Why be a Public Health Trainee in Torbay


About Torbay

Torbay has a national reputation for integrated care with a public sector committed to working in a Joined-up way to improve health and well-being and to deliver excellence care services.

This commitment provides a firm foundation to tackle the health needs of the people of Torbay who continue to experiences significant challenges to their well-being.

Key challenges for the population of Torbay and South Devon:

  • Many people in Torbay experience significant poverty
  • Many people live alone especially amongst the more elderly population
  • There are a large number of people providing unpaid care 
  • Around 500 people die prematurely in Torbay a year, before the age of 75
  • The proportion of the population living with long term conditions such as diabetes, hypertension or respiratory diseases is higher than average, and is increasing
  • There are higher proportions of children living in poverty
  • There are higher rates of children in care
  • The consequences of alcohol misuse is a problem for all sectors
  • More than 1 in 4 people across Torbay are estimated to be obese and 2 in 3 people are overweight.
  • Rates of violent crime and youth offending are high
  • Torbay has one of the highest incidents of reported domestic abuse in Devon and Cornwall
  • Torbay’s economy is amongst the weakest performing in the UK
  • Housing availability, affordability and decency are a problem
  • There is a gap between children in different areas as to how ready they are for school.
  • Rates of self-harm and suicide are higher than  the national average

These challenges could be considered as risk factors for a rising tide of demand on our health and care services, where we are seeing:

  • Increasing emergency admissions and pressure on hospital beds
  • Challenged child and teenage mental health services
  • Pressure on children’s services with high numbers of Looked after children
  • Rising costs in all sectors and especially in services for older adults

This rising tide threatens to engulf our care services and requires connected effort to address it by all sectors; public, private, community and voluntary.

Understanding the risk factors, and what’s causing them within the population, enables a preventative approach to be undertaken to reduce the burden on the health and social care services.

The Public Health team is at the forefront of action to develop a new way of working as system leaders and forging links for new innovative ways of working. 

What we can do to TURN THE TIDE

No one organisation in Torbay can turn the tide alone. This can only be done through organised effort across all sectors together with the meaningful involvement of people living in the communities in Torbay.

Torbay Public Health team have long been involved in working with partners on the health of the population. In 2014, Torbay and South Devon NHS applied for Pioneer status to develop work to join-up care services across health and social care, building on the work already begun by community services. At the same time the hospital in Torbay began the process to acquire the community trust and develop an integrated care organisation. Thus launched the Joined-up initiative which set the groundwork for our subsequent work within our integrated care system. We are a wave 2 area and leaders from Torbay are at the forefront of this work across Devon, building on the system working we have now been promoting for many years.

We now need to think how this work can be extended to other public sector organisations in Torbay and how the private, community and voluntary sectors can get involved. What role for example does housing have, what about schools and colleges, police, fire and private sector businesses and what about community groups and volunteer initiatives? The Public Health team are in a unique place to bring these partners together and create a common purpose to engage all who live and work in Torbay in this agenda?

The role of Public Health

Public Health has a long history of partnership working and a value base that is rooted in working with and for communities as well as individuals. Public Health sits across the NHS and Local Authority and is in an ideal position to promote work across the two. Some of the programmes we have worked with our partners on over the last year include to:

  • Create a new model to provide services to promote healthy behaviours.
  • Improve the way we look at all our data across organisations so we better understand our common needs and assets.
  • Support the Community and Voluntary Sectors and promote programmes that build community resilience.
  • Leading on work to bring together contracts to support people with multiple complex needs 
  • Promote the development of Joined-up plans across Children’s services, Public Health, Adult Social care and health services.
  • Ensure prevention is at the heart of all our partners plans by set out a framework for prioritised work – Our DPH is SRO for prevention across the STP 
  • Develop plans across sectors to address key areas such as Obesity, mental and emotional health and well-being. 
  • Develop a framework for healthy places – Healthy Torbay – to address the role of housing, planning, the environment and community safety to promote health and well-being

Current challenges for Public Health and population health

We are all facing the future with shrinking budgets where hard choices will need to be made. However Public Health have been at the heart of an effort within out STP/ICS re-focus on prevention. We will do this by changing the ways we collectively work using the opportunities to gain health capital and prevent its loss as our guide.

These challenges are outlined in our Joint Health and Well-being Strategy

1. To focus on prevention within all plans across organisations and with all front-line staff considering prevention of ill health as a key task. For example:

a. The concept of “Every Contact Counts” extended whereby care givers and others give advice on health enhancing behaviours each time they meet a client.

b. Behavioral issues such as alcohol and obesity becoming key issues across all organisations not just public health

c. Access to services – we need to improve take-up to reach the hundreds of people with early signs of disease not known to the care services such as those with early diabetes, hypertension and dementia so we can improve the quality of life in later years.

d. A strengths based approach - Finally I would like to see a Joined-up and assets based approach embedded in all we do. 

e. Community resilience – we need to further embed the work on promoting assets within communities and in social prescribing whereby alternatives to medicines are prescribed promoting things that really matter to people. This requires exploring new ways of working and real involvement of the community and voluntary sectors.

2. A multi-agency effort to promote well-being and tackle the causes of poor health and the development and delivery of programmes within the Healthy Torbay framework.
For example, we work to ensure those working in housing, in planning and transport, in sports and in tourism consider how in their plans they can deliver a healthier bay and promote well-being. This should extent to Health at Work programmes across Torbay

3. Mental health – we need to consider mental health and well-being services at every contact and focus on the promotion of mental health across all agencies.

4. Children – we need to ensure we deliver on the work we have planned for children especially focused on emotional health and well-being and deliver an offer for children which is truly joined-up and focused on the early years.

5. Ageing – we need to bring greater focus on ageing well, positive ageing and addressing social isolation to enable those in their later years to live fulfilling lives

What will it like being a trainee in Torbay?

In Torbay we are a small team but a passionate one. We feel we are at the forefront of integrated working and have high levels of trust and good relationships, not only across the Council but also with the CCG and our providers and increasingly within the Devon-wide STP. Our DPH sits on the CCG Governing Body and is the Senior Responsible Officer for prevention within the Devon STP sitting on all key leadership groups. Team members are held in high regard across the partnership and we believe strongly in co-production and collaboration. If you want to learn working in complex adaptive systems this is the place!

So, it’s an exciting place to work!

However also;

  • The team is fun to work with and supportive.
  • We take building the capabilities of the team seriously
  • We have great links and relationships with all partners
  • You will have lots of opportunities to work in a variety of areas.
  • With only 2 consultants in the team, there is always lots to do so you are likely to be given many exciting and varied opportunities 

Key Contact: Dr Caroline Dimond Caroline.Dimond@torbay.gov.uk