Introduction

The South West Public Health Training Programme, working with the School of Primary Care, support two GP trainees each year to extend their final year of training to enable them to undertake a scholarship in Public Health leadership.  

The posts enable Scholars to gain key public health skills alongside their general practice training thereby giving them the opportunity to manage and improve the health and wellbeing of the individual patient in surgery along with that of the whole population in which the patient belongs. 

In the fast changing world of general practice and with clinically led commissioning, considering health on a population level has become more and more important for all GPs and those with experience, skills and links with public health teams will be in a very good position to ensure the needs of patient populations are met.   

The scholarships provide the GP trainees with the opportunities to explore areas of particular interest to them and develop skills that will be of benefit to them in their future careers.  There is also a great opportunity linking to Public Health to really focus on improving health outcomes and reducing health inequalities. 

The following case studies and reflections provide an insight into some of the important work that the scholars have led on. 

Professor Maggie Rae PrFPH, FRSPH, FRCP(Hon), FRCP Edin, FRCPath (Hon) 

 

Charlotte Mundell

I am a GP registrar in my third year of the general practice training programme and have spent six months with South Gloucestershire Council, undertaking a public health scholarship alongside my primary care training. I chose to undertake this scholarship to understand and apply the core principles of population health and the actionable evidence to improve the health and wellbeing of populations. I also wished to develop my non-clinical leadership and management skills.  

Together with my supervisor, I have undertaken several projects. The largest piece of work was producing the strategy update for the local authority suicide prevention plan.  The development of this plan is in-keeping with the national strategy and forms part of the NHS Long Term Plan (2019). The strategy involved collaboration between several agencies across South Gloucestershire including Avon and Wiltshire Mental Health Partnership (AWP), University of the West of England, Highways England, Prison service, the Police and the Voluntary sector.  

I learnt many skills through reviewing national and local suicide data including statistical analysis, critical appraisal skills and principles of epidemiology. The recommendations and action points I developed, take into consideration the significant impact COVID-19 will have had on suicide risk factors and the uncertainty about how this may be reflected in population level mental health over the coming months and years. This piece of work will be taken forward with the wider piece of the Adult Mental Health Needs Assessment and will influence action in the South Gloucestershire Adult MH Strategy.  

Another piece of work, in collaboration with the BNSSG smoke free pregnancy practitioner, looked at addressing a gap in service delivery for women who smoke cannabis in pregnancy. I undertook a large evidence review of available literature and presented my findings to a multi-disciplinary meeting to discuss how this could be used to shape the implementation of this service for BNSSG. 

The final project is a ‘Mini-Needs Assessment’ for healthy weight in the early years age group. This came about through discussion around childhood obesity and the stark reality that by reception age, 13% of children in South Gloucestershire are identified as being overweight or obese. I worked with the lead health visitor and healthy weight practitioners to review the data and suggest some recommendations. These are being taken forward by the healthy weight team as action points with possible funding from the COVID recovery fund to implement my findings. 

Alongside my projects, I attended many meetings and training events provided by South Gloucestershire, including:  

  • Health Inequalities Improvement Programme 

  • Attendance at key strategic meetings within the local authority 

  • Youth mental health first aid course 

  • Body image and eating disorder awareness 

  • Monthly public health registrar tutorials 

  • Future Landscape of population and public health 

I envisage that the skills learnt will help me with population health work I am due to partake in within my role as a salaried GP. Also, possibly thinking towards future involvement with Clinical Commissioning Groups (CCG), Integrated Care Partnerships (ICP) and Integrated Care Systems (ICS) organisations.