, developing
capacity capability, working in partnership
with others and using media effectively...
Public Health Skills and Career Framework - UK
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• - the UK Public Health Register
  (www.publichealthregister.org.uk)
• opened in 2003 to provide public protection and
  maintain high standards of practice
• standard, dual and retrospective (portfolio)
  routes to registration as Specialist (levels 8-9
  of the PHSCF)
• Generalist Specialist in Public Health route
  portfolio of evidence of knows-how and
  shows-how 2003-2006
• 317 on register in May 2008, 275 via Generalist
  route over 400 in total in process
• Defined Group (since 2006) all knows-how and
  very high levels of competence in selected
  defined areas
• Since 2007 development of Public Health
  Practitioner Advanced Practitioner Registration
  (levels 5 7 PHSCF)

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Choosing Health making healthier choices
easier Government White Paper, 2004 Launched new
group of accredited NHS workers - Health
Trainers ...shift from advice from on high to
support from next door Since 2006 in 20 most
deprived areas, from 2007 across country
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NHS Health Trainers
Northumberland
Rotherham
Bury
Bury
Southwark
Southwark
Liverpool
Bradford
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What is a Health Trainer?

• Key tool in addressing health inequalities
• Drawn from local community
• clients drawn from hard to reach, disadvantaged
  groups
• Work with clients 11 to assess lifestyle and
  well being, set goals, agree action plan and
  provide support on behaviour change
• 1200 Health Trainers trained and in post
• Accredited nationally, City Guilds (level 3)
  and Royal Institute for Public Health (level 2)

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National occupational standards for Health
Trainers

• Evidence based handbook (June, 2008)

• 4 Competencies
• Make relationships with
• communities
• Communicate with individuals
• about promoting their health well-being
• Enable individuals to change their behaviour to
  improve their own health and well-being
• Manage and organise your own time and activities

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Building public health capacity and capability
the role of the Teaching Public Health Networks

• Launched in 2006.
• Nine regional networks.
• Partnerships between academic and service public
  health organisations.
• Aim to promote teaching and learning in public
  health, through the academic, public sector, and
  third sector.

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Aims and objectives of SE TPHN

• Covers SE region 8m pop.
• focus on childhood obesity, and the wider public
  health workforce working with children
• increase the availability of public health
  education and training to increase potential for
  wider workforce to contribute to reducing obesity
  in children.
• develop a network of educational providers for
  the childrens workforce in schools, and academic
  and service public health providers to share good
  practice regionally and nationally

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Why obesity?

• Audit commission report 2006 Tackling
  childhood obesity first steps, recommended
  that frontline staff be given more training
  information - especially those in schools who
  have a key role to play
• Literature review of obesity prevention in
  schools concluded little research has been
  undertaken to determine teachers knowledge,
  skills attitudes, their training resource
  needs around childhood obesity (Davidson F,
  2007)
• Healthy Weight, Healthy Lives A cross
  government strategy for England national
  obesity strategy recognises need to address the
  different training needs of staff groups
  including those in schools

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A Healthy School offers children
and young people opportunities to be healthy and
active, so that they are able to achieve their
full potential at school and in life
National Healthy Schools Programme
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2009 targets

• National targets set out in Choosing Health 2004
• By 2009, 75 schools in England will have
  achieved National Healthy School Status
• By 2009, 100 schools in England will be engaged
  and participating in the programme
• How are we doing?
• 56 schools in England are Healthy Schools
• 97 schools in England are participating in the
  programme
• Today, an estimated 3.7million children and young
  people go to a Healthy School
• 9 out of 10 schools in England taking part in the
  national programme
• Over 7 million Children and young people attend a
  school that is part of the National Healthy
  School Programme

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Whole School Approach
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• Every Child Matters Change for Children is a new
  approach to the well-being of children and young
  people from birth to age 19.
• The Government's aim is for every child, whatever
  their background or their circumstances, to have
  the support they need to
• Be healthy
• Stay safe
• Enjoy and achieve
• Make a positive contribution
• Achieve economic well-being
• Workforce remodelling across sectors,
  particularly between education social care

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Healthy Schools Workforce influences on
Physical Activity
Local Authority Childrens Services -Youth
Workers -School Travel Plan -Healthy Schools
Mgr -PDL Manager -Headteacher/ SMT -Class
teachers -SENCOs -TAs -Lunchtime/ play
supervisors -HLTAs -SSCOs -PLTs/ PE
teachers -Librarians
Parents pupils Eg. PTA (3.8), Governors
School ethos 3.1
Curriculum 3.3
Policies 3.2
After school clubs 3.4
Private sector Eg.Supermarkets Sports coaching
provider
Staff Role models 3.10
Play time
School Travel 3.7
PCT Eg. Health Promotion Specialists, School
nurses,Health visitors
NGOs , Govt. schemes Eg. Extended Schools
Ctrs Sports England (Active Mark) Sports
Partnerships (3.6)
Voluntary/community -British Heart
Foundation -MEND (Mind, Exercise, Nutrition, Do
It)
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Healthy Schools workforce influences on
nutrition

• Parents pupils
• PTA
• Governors
• Peer mentors
• Buddies
• School council

• Local Authority
• Headteacher, SMT
• Teachers
• Advanced skills teachers
• TAs
• SENCO
• HLTAs
• Lunch/playtime supers
• Cook
• Catering assts.
• Admin.
• Caretakers
• Healthy schools Mgr
• Ed. Psychologists
• Librarians / IT
• Inspection service

Curriculum Fruit Veg (2.9) Scheme
Policies (2.3) School ethos Eating
envt.(2.5) Dinners (2.7)
Tuck shop (2.6) School milk

• Private sector
• Catering companies
• Suppliers
• Nutrition consultants
• Retail outlets

Water bottles (2.10)
Lunch boxes (2.8)
Breakfast clubs

• NGOs, Govt. schemes
• School Food Trust
• Skills 4 Schools
• DfES/DH
• National Fruit Veg. Scheme
• Training Development Agency
• QCA
• School Workforce Development Board
• Healthy Schools Programme
• Food in Schools
• British Heart Foundation

• PCT
• Health promotion specialists
• Dietitians
• Health Visitors
• School Nurses
• GPs
• Practice nurses
• Nutritionists
• Dental service

• Voluntary / community
• Adopt a Chef
• Community associations
• Local councils
• Church / religious groups

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Training structures in SE

• Linking across policy agendas, sectors and a
  multitude of providers is complex -  
• Diverse training routes, qualifications and
  professional bodies for Governors, Head Teachers,
  Teachers, Teaching Assistants, Support Workers
  (eg Midday Supervisors, Playworkers, Caterers)
• Vast numbers of teachers (57,000) and support
  workers (74,000) across SE
• Identification of all education and training
  providers - Universities (20), FE Colleges (71),
  County Councils (19) etc across SE
• Focus on Initial Teacher Training (ITT) and
  Support Workers in Schools (SWiS) qualification

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Teachers role in promoting health

• Survey of all ITT providers (36) to identify
  current inclusion of health improvement content
  relevant to Every Child Matters
• Variable, and generally inadequately addressed
• Current joint research with Schools of Education
  to review trainee teachers knowledge, attitudes
  and expectations re health promotion role
• Aim to modify content of basic ITT

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Support workers role in promoting health

• SWiS qualifications for all support workers at
  NVQ levels 2 3 modular
• Initial review of SWiS competencies against
  draft occupational standards in Public Health
  Skills and Career Framework
• identified opportunities to enhance health
  promotion role at basic levels of PHSCF

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New role of Parent Support Adviser is to
work with parents in a schools context to help
improve behaviour and attendance overcome
barriers to learning and increase the number of
parents involved in their childs
education both at school and at home
SE TPHN aims to develop module for PSAs and other
SWiS
BUT do they have knowledge and skills in health
promotion?
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Issues....

• Training and regulation / accreditation important
  for public safety
• Health promotion firmly embedded within and
  enhancing public health in UK
• International accreditation systems (PHEA) need
  to learn from and integrate existing approaches
  to developing regulation
• .and recognise it is a long process!

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• Even where policy supportive, policy silos are
  not joined up, and skills gaps evident
• Building future public health workforce from
  broader, more diverse base PHSCF allows for
  inclusion and progression
• Important for individuals recognises skills
  provides building blocks for career development
• Working with for the community building
  assets resilience
• Thankyou!