Contents
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Item |
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Introduction |
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Scope of Policy |
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Placement Locations in the South West |
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Coordination of Placement once agreed |
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Arranging Extended Phase 2 Placements |
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Induction |
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Outline of Responsibilities and Expectations |
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Placement Evaluation and Quality Assurance |
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Placement Contacts in the Office of the Regional Director of Public Health |
List of Figures
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Item |
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Figure one: The Public Health System from October 2021 |
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Figure two: Public Health Training Pathway and Placement Opportunities with the Regional Office. |
List of appendices
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Item |
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Appendix 1: Examples of Work Undertaken by Registrars within the Population Health and Wellbeing and Screening and Immunisation Teams |
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Appendix 2: Pre-placement meeting agenda/learning agreement |
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Appendix 3: Supervision Template |
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Appendix 4: Exit Interview Proforma |
1.0 Introduction
Following the closure of Public Health England on October 1st, 2021, the Regional Director of Public Health and their deputy will be jointly appointed by the Department of Health and Social Care’s Office for Health Improvement and Disparities and NHS England/Improvement. Their regional office will provide a combination of leadership, coordination and programme delivery that span the domains of health care public health and health improvement and supporting strategically (and with major incident response) on health protection. The Office will support Integrated Care Systems and the NHS system more generally in working towards a population health-based approach. It will collaborate with and support Directors of Public Health in Local Authorities to deliver ‘place-based’ priorities through established networks where efficiencies can be made delivering at scale.
Figure 1 shows how the Office of the Regional Director of Public Health will be positioned in the public health system:
- the national organisations of UK Health Security Agency, the Office for Health Promotion and Disparities led by the Chief Medical Officer in Department of Health and Social Care, and NHS England/Improvement;
- regions comprise the UK Health Security Agency and the Office of the Regional Director of Public Health. It also includes the regional facing arm of government where engagement is required to address underlying determinants of health;
- The ‘place-based level’ comprises Local Government and the Directors of Public Health and the local face of NHS/providers through the Integrated Care System and Primary Care Networks.
Each tier is interdependent horizontally and vertically and public health professionals wherever they are positioned are adept at operating across these levels and structures. This is illustrated by the dark blue arrows on Figure 1.
Figure one: The Public Health System from October 2021
What Constitutes the Office?
Formally, and from October 1st, 2021, the Regional Office of the Director of Public Health will be led by the jointly appointed Regional Director of Public Health and their deputy. The Office of Health Improvement and Disparities hosts the regional Population Health and Wellbeing Team, led by a Deputy Director and comprises a team of consultants and specialist practitioners in public health as well as specialists in health surveillance and intelligence. The Office also hosts a small workforce development and business support team.
To maximise impact on cross-cutting programmes, the Health Care Public Health Team transiting to NHS England/Improvement will be part of the Office working in an integrated way with the Population Health and Wellbeing Team and managerially accountable to the Regional Director of Public Health. This team comprises consultants with specialist skills in health care public health and dental public health consultants. A specialist practitioner holds the portfolio for Health and Justice.
The regional Screening and Immunisation Team also transiting to NHS England Improvement (historically part of Public Health England but embedded with NHS England/Improvement) will be an integral part of the Office and comprises consultants who have specialised in screening and immunisation and a specialist practitioner team. All teams work within their host agencies at local, regional and national levels and externally with the agencies that comprise the wider system of public health to tackle health inequalities and improve population health.
This policy document outlines information regarding specialty public health training within the Office of the Regional Director of Public Health. This includes (1) the regional Office for Health Improvement and Disparities for population / health and wellbeing and (2) NHS England/Improvement for Health Care Public Health and Screening and Immunisation.
Prior to transition on October 1st, the population health and wellbeing team and Screening and Immunisation Teams built up a wealth of experience and expertise in the provision of public health placements. Two reference documents should be considered alongside this policy outlining opportunities as below:
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South West Deanery Screening and Immunisation Training Offer April 2019 |
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Population Health Care March 2019 |
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The policy is based on the Faculty of Public Health Specialty Training Curriculum (2015).
2.0 Scope of policy
This policy concerns placements with the teams that comprise the Office of the Regional Director of Public Health. This includes the Screening and Immunisation Team and the Health Care Public Health Team embedded with NHS England/Improvement AND the Office of Health Improvement and Disparities South West Health and Wellbeing Team. These teams work closely together to deliver a range of public health services and programmes under the direction of the Regional Director of Public Health and their ‘Office.’
This policy applies to all registrars in Phase 2 of training.
- In Phase 2, registrars working with an Educational Supervisor (normally in a Local Authority) may engage in regional work; normally a through a project/activity where Educational Supervision remains with the extant Educational Supervisor. Using pro-forma, any placement opportunity will be agreed by the Training Programme Team and the regional team’s Specialty Tutor prior to advertisement. If approved, the advert will be disseminated to all eligible registrars by the Training Programme Team with a request for expressions of interest. Should there be more than one expression of interest informal interviews will be held by the regional team’s Activity Supervisor and member of the Training Programme Team to appoint a registrar to the placement (considering their experience, work-plan objectives, remaining learning outcomes and personal/professional career development). Where a registrar identifies a project opportunity that could be hosted within the regional team this should be discussed between their Local Authority Educational Supervisor and the Training Programme Team in the first instance. Should the Training Programme Team agree to proceed, they will liaise with the Specialty Tutor in the regional team. Unless there are exceptional circumstances, placement opportunities should be advertised to all registrars. All placements will require agreement between the Local Authority Educational Supervisor, the Training Programme Team and the relevant regional team Specialty Tutor prior to commencement.
- In Phase 2 registrars, in their ST5 year of training, who want to develop their public health experience at regional level or specialise with one of the teams that comprise the regional office, can consider an extended placement. This will be based on an assessment of their learning needs and consideration of Key Area 10 outcomes. These placements will require agreement between the Training Programme Team, regional team’s Specialty Tutor and proposed regional team Educational Supervisor.
- Examples of work undertaken by registrars placed within Public Health England’s Population Health and Wellbeing and Screening and Immunisation Team are provided in Appendix 1.
Figure two - Public Health Training Pathway and Placement Opportunities with the Regional Office.
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Phase 1 |
Phase 2 |
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ST 1 |
ST 2 |
ST 3 |
ST 4 |
ST 5 |
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Knows |
Knows how / shows |
Shows how / does |
Does |
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Developing knowledge of regional public health teams and programmes through short-term activity-based placements in Phase 2.
Extended regional placements available following completion of phase 1 and 2 competences (normally ST 5). |
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DFPH Exam |
MFPH Exam |
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3.0 Placement locations in the South West
Registrars on placement with the Office of the Regional Director of Public Health will be allocated a location relevant to the project/programme of work and the team they are working in. This will normally be geographically based according to current training rotation and as agreed with the Training Program Team and the regional team’s Specialty Tutor.
The following are established training locations under the Office of the Regional Director of Public Health / Office of Health Improvement and Disparities:
- 2 Rivergate, Bristol. BS1 6EH;
- Follaton House, Totnes, Devon, TQ9 5NE.
The following are established training locations for NHSEI:
- Bewley House, Chippenham, SN15 1JW;
- Blackbrook House, Taunton, TA1 2PX;
- South Plaza, Bristol, BS1 3NX;
- Peninsula House, Saltash, PL12 6LE.
4.0 Coordination of placement once agreed
Following agreement to commence a placement (project/extended), a pre-placement meeting should be convened at least four weeks before placement commencement. The pre-placement meeting will identify learning needs and agree a provisional learning contract (Appendix 2).
As well as a brief introduction to work undertaken across the Office of the Regional Director of Public Health, the meeting will provide an opportunity to discuss the project or work-plan in more detail. The meeting should involve all relevant supervisors.
At the pre-placement meeting the registrar should make the Activity/Educational supervisor aware of any reasonable adjustments required to enable the placement, or any annual leave or study leave they need to take during the placement. The duration of the placement may need to be extended to take account of this.
At the pre-placement meeting registrars will be provided with induction documentation and agree with their regional supervisor the relevant visits and key individuals/agencies they should meet during their placement.
Registrars will have an honorary contract for the duration of their training. This is coordinated by the SW Public Health Training Programme. This will be discussed at the pre-placement meeting to allow time for completion. Specialty Registrars in Public Health are DBS checked at the start of their training and records are held by the Training Programme Team. Therefore, DBS checks will not be required prior to placement commencement.
5.0 Arranging extended placements (ST5)
In ST5, registrars may consider, with the Training Programme Team, an extended placement in one of teams that comprise the Office of the Regional Director of Public Health.
These placements will only be agreed for a minimum period of 6 calendar months. Following discussions with Training Programme Team, the registrar should arrange a meeting with relevant regional Specialty Tutor and proposed regional Educational Supervisor at least 8 weeks prior to an anticipated placement start date. At this pre-placement meeting, a bespoke training programme and learning agreement will be developed to address learning needs identified by the registrar with a focus on consultant-readiness (ensuring similar opportunities that would occur in a final year placement within Local Authority settings).
Where there is a vacancy and in accordance with the Training Programme Team, registrars on an extended training placement may apply for an ‘Acting-Up’ post. Such posts will be discussed with the registrar during their placement. These posts are advertised to all registrars eligible for an ‘Acting-Up’ post and are not exclusive to those on the extended placement.
6.0 Induction
The aim of induction is to enable registrars to become acquainted with the training location and the Office of the Regional Director of Public Health organisational structures (Population Health and Wellbeing / Screening and Immunisation Team), role of team members and role and responsibilities of external partners.
Registrars will have a structured induction overseen by their Activity / Educational supervisor using an induction pack provided to them in advance. This will include any mandatory training requirements. Registrars, with advice from their Activity/Educational supervisor, should familiarise themselves with local reference materials, resources and local tutorials they can access during this time including all relevant policies pertaining to working in the placement setting.
7.0 Outline of responsibilities and expectations
The Office of the Regional Director of Public Health expect the following from registrars during all placements:
- to inform their placement Activity / Educational Supervisor of any special requirements, ideally at the pre-placement meeting;
- to agree a learning contract with their placement Activity / Educational Supervisor;
- to attend the workplace as required and on time;
- to share their outlook/work diaries with relevant staff;
- to notify their placement Activity/Educational Supervisor (or team administrator if not available) when ill and unable to work;
- to act in accordance with location policies and procedures, including health and safety;
- to agree tasks and projects with their placement Activity/Educational Supervisor;
- to participate in one-to-one supervision sessions with their placement Activity/Educational Supervisor;
- to attend relevant internal meetings to maximise learning as advised by their placement Activity/Educational Supervisor;
- to work closely and collaboratively with all members of the Office of the Regional Director of Public Health;
- to alert their placement Activity/Educational Supervisor of deadlines on work at risk of not being met;
- to Inform their placement Activity/Educational Supervisor of any difficulties straight away that are impacting on the placement;
- to undertake reflective practice on learning experiences and document these;
- to provide mutual support to other registrars attached to the team;
- to work as engaged members of the regional team and recognise the pressures on other team members and work collaboratively to balance personal needs and team need appropriately.
Registrars should expect the following from their placement Activity/Educational Supervisor from the Office of the Regional Director of Public Health during their placements:
- to support the registrar to identify learning needs;
- to provide learning opportunities which contribute to meeting learning needs and competencies;
- provision of formal and documented one-to-one supervision using the agreed supervision template (Appendix 3) on a frequency no less than fortnightly;
- to agree the learning agreement with the registrar;
- to regularly monitor the registrar’s performance considering feedback from other members of the team and relevant partners;
- to sign and return Activity Summary Sheets, Learning Outcomes Summary of Assessment Sheet and Annual Review of Competence Progression (ARCP) forms as required and in a timely manner;
- Placement Activity Supervisor to liaise with the registrar’s Educational Supervisor and Training Programme Team as and when required.
The Office of the Regional Director of Public Health will provide the following resources for registrars on placement:
- access to desk-space, a computer, communication systems (e.g. Skype/Teams) the internet, email account and IT support:
- access to the organisation’s library resources and signposting to other key national and regional resources;
- access to Civil Service Learning;
- all relevant information to support daily work;
- administrative support may be available by negotiation for specific activities.
With regards to leave of absence:
- annual leave, study leave, and other planned leave should be negotiated with the supervisor in conjunction with the Training Programme Team as appropriate;
- registrars will be expected to report sickness absence to their placement Activity/Educational supervisor during their placement, which should subsequently be reported to the Training Programme Team by the placement Activity/Educational Supervisor.
8.0 Placement evaluation and quality assurance
The Office of the Regional Director of Public Health will have a named Training Lead to oversee this policy, coordination of placements and support to Specialty Tutors/supervisors.
They will oversee the quality assurance of placements working closely with the Training Programme Team. The Training Lead will attend the South West Population and Public Health Academy Board as a representative of the Regional Office for the Director of Public Health and report quarterly on training in the location.
Additionally, there will be a Specialty Tutor embedded within the Screening and Immunisation Team and two within the Population Health and Wellbeing Team (one supporting health care focused placements and their supervisors and one supporting health improvement focused placements and their supervisors). All Specialty Tutors will contribute to the development of their team placements and support Activity/Educational Supervisors therewithin. This will include a focus on quality and assurance. They will be invited to attend Specialty Tutors convened by the Training Programme Team.
As part of the pre-meeting, the placement Activity/Educational Supervisor will advise the registrar that they are the first point of contact for discussions about the placement itself and will provide opportunities throughout the placement to discuss concerns or ways to improve the placement experience. This will normally be considered during formal one to one supervision sessions and will involve the Specialty Tutor if required. Registrars can escalate seek advice / escalate to a Specialty Tutor should they be unable to speak directly to their Activity/Educational Supervisor. However, direct discussion with the Activity/Educational Supervisor will always be encouraged unless in exceptional circumstances.
At the end of the placement, the registrar will be asked to provide feedback on the placement as part of an exit meeting (Appendix 4)
The Training Lead (with Specialty Tutors when required) will formally meet with members of the Training Programme Team and registrar representative(s) quarterly to review placements in the Office of the Regional Director of Public Health and ensure that the training policy is being upheld and updated.
All Activity and Educational Supervisors will remain fully accredited. Failure to do so will result in their being removed from the list of accredited supervisors until such time that gaps in accreditation are met.
From 2022, the Office of the Regional Director of Public Health will be required to participate in the South West Quality Panel process. For this purpose the three areas will be assessed and considered as one discreet location as in previous years:
- Screening and Immunisation Team (NHSEI);
- Health Care Public Health (NHSEI);
- Health Improvement (Office of Health Improvement & Disparities SW)
Following the annual review meeting an action plan will be produced to address matters raised through this process. This will be supported by the Training Lead for the placement location and Specialty Tutors.
To support the Quality Panel, all Activity and Educational Supervisors will be asked to complete an online survey for each registrar they have supported on placement.
Training Contacts in the Office of the Regional Director of Public Health
- Training Lead – Prof Mike Wade, Mike.Wade@dhsc.gov.uk;
- Specialty Tutor Health Improvement – Rachael Marsh, Rachael.Marsh@dhsc.gov.uk;
- Specialty Tutor, Health Care Public Health – Dr Ulrike Harrower, ulrike.harrower1@nhs.net
- Specialty Tutor, Screening and Immunisation Team, Dr Emma Kain, emma.kain@nhs.net
- Training Administrator, Sophie Chivers, sophie.chivers@nhs.net
APPENDIX 1: Examples of Work Undertaken by Registrars Placed within the Population Health and Wellbeing and Screening and Immunisation Teams
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Population Health & Wellbeing – examples below for mental health, CVD prevention, inclusive and sustainable economies, violence prevention and inclusion health |
Screening & Immunisation |
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Public Mental Health Regional promotion of prevention and promotion planning for mental health as central to the COVID 19 recovery; integrate and apply public health expertise and skills to engage, influence and negotiate with system leaders in the 7 integrated care systems and 10 remaining unsigned local authorities across the south west; apply mental health policy, evidence and guidance including good practice from national and regional case studies to secure a minimum of 100% increase in the number of signatories in the South West region by March 2022. Real Time Surveillance Systems for SuicidePrevention - Lead in the sector led improvement programme to drive the quality improvement of implementation of local suicide prevention plans; monitor and quality assure the allocation of SLI funding and spending review funding for real time surveillance; negotiate the development of a regional data access agreement; work with local areas and suicide prevention planning to co-produce regional good practice guidance for integrating coroner’s audits, first responders and inquest findings Translate the data and findings of the recently revised SW LKIS Self Harm report to understand the possible drivers for the relatively high prevalence rates of self-harm admissions in the South West of England; form and manage a multi-agency collaboration to influence, assess the application of NICE guidance self-assessment toolkit across the region; development of a training intervention for stakeholders and key workers along the self-harm pathway including service configuration, the relationship between A&E attendances and hospital inpatient admissions and impact of coding of different forms of harm. Young People and Children Suicide Prevention - conduct a regional rapid needs assessment, thematic review and gap analysis of suicides and attempted suicides amongst children and young people; build links with safeguarding partnerships; child death overview panels and self-harm contact points throughout the system; develop recommendations with an action plan for promotion through ICS suicide prevention groups.
Inclusion Health System mapping to understand the pathways through which inclusion health interventions are commissioned and provided, including running a stakeholder event aimed at commissioners who are in control of budgets which can be used to support inclusion health groups. Regional mapping of offer for vulnerable groups across Local Authorities in the South West. Evaluation of regional programmes, e.g. the Safe Surgeries initiative (which reduces barriers to primary care for vulnerable groups). Lead programme development for one of the current gap areas identified at regional level in the Health and Wellbeing team workplan (sex workers, Gypsy Roma Traveller communities, modern slavery) or a cross-cutting theme, e.g. women with multiple and complex needs.
Develop a regional engagement plan to support the implementation of evidence-based principles of effective inclusion health work, e.g. setting up of a rolling programme of communications, or sharing best practice on working with People with Lived Experience. Develop a regional inclusion health strategy for the South West and scope a routine surveillance offer e.g. an annual inclusion health monitoring report including identification and assessment of potential data sources, and proposed use.
CVD prevention Developing a System Quality Assurance Framework with NICE, DHSC, SW DsPH, SW ICSs, NHSE/I. Leading the development of intelligence to insight to action strand of work for CVD Prevention. Leading the innovation spread programme in the South West. Developing the communications and engagement programme of work with third sector organisations.
Violence prevention Produce a short summary on the epidemiology of violence during COVID-19 pandemic including domestic abuse, sexual violence, honour-based violence, modern slavery, county lines, hate crime, child sexual exploitation and violence against elders. Develop a regional violence intelligence strategy for the SW and scope a routine surveillance offer e.g. a monthly/ quarterly violence monitoring report including identification and assessment of potential data sources, and proposed use. Develop an evidence-based public health strategy for violence prevention for PHE SW, taking a whole-systems approach, engaging with stakeholders to define shared regional public health priorities in the recovery from COVID, and aligning with wider public health priorities on wider determinants and inequalities. To develop an engagement plan to support the implementation of public health priorities (as identified in the strategy) in violence prevention by partner agencies and communities. Inclusive and sustainable economies Narrative review of frameworks from across a range of disciplines which are complimentary to the PHE ISE Framework, with development of suitable outputs (e.g. summary paper, slide deck) to facilitate shared understanding of the historical and inter-disciplinary context within which this programme of work will be progressed. Undertake regional mapping to generate a baseline picture of the regional and sub-regional systems already in place which span the three domains: social; environmental and economic. This should include identification of current networks, partnerships (or other working groups); key stakeholders; current policies, visions and priorities; monitoring/indicators in use; and an overview of activities. To lead on the planning, and delivery of a series of workshops to support the development of a place-based, integrated and collaborative approach to ISE across the South West. Outputs from these workshops will be used to inform the development of networks and vision for the SW. Support development of regional and sub-regional processes for assessment of need, prioritisation and monitoring progress across the 3 domains and 12 sub-domains that make up the ISE framework with reference to and development of the data catalogue. |
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APPENDIX 2: Pre-placement meeting agenda/learning agreement
Name: Year: Date:
Plan duration:
Placement supervisor:
Training Programme Director:
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Items |
Detail |
Plan |
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Reasonable Adjustments Required to Support Placement / Learning (e.g. physical adaptations / support) |
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Honorary Contact (set-up prior to placement commencement and send to Training Programme Team) |
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Previous work experience relevant to the placement
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Exam milestones
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Phase-based learning outcomes to achieve
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Generic skills to achieve
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Anticipated study-leave to support learning outcomes
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Introduction to the Office of the Regional Director of Public Health including induction document and outline of training Policy. |
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Signed (Registrar): Date:
Signed (Placement Supervisor) Date:
APPENDIX 3: 1:1 Supervision Template
Date:
Supervisee:
Supervisor:
Agenda
1) How are you? Is there anything I (supervisor) or the organisation can do to assist your wellbeing?
Work related stressors
StRs are encouraged to RAG rate areas for discussion prior to the check-in to aid effective conversation.
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Areas for discussion |
Discussion Points |
Agreed Actions |
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Demands – issues such as workload, work patterns and work environment |
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Control – how much say the person has in the way they do their work |
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Support – encouragement, support and resources provided by the organisation, supervisor and colleagues |
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Relationships – promoting positive working to avoid conflict and dealing with unacceptable behaviour |
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Role – whether StR understands their role within the organisation and there are not conflicting roles |
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Change – how organisational change (large or small) is managed and communicated |
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Physical Health includes joint, bone and muscle symptoms such as back, knee or wrist pain.
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Areas for discussion |
Discussion Points |
Agreed Actions |
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Have joint, bone or muscle aches and pains interfered with your work or daily routine in the last week? |
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How confident have you felt in being able to manage your joint, bone or muscle symptoms in the last week? |
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How much fatigue or low energy have you felt in the last week? |
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How often have you taken regular breaks and lunch away from your desk? |
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In the past week, how many days have you done a total of 30 minutes physical activity? |
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2) General Placement Issues / observations (what’s working well / areas for improvement)
3) Work plan update
4) Activity Summary Sheet / Learning Outcome Sign-off
5) AOB
Signed: Supervisee: ___________________________/Date: ______
Signed Supervisor: ____________________________/Date: ______
APPENDIX 4: Exit Interview Proforma
Date of meeting:
Registrar: Activity/Educational Supervisor:
1) General Feedback on Placement (what has worked well/areas for improvement)
2) Project / Programme Update and Handover Arrangements (have poster/publication opportunities been considered?)
3) E-portfolio / Sign-off (agree arrangements for final sign-off with Educational Supervisor)
4) Consideration of any Multisource Feedback and Areas for Further Professional Development
5) Keeping in Touch
6) AOB
Signed: (Registrar): ___________________________/Date:
Signed: (Activity / Educational Supervisor): ______________________/Date: