Population Health Fellowship

Population health is an approach aimed at improving the health of an entire population. It is about improving the physical and mental health outcomes and wellbeing of people, whilst reducing health inequalities within and across a defined population. It includes action to reduce the occurrence of ill-health, including addressing wider determinants of health, and requires working with communities and partner agencies.

The need for more population health is increasingly reiterated in policy and research, which is why Integrated Care Systems are responsible for optimising outcomes and reducing health inequalities at the population level.

This is an opportunity for healthcare professionals from both NHS and non-NHS organisations, providing it is someone who is in a role that has relevance to Population Health, interested in population health and passionate about health inequalities. The fellowship targets early to mid-career healthcare professionals providing NHS services (AfC band 6 and above, or equivalent; dentists-in-training; doctors-in-training post-FY2 and their SAS equivalent). The aim of the fellowship is to develop a network of professionals from a non-population health background with population health skills to benefit place-based healthcare systems across England.

It is a one-year part-time programme at two days a week alongside your substantive post, which starts on Tuesday 1st October 2024. Fellows will work on a supervised population health project which is focused on health inequalities and will be supported by a taught programme.   

Reimbursement of your salary element of the participation in the fellowship will be provided to your substantive employer and you must discuss this opportunity with your line manager and educational supervisor (if applicable) of your intentions to apply.

Applications are invited for the five Fellows in Population Health, funded by NHS England, and working in one of the following Integrated Care Systems commencing the programme on 1st October 2024:- 


Devon Integrated Care System – hosted by Public Health team, Devon County Council

The Population Health Fellow (PHF) will build on the work and role of the last three PHF and will work with the existing ICS Population Health team with leadership from the DPH at Torbay who is the SRO. For this cohort supervision will be through an ES in Devon with support from Tina Henry, DDPH and Devon Healthcare SRO. The programme aligns to and links with the Population Health Programme.  

The benefits of the project will ensure that the population health programme has a demonstrable impact on health inequalities and inclusion health. The project is not new but builds on earlier system work through the prevention programme and wider health inequalities and PHM work. An example of work undertaken by previous posts included assessing access to long covid services to determine the impact on health inequalities and social prescribing.  

The Fellow will provide a bridge to the Population Health work and will work with PH and ICS colleagues on the programme to ensure the priority actions over the 2024/25-year meet the CORE20PLUS5 objectives and impact on health inequalities. The programme of work will match the applicant’s areas of interest and development. 

Population Health Management remains a core component of the Population Health Programme with plans in 2024/25 to continue to strengthen leadership and system-wide awareness of health inequalities and inclusion health with a focus on the NHS framework for inclusion health. NHS England » A national framework for NHS – action on inclusion health 


Cornwall Integrated Care System – hosted by Cornwall and Isles of Scilly Integrated Care Board

Depending on identification of potential fellows, their work area of interest and substantive employer, we have a range of project areas for a fellow to work within that are joint projects with our public health team: 

  • InHIP 2 – unwarranted variation in primary care achievement of care processes in CVD 

  • Quality improvement in primary care – broadening review of unwarranted variation in primary care, for patient access to, uptake and outcomes in LTC management care processes - CVD and diabetes 

  • Community health and well-being worker implementation – real-time evaluation of outputs and emerging outcomes 


Bath and NE Somerset/Swindon/Wiltshire Integrated Care Organisation – hosted by Public Health team, Swindon Borough Council

Target population or group 

People with undiagnosed hypertension in Core20Plus groups. 

Expected benefits of project for population health and/or to staff patients or others 

Increase case-finding to at least 80% estimated prevalence of hypertension in an equitable way across population groups with a focus on Core20Plus groups. 

Outputs anticipated in the timeframe of the one-year fellowship 

  • Detailed population profiles quantifying known and undiagnosed hypertension cases with a focus on BSW Core20plus populations.  

  • Co-production workshops with stakeholders to develop innovative approaches to improve case finding.  

  • Support Prevention Strategy Group to prioritise innovative approaches.  

  • Work with commissioners to procure priority interventions. 

  • Develop an evaluation approach.  

  • Work with providers to operationalise. 

Whether this is a new project or an existing one 

This is a new project. However, there are existing projects also aiming to increase case-finding (NHS Health Checks, Community Pharmacy Hypertension Service, General Practice QOF) 

Key individuals plus internal and external stakeholders, with whom the fellow would expect to interact to undertake the project  

  • Prevention Strategy Group 

  • Population Health Board  

  • ICB Health Inequalities and Prevention Team 

  • ICB Population Health Analytics Team 

  • VSCFE partners 

  • Patients and public  


Gloucestershire Integrated Care Organisation – hosted by Public Health team, Gloucestershire County Council

The public health team has previously supervised 3 Population Health fellows. 

Gloucestershire ICS has a strategic commitment to the consolidation of population health approaches to health and social care delivery. This is evidenced by the ICS’s early participation in the 2019 NHSE Optum Population Health Management development programme, and investment in the approach by the ICB and Public Health team. This commitment to establishing a population health management approach is also evidenced by ongoing investment in a comprehensive PHM programme (described in more detail in section 9) to develop the required infrastructure (workforce, information governance, system engagement, linked data) to support the ICS to move toward PHM maturity in the medium term. 

Project – using routine linked data to support a shift to prevention amongst older people drawing on Adult Social Care and Continuing Healthcare Packages 

Aim – To understand how novel linked datasets can support ICSs to shift to prevention amongst older people drawing on Adult Social Care and Continuing Healthcare Packages 

The target population is older people resident in Gloucestershire and requiring adult social care support and / or  continuing healthcare packages of care who would benefit from proactive, preventative care.

Expected benefits of the project for population health are increased understanding among commissioners of the characteristics of particularly vulnerable groups and of the routine data that is held, and not held, locally which might better inform their care.

Outputs anticipated in the timeframe of the one-year fellowship 

  • Personal development outcomes for the Fellow in terms of understanding and applying population health approaches in a complex system 

  • Rapid review of population health approaches to ASC and CHC, and to the methodological literature on use of linked datasets to support prevention in these areas 

  • Development of methodological approach to utilise Gloucestershire linked dataset to take a data-led approach to prevention in ASC and CHC 

  • Peer-reviewed publication describing outputs above and presentation at Public Health Conference (e.g. South West Public Health Science Conference, Lancet Public Health Science Conference) 

Plan for data analysis, highlighting use of any advanced analytic tools/software 

  • Agreement of definition and coding within Gloucestershire linked dataset of at least 2 over-arching ‘cohorts of interest’; older people (e.g. 65 plus) in receipt of adult social care (ASC), and in receipt of continuing healthcare (CHC) cohorts key ‘cohorts of interest’ using binary outcomes such as ‘entry into adult social care’ or ‘assignment of continuing healthcare package’ 

  • Descriptive analysis of adult social care and continuing healthcare cohorts (‘cohorts of interest’) using linked data on primary, secondary and mental health care   

  • Comparative analysis of the cohorts of interest relative to mainstream population cohort, matched by age, sex and ethnicity using descriptive statistics (e.g. Tables of count, mean/median, proportions, 95% confidence intervals and bivariate tests of significance) 

  • Multiple regression of binary outcomes such as ‘entry into adult social care’ or ‘assignment of continuing healthcare package 

  • Depending on interest of Fellow, quantitative analysis could be complemented with qualitative work to understand reasons for entry to ASC and CHC and opportunities to shift to prevention (e.g. workshop)  

Local/organisational support will be provided by public Health – learning outcome and project supervision, Continuing Healthcare and ASC teams (subject specialist support), along with Business Intelligence (methodology and analysis support).

The Fellow will work with support teams above to design and develop the methodology, and lead on development of outputs. Fellow would not be expected to directly run analyses of linked data due to Information Governance constraints as standard – they would work directly with BI analysts to commission analyses however and would be expected to learn and test approaches to analyses with less sensitive datasets which could be made accessible  

This would be a new project and is supported by a contemporary strategic drive within GCC and the ICB to use Population Health Management (PHM) to inform the ICS shift to prevention in ASC and CHC. 


Bristol/North Somerset/South Gloucestershire Integrated Care Organisation - hosted by Public Health team, North Somerset Council

The project will involve developing a whole-system programme for stopping smoking is an ICS strategic commitment1. Partners have set a vision for a Smokefree BNSSG where less than 5% of the population smoke by 2030.Smoking prevalence remains high, 13.8% of adults in BNSSG smoke. In line with the national picture, higher smoking rates are associated with higher rates of deprivation. In BNSSG, 1 in 3 people living in areas of high deprivation smoke. Higher rates are found in populations employed in routine and manual occupations and in populations receiving treatment for their mental health. Utilising the prevention triangle, an adopting a universally proportionate approach, our whole system strategy incorporates Smokefree action across statutory services, and VCSFE. Our system level plans can be found in the ICS Joint Forward Plan (JFP).

The ICS JFP for Smokefree BNSSG describes the population health data and insights required to inform on our strategic approach. In alignment to Local Authority’ need assessments, plans and strategies, we are seeking to develop a systemwide approach to data recording, reporting and monitoring. This includes quantitative and qualitative data and intelligence. This is to track in real time, progress towards our Smokefree vision, and inform on if our approach is meeting population needs. This resource will be directly linked to our model development for Smokefree peer support and asset-based community development.  

This project will include: 

1. Leading the development of data and intelligence tools, and/or a BI dashboard to track: 

  • number/% of people who smoke (By geography and settings) 

  • number/% of people who stop smoking (By geography and settings) 

2. Leading the development of our qualitative insights from people who smoke, from priority populations, including:  

  • experiences of attempting to stop smoking  

  • experiences of accessing advice and support  

  • What matters to people in the wider context of their lives, and their assets, strengths, challenges, and needs. 

  • Intersectionality with other prevention priorities (substance and alcohol use, and unhealthy weight).  

This will require direct engagement with people who smoke, or have stopped smoking, from various populations, including those with higher rates as described above.  This will build on the learning of our previous systemwide drug and alcohol dashboard, but will be a new project and output for the system. The qualitative insights will be new for the Smokefree agenda and directly impact on the model formation for Peer support and Asset Based Community Development.  The Fellow will become part of the Population Health Improvement Team, and a key member of Smokefree BNSSG – our system wide tobacco control alliance.


If you are applying from a training programme you will be required to provide a letter at the application stage from your training programme director to confirm that they will release you from the programme.

This fellowship was previously nationally delivered but this year is being delivered regionallyYou can visit National Population Health Fellow website for more information on the previous years Fellowship programme.

There are links on this webpage regarding how to apply, the eligibility criteria and important documents such as the Rough Guide and FAQs.  You will be required to copy/paste the application form into a document in order to submit or if you require the application form to be sent to you in a Word document, or have any other queries please email england.publichealth.sw@nhs.net

Closing Date for applications: - Tuesday 2nd July 2024 at 12 noon.

Proposed Interview dates - 19th July and 24th July 2024