HC 1048-III Health CommitteeWritten evidence from Intelligence for Healthy Lancashire Group (PH 52)

Public Health Intelligence

1.0 Introduction

The re-organisation of Public Health brings about the issue of public health intelligence within that group. Many experienced and qualified analysts are being lost or having their skills eroded due to them being moved into generalist analyst roles. Through the Intelligence for Healthy Lancashire group the following comments have been gleaned and I submit this on their behalf.

Public health intelligence professionals have been an integral part of public health teams since the first appointed analysts in the late 1980’s and early 1990’s.Their contribution as trained epidemiologists has played a significant part in the work of public health teams in PCT’s up and down the country since that time.

This is a list of threats and challenges which may accrue for Public Health Intelligence (PHI) teams subsequent to the changes to Public Health in the Government White Paper.

Access to recognised and essential data are also potentially under threat.

There is an expanded customer base for PHI that includes public health, the local authority, GP Consortia and other agencies represented on the HWBB

If Public Health subsequently leaves the NHS for local authorities there could be a loss of access to NHS data (SUS, monthly and annual births and deaths data etc) – Need regulation change to allow PHI staff to continue to access these datasets.

Reductions in the availability of core data from national sources may mean that public health intelligence teams will have to produce more information themselves or purchase it from a commercial sources.

This presents potential problems. The trademark of PHI professionals is our willingness to share expertise/methodologies and assumptions behind data and seek advice from peers in a culture of openness and trust. Reliance on voluntary accreditation and industry-owned standards of good practice poses threat to data quality. Need to Develop Codes of Practice and quality standards for commercial intelligence providers.

There is a continued need for a national data repository which will allow local benchmarking against national comparators

Continuity of historic and existing data sets and data flows from which to draw on local level

The loss of outputs from local PHOs, eg small area data, prevalence modelling, GP practice profiles, standard analytical tools and templates etc will constitute a risk and may place a burden on local PHI teams to replicate these outputs.

Developing GP consortia have different boundaries to the LA’s/PCT’s which poses additional questions eg how will we get access to historic trend data for these new areas - (births and deaths)?

PHI staff currently have access to Quality Outcomes Framework (QOF) data and have used this for analysis for the JSNA and other work. It is unclear how access to primary care data will be managed

Public Health Intelligence should remain part of multi-disciplinary public health teams to continue to work closely with PH colleagues on health needs analysis, service re-design and health surveillance

2.0 Professional Development

The skills, knowledge, experience and breadth of work performed by Phi staff must be recognised and planned for/preserved to ensuring that the role of that professional group is not compromised by the NHS restructure.

In his letter of August 2010 the CMO said that “it is essential that we do not lose Public Health expertise from the system” There is a real threat that such PHI capacity and expertise may be eroded during the current changes to the NHS and Public Health in particular. Properly trained PHI professionals hold specialist knowledge of statistical and epidemiological methods and sources of information for interpreting and understanding data sets not available elsewhere within the NHS or local authority system

The Scally report on regulation of Public Health Professionals “the case for statutory regulation of defined specialists is not made – Purpose of regulation is to safeguard and protect the public from harm – such safeguards also pertain to PHI to ensure that intelligence is properly developed and interpreted in a way that allows better commissioning and service re-design.

Formal recognition through the UKPHR must be maintained to ensure that PHI specialists can gain formal recognition. This will ensure a quality workforce and help to meet the enhanced requirement for adequate and appropriate training and support for PHI and satisfy the need for continuing professional development in this field.

Developing current trend in replacing PHI posts with generic posts and generic job descriptions. Recommend the use of JDs from the Faculty of Public Health Career Framework to ensure that PHI skills are maintained and developed.

June 2011

Prepared 28th November 2011